No, I can’t Just Move

Hello my Zebras and Spoonies! Thanks for coming and hanging out with me today, I’m glad that you are here. Today I am going to be talking about receiving abortion care in America.

I was attending a social event when a comment was made that Roe vs Wade being over turned doesn’t effect very many people and that those it does effect can just move to another state. In the moment, I think my head exploded and I wasn’t capable of giving any kind of intelligent reply. But my brain hasn’t been able to let this go so I’m going to write about it in hopes that it will help me process all the feelings that this triggered in me. Hopefully, it will also help elucidate why I feel that this is such an enormous issue.

The first thing that I have to put onto the table is that it doesn’t matter how many or few people are effected, if the government is diminishing the rights of the people, it is a big deal. It is simply not ethical to consider it alright simply because it doesn’t effect a large group of people or a group that you belong to. And the right to body autonomy is one that I personally feel is of particular importance. One that needs to be maintained for all people.

However, it does, in fact, effect a large group of people. Currently, about 51.1% of the American population has a uterus. If you want to argue that only those individuals that can become pregnant are being impacted… alright, then let’s look at those numbers. The youngest documented individual giving birth was 5 years old. Yes, 5 years old. Go ahead and look it up. And the Oldest individual giving birth was 67 (well, the oldest that became pregnant without IVF). That means that the majority of individuals have the potential to become pregnant based on that wide age range that can possibly carry a baby to term. However, the general age range that is considered to be most likely to become pregnant is 15-50 years old. At the end of 2021, the American population was 332,915,073 so that’s 170,119,602 individuals with a uterus. According to the US Census Bureau’s data 61% of those individuals are within the age bracket for being likely to become pregnant which is 103,772,957 people. That’s a low estimate and it’s about a third of the American population. So, that’s not a small group of people being impacted by this.

So, clearly, saying that the over turning of Roe vs Wade only effects a small group of people is simply inaccurate. And that’s without getting into the larger picture issue that Roe vs Wade being over turned has now brought many other rights into the firing range. Since Roe vs Wade established the privacy laws, everything that’s using that as a foundation is now subject to challenge. That means medical autonomy and medical privacy are up for debate and could be rights that the Supreme Court could decide to revoke. I think it’s fair to say that those rights being put in a position of risk is a matter that effects every American. This isn’t about just a small group of people.

Generally speaking, only about 5% of those with a uterus will experience difficulties becoming pregnant. Without birth control, 95% of individuals with a uterus become pregnant within a year if they are sexually active regularly. During each fertility window, an individual with a uterus has a 33% chance of becoming pregnant if they have sex just once. These are pretty high stake odds when you consider the current legal status of many states. There are 16 states that have made abortion illegal (or it soon will be).

Adding to this is the fact that there is already discussion about revoking the protections for birth control with IUDs and Emergency Contraception being the types most debated. Let’s keep in mind that 95% of individuals with a uterus use some form of birth control during their life time. This means that there will be no way to reliably prevent becoming pregnant beyond abstinence. But this is also a false promise for preventing pregnancy because 25% of individuals with a uterus are raped by the time they are 40 years old. Many of those victims are repeatedly victimized over years. This makes abstinence something that 25% of individuals with a uterus have taken from them.

So, there are 16 states that have made abortion illegal. But there are another 6 states that might still decide to make abortion illegal. And there are states that the pre Roe vs Wade abortion bans are making things murky at best putting health care providers at considerable legal risk. Both these factors are likely to limit abortion availability even further. As it stands, there are 27 states that abortion is legal. This makes access a serious consideration. Every facility, of every kind, across the nation, is struggling to meet the needs of the patients they are currently receiving. What happens when a facility suddenly starts getting twice as many patients? There aren’t any more doctors or nurses or resources to add to help that facility out. These facilities simple aren’t equipped to help all the individuals that might need an abortion and have to seek one out in a state that doesn’t provide that service any longer.

Any time there is a question of access, there has also been a question of equity. When it is difficult to get care or services those with more money are more likely to get it. This means that those of color and those who are disabled are going to be less likely to get the care that they need because they are also the individuals that are less likely to be able to afford it. This is only going to create a further burden on these groups and create a larger inequity as they are expected to care for children from pregnancies they were not given access to terminate. Not to mention these groups are also more likely to suffer more serious penalties if they have an illegal abortion.

And how feasible is it to just go to another state for an abortion? If you are considering just going there for care and coming back, you are possibly still going to be facing criminal charges in your home state. Thus, going to another state for an abortion means going to that state to live. This means that the individual must give up all their social connections and familial ties in order to receive that care. They will most likely have to quit their job which means that they will not have medical insurance when they arrive at the new state. Most employers do not have national lateral transfers as an option and the ones that do will not likely do such a transfer in a timely fashion thus making it a non option. Even if they work in a field of demand (like nursing), they are not likely to get a job that the medical insurance begins coverage on day one. That benefit usually starts somewhere around the 90 day mark. State insurance coverage will only be an option if you had it in the state you are leaving and it often takes 30 or 60 days to process that application. Not having medical insurance means that many of these individuals will then have to chose between increasing their medical debt or having a child they cannot afford.

If the individual has chronic illness moving to another state is more difficult and doing so without insurance puts their health at risk. 60% of American adults have a chronic illness. 42% of Americans have more then one chronic illness. 33% of individuals who are likely to becoming pregnant (age 15-50) are also an individual that has a chronic illness. For this group, making a quick move without making sure that a job, housing and medical care has been arranged can mean a significant impact in their health and well being. It can also mean increased debt if medical emergencies arise.

But it is much more complicated then that. In the United States about 40% of school-aged children and adolescents have at least one chronic health condition. This makes it highly likely that even if an individual with a uterus does not have a chronic illness either their partner or one of their children will. 59% of individuals that get an abortion have had at least one previous full term pregnancy which means that over half of these individuals are parents. This is not care that individuals with a uterus only seek out before they have established their families. By asking them to move to get this care, you are also asking them to disrupt their whole family for that care. These means putting any chronic illness management at risk. It is not ethical to force these parents to choose between ensuring that they get the care they need or ensuring that their child or partner does. Medical ethics demands that we ensure that a family can meet the medical needs of all of their family members.

Then there is the simple issue of affordability of moving. No one is going to be able to purchase a house on short notice. That is something that takes time. Thus, someone moving to another state to get an abortion would be looking at apartments, at least for when they first move to the new state. But this is part of how equity comes into play and why being rich can make a big difference in getting the care that you need. In most areas, small 1 bed room apartments have a rent of at least $1,500. Most of these rents will require both first and last month’s rent up front. Oh, they will also want a security deposit that is usually the same as one month’s rent. That means that just to move into an apartment a person will need to have $4,500. That’s not going to get them heat or electricity or water. Just the building. That’s not going to get your belongings to this new apartment either. Even if you pack and transport your belongings yourself, there are costs associated with moving your household. So, for the first month, with the costs of moving and the utilities you’re looking at needing around $5,000.

So, before an individual with a uterus can get the care that they need, they will need to spend about $5,000 and they will likely be putting their (or a loved one’s) chronic illness management at risk. Not to mention they will need to socially isolate themselves by leaving their community and extended family. Then they will need to go into debt to pay for the care that they need. This simply does not come close to meeting the standard for ethical and equitable health care. This would be considered completely unacceptable for any other medical procedure in this country. Why would we begin to consider this acceptable for this procedure?

The last thing that I have to say about this matter is that it really doesn’t matter if an individual with a uterus can get an abortion somewhere in this country. Because I don’t feel that Roe vs Wade being over turned is really about abortions. To me, Roe vs Wade has always been about having body autonomy or medical autonomy. That’s the right to choose what happens to your body and ensuring that the government cannot force you to do anything with your body that you do not want to do even when some one else’s life is in danger. By overturning Roe vs Wade, the Supreme Court decided that I, as an individual with a uterus, do not have unconditional body autonomy. This means that the Supreme Court has decided that there are conditions in which the government can decide that I can be forced to put my own body at risk for the well being of another person. That’s a terrifying standard to set. And I believe that it leaves a very dangerous door ajar. What else will they decide they can force upon me and my uterus? Will they decide that they can extend it beyond my uterus?

If we look back through American history, we will find some very dark and evil things that are hiding in our closet. Forced sterilization right along with forced pregnancies are very much a part of American history. All so the government could decide which kinds of people were coming into their country. Eugenics is very much part of our history. There were numerous government funded programs that took control of individual’s through their uterus. Society accepted the notion that modern societies, as a matter of policy, should promote the improvement of the human race through various forms of governmental intervention. What is often not appreciated is that Nazi efforts were bolstered by the published works of the American eugenics movement as the intellectual underpinnings for its social policies. One of Hilter’s first acts after gaining control of the German government was the passage of the Law for the Prevention of Hereditarily Diseased Offspring (Gesetz zur Verhütung erbkranken Nachwuchses) in July 1933. The Nazis, when proposing their own sterilization program, specifically noted the success of sterilization laws in California documented most notably by the American eugenicist P.B. Popenoe.

It is important to always remember that reproductive rights are essential. When we allow governments to take control of the reproductive decisions for its people historically those governments have chosen to commit atrocities with that degree of power. And America was among the governments committing these atrocities. Thus, I cannot see the over turning of Roe vs Wade as being limited to just abortion rights. So, no those of us who have a uterus cannot just move to another state to regain the essential rights that were stolen from us when Roe vs Wade was over turned. And no, this does not impact just a small group of people.

Well, that’s about it for my rambling today. Thanks for coming and spending some time with me. If you like what you read, click on that like button. It really does help! Until we talk again, you take care of yourselves!