On Roe v. Wade anniversary, taking stock of unrealized promises

On Jan. 22, 1973, the U.S. Supreme Court affirmed the legality of a woman’s right to abortion in Roe v. Wade. This historic decision made a promise to Americans: that women had a fundamental right to self-determination and reproductive health.

On this 43rd anniversary of Roe, we must celebrate its benefits. Yet we must also recognize its limitations and seek new ways to secure women’s control over their reproduction.

In many respects, Roe was a game changer. At the time of the decision, nearly all states outlawed abortion except in special circumstances or to save a woman’s life.

Medical professionals fought for and welcomed Roe because they were horrified by the thousands of cases of sickness and death they treated each year among women who had to resort to unsafe illegal abortions. Feminists also strongly supported Roe, believing that women’s right to control their bodies was an integral component of citizenship. After the decision, with growing numbers of clinics and health care centers offering abortion services, the death rate plummeted, and pregnancy termination became a routine medical procedure.

Unprotected rights

Almost as quickly as Roe transformed the landscape of abortion provision, it failed to live up to its promise as a protector of women’s reproductive rights. In 1976, Congress passed the Hyde Amendment, which banned federal funding for abortion in all but the most severe circumstances. For poor women who relied on Medicaid, their ability to access abortion became severely constricted.

In subsequent years, state governments and the Supreme Court have continued to slowly chip away at Roe, enacting and allowing waiting periods, parental consent laws and unnecessary requirements on abortion clinics and the doctors who perform the procedure.

It is not only abortion that has come under attack. Reproductive health requires an interlocking set of provisions that range from economic security, prenatal care and protection from violence to access to birth control and comprehensive sex education. In recent years, states such as North Carolina have restricted food stamps and unemployment insurance, instituted abstinence-based sex education curriculums and refused to expand Medicaid. All of these moves restrict women’s reproductive control and self-determination.

A demotion for N.C.

A recently released study by the Population Institute awarded North Carolina a “D” for reproductive health, a demotion from our grade of “C” last year. Ninety percent of counties in our state lack an abortion clinic.

Even if women can travel to find a clinic, they confront major barriers. North Carolina now prohibits abortion after 20 weeks; requires parental consent, counseling and ultrasounds; and requires a 72-hour waiting period that often puts the procedure out of the reach of women who lack the funds to make repeat visits to far-away clinics. These functional erosions of a basic right are unacceptable.

Today, as we commemorate Roe, we must recognize that it never enabled all women to access an expansive set of reproductive rights. While we seek to protect the decision, we must also advocate legal and policy changes that will establish that all people, regardless of their financial circumstances, have equal access to rights ranging from freely available abortion and contraception to comprehensive medical care, affordable housing and an adequate income.

More than 40 years ago, we took a big step forward. Now, we must fight even harder to preserve women’s abilities to make their own health choices. Only then will the true promise of Roe be realized.

This story was originally published January 21, 2016 at 5:01 PM with the headline "On Roe v. Wade anniversary, taking stock of unrealized promises."