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America still confronting an artificial divide regarding abortion

We are a nation divided. Increasingly extreme ideologies have come to define us, polarize us, and inspire the law of the land.

Many falsely believe that Roe v. Wade, the 1973 landmark decision by the U.S. Supreme Court, was the start of abortion in the U.S. In reality abortion was not only common, but a leading cause of pregnancy-related injury and death for women in pre-Roe America. Women who died from illegal abortion were predominantly black and in the second trimester. Middle- and upper-class white women also received illegal abortions, but were better positioned to avoid tragedy. Roe v. Wade was not the start of abortion in the U.S., but effectively made abortion safer for millions of American women.

Since 1973 individual states have worked to restrict abortion access, yet abortion remains common. 1:4 American women has an abortion in her lifetime. Abortion impacts women of all backgrounds, however poor and minority women remain at the highest risk of unintended pregnancy. Despite the faith-based objections to legal abortion, religious women also pursue abortion care. In 2014 24% of abortion patients identified as Catholic, 17% as Protestant, and 13% as Evangelical. Contrary to the far-right misrepresentation of abortion occurring late in pregnancy, abortions generally happen early, with 88% occurring in the first trimester. It is worth noting here that “late term abortion” is not a medical term but a political construct.

Some of us identify as “pro-life”, believing in the sanctity of embryonic human life. While valid, this position requires a blissful ignorance of the reality that without access to legal abortion women have died, and women will continue to die. Others among us identify as “pro-choice”, motivated by a need for bodily autonomy. This position, while also valid, tends to alienate the other side. Herein lies our artificial divide, fueled by ideology and blinding us to our shared goal. At the end of the day we all want fewer abortions, albeit for very different reasons. As an Obstetrician-Gynecologist my reason is simple: I do not wish for any of my patients to experience the devastating circumstance of an unplanned pregnancy, a pregnancy resulting from incest or rape, a teen pregnancy, or to be given the heartbreaking news that her long-awaited baby will be unable to survive outside of her womb.

If we could only set our ideologies to the side for a moment, we could work together towards the shared goal of fewer abortions. Restricting access to abortion does not decrease the rate of abortion, as has been consistently demonstrated both in the U.S. and abroad. Focusing instead on reducing the rate of unintended pregnancy would require a two-pronged approach:

(1) Education: Our children deserve comprehensive, medically accurate, and age-appropriate health education in their K-12 public schools. Pennsylvania public schools currently teach an abstinence-based curriculum that is not required to be medically accurate, or to include information about contraception, sexual orientation, or consent. PA House Bill 1335 seeks to update these educational standards and was referred to the House Education Committee in May 2021 with no further action.

(2) Contraception: All sexually active people deserve access to free and effective contraception. The Affordable Care Act of 2010 increased access to a wide range of contraceptives by reducing out-of-pocket costs. Despite this, some insurers continue to deny coverage for, or charge high copays or deductibles for brand-name drugs. Adolescents, who remain at high risk of unintended pregnancy, may avoid discussing contraception with their healthcare providers due to privacy concerns. The American College of Obstetricians and Gynecologists supports over-the-counter access to hormonal contraception without age restriction, recognizing that accessing a prescription can serve as a barrier to care.

Through education and contraception, the prevention of unintended pregnancy is the single most effective way for us to reduce the rate of abortion. Yet there will always be a need for safe and legal abortion. Currently, 88% of abortions occur in the first trimester of pregnancy. State-based abortion restrictions have been shown to delay care into the second trimester. There is no doubt that following this week’s Supreme Court ruling, more women will be forced to travel and thereby delay their abortions. Earlier abortion is not only safer for women (a majority of early abortions are now completed with medication instead of surgery), but also presents less of a moral dilemma to those firmly opposed to second trimester abortion.

It is my greatest hope that my fellow citizens will abandon this artificial divide as we search for common ground and shared ideals. We all value women and children. We all value our freedoms. And we all hope for a happier and healthier future for our great nation.

Dr. Natasha Alligood is a board-certified obstetrician gynecologist, and mother to two daughters. The thoughts and opinions expressed are her own and do not reflect the various institutions with which she is affiliated.

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