Five things you need to know now that the Roe v. Wade case has been overturned

The Supreme Court's decision at the Dobbs v. Jackson Women's Health Organizationwill dramatically and rapidly change the situation of access to abortion in the United States. Not only will abortion 15 weeks after pregnancy, but it will also overturn the nearly half-century precedent set in the Roe v. Wade case, which guarantees the constitutional rights of abortion. Dobbs decisions allow states to set their own limitsso where people live determines the level of access to abortion.

The majority opinion written by Judge Samuel Alito said, "The Constitution does not give the right to abortion. Roe and Casey [Planned Parenthood v. Casey, 1992] have been rejected and have the authority to regulate abortion. There is. " It will be returned to the people and their elected representatives.

Shortly after the decision was announced,protests and celebrationsbegan out of court and nationwide — with the laws currently in force. Emphasizes the patchwork of restrictions. State officials in conservative states said they would act swiftly to limit abortion, but in other states some officials have promised to retain their right to access.

Here are five important points that affect access to abortion.

1. Abortion is still legal.

The Supreme Court's ruling means that access to abortion will soon be verynon-uniform

16 states and the District of Columbia , There are laws that protect the right to abortion. In the other two states, the court ruled that the State Constitution establishes that right. These states are concentrated on the east and west coasts.

On the other side of the spectrum, 13 states have"trigger" methodsthat quickly ban almost all abortions, with at least half a dozen. Moved on Friday to implement them including Arkansas, Kentucky, Missouri, South Dakota. Four more have pre-Roe bans. In the other three states, the book has laws prohibiting abortions after 6 weeks of gestation.

Access to abortion may evolve in other states as well. Kansas and Montana, one of the states in which the right to abortion is enshrined in the Constitution, could be rolled back by various efforts by state legislators and ballot protection. In at least eight states, the right to abortion is not explicitly protected or prohibited by state law. In

andMichigan, state law of 1931 prohibits almost all abortions, but its enforcement is temporary by a May court ruling. Was stopped at. Democratic Attorney General Michigan Dana Nessel said he would not enforce the law, but it remains questionable whether that also applies to local prosecutors.

As before the 1973 Supreme Court's decision, people seeking abortion treatment are subject to various restrictions, even in states where the procedure is still legal. They include gestational age, which outlines the maximum points of pregnancy at which someone can have an abortion, requirements for patients to receive pre-counseling, waiting periods, and parental notification rules for minors.

2. What can the Biden administration do?

President Joe Biden said his administration is consideringadministrative measuresto counteract the effects of the ruling. In a statement after the decision,, Biden said it was a "sad day" and that without Law, "the health and life of women in this country is at stake."

But in short, without the new law from Congress, he has limited options.

Supporters of the right to have an abortion andDemocrats of Congressare available up to 10 weeks gestation and women can easily have an abortion, including taking two tablets. I urged the administration to be able to have an abortion. Evaluate the availability of federal property services even in states that are banned, and enhance digital privacy to protect patients.

Abortion is an increasing proportion of all abortions offered in the United States. According to theGuttmacher Institute, a research institute that supports the right to abortion, pills make up more than half of the total. Dosing in the first year accounted for the majority of abortions in 2020.

Under the Biden administration, the Food and Drug Administration has already lifted one major restriction. Patients can now receive by mail Mifepristone, the first drug used in the series. Mary Ziegler, a professor of law at the University of California, Davis and an abortion historian, said that the Byden administration was in a position to limit access to drug abortion even when conservative states were moving. The FDA's rules and guidelines regarding Mifepristonesupersede state law, which criminalizes the method. Attorney General Merrick Garland took this position in astatementissued shortly after the decision was announced. About its safety and effectiveness. Biden reinforces the message with his remarks.

In a comment before the judge's decision was announced, Zeigler argued that this position was "the greatest thing they could do." Still, the FDA's approach is uncertain, as legally, future Republican administrations could easily revoke actions taken by Biden officials. "If it works, it's not permanent and may not work," she added. The Biden administration can also increase the number of pharmacies that can dispense medicines.

3. Can people in states where abortion is illegal have access to drug-induced abortion?

So far, as a result of Dobbs' decision, the ban on abortion is likely to set restrictions or bans onabortion drugsas well. increase. However, some supporters have pointed out that people in these states may still be able to obtain abortion medications and perform "self-managed" abortions at home. In addition, abortion medications are still available in states where abortion is permitted.

Before Roe capsized, manystates already restricted the availability of abortion drugsWas enacted. This includes prohibiting pills from being sent by mail and not allowing patients to prescribe medications through telemedicine appointments. But people have found a workaround — a practice that is likely to continue. These actions, such as traveling to a neighboring state to secure medicines or sending them to a friend's house or a PO Box elsewhere, may carry the risk of criminal accusation, depending on the details of state law. ..

Even among abortion rights activists, there are concerns that outlawing abortion is even more advanced and that traveling to another state to obtain an abortion could be a crime. However, this is an untested legal frontier and may be bound in court.

Biden takes a strong position on this question, saying that there is nothing to prevent women living in abortion-prohibited states from traveling to abortion-allowed states. I took it. The woman "must continue to travel safely to another state to seek the care she needs," he said, adding that his administration "will properly defend its foundation." He also said that state doctors who continue to allow abortions can provide abortions to women in other jurisdictions.

4. How does this affect a doctor's ability to provide care?

In many states banning abortions, obstetricians and gynecologists, emergency room doctors, and doctors of all kinds who care for pregnant people may be subject to the law. Providing expensive and abortion services can lead to criminal liability.

This has serious impacts on assisted reproductive technology, Dr. Nikki Zite, OB-GYN in Knoxville, Tennessee,recently told KHNin Tennessee. Trigger methodAbortion is said to be acceptable only to prevent death or "to prevent a serious risk of substantial and irreversible impairment of a pregnant woman's major physical function."

"But it's not clear how much risk you need," Zite said. "Various doctors practicing in different institutions have different interpretations of the law."

There are also gray areas that are not covered by the law. In very early pregnancies, the fertilized egg stays outside the uterus, most commonly in the fallopian tubes, andectopic pregnancyas that type of pregnancy progresses, the woman can bleed and die. there is. Patients with

miscarriagemay need to take abortion medication orpregnancy surgery to remove tissue remaining in the uterus202} — D&Known as C.

"The challenge is exactly the treatment of abortion and miscarriage Dr. Sarah Pragerrecently told KHNPrager is a professor of obstetrics and gynecology at Washington University in Seattle.

Doctors may hesitate to carry out D&Cs, fearing that someone has done them, miscarriage Treat Secret Abortion.

"Doctors should not be afraid to be criminal for caring for a patient," Zite said. "I think there will be a myriad of unintended consequences. I think people will lose their lives. And I think there are people who are eager to get pregnant but are in a terrifying situation with pregnancy complications. You will not be able to make a decision on how that pregnancy will end, and it will be another kind of devastation. "

5. This ruling could have more impact than abortion.

Of course, according to reproductive health experts. Depending on what is determined to be an "abortion," the state may knowingly or accidentally criminalize in vitro fertilization and certain forms of contraception, limiting the training and availability of doctors and other health care providers. I have.

At stake is what was determined to be an abortion. Medically, abortion is the early termination of pregnancy by natural means (spontaneous miscarriage, miscarriage) or by human intervention through drug therapy or surgical procedures. But when does pregnancy begin? According to doctors, pregnancy begins when a fertilized egg is transplanted into a woman's uterus. However, many anti-abortion activists say it begins when sperm and eggs combine to form zygotes. This can happen a few days ago. Its early time frame means that anything that interferes with the implantation of the fertilized egg, such as the IUD (intrauterine device), which is a common form of contraception, can be defined as a miscarriage. Similarly, in vitro fertilization, which involves removing a woman's egg, fertilizing it, and then transplanting it into a woman, can be interpreted as having a miscarriage unless all fertilized eggs are transplanted.

Judge Clarence Thomas's opinion ofagreed with the decision to overthrow Law and raised other questions. He suggested that the court could use the same argument in the Dobbs case to overturn other important judgments, including those that established contraception and same-sex marriage rights. It is not clear if the other judges agreed, and Judge Samuel Alito, who wrote the main opinion, said he did not believe the abortion decision would affect other issues.

American Association of Pro-Life Obstetricians &Gynecologists praised this decision and called it "momentary." However, others are concerned that this ruling could adversely affect women's access to care where strict abortion legislation is enacted or enacted. Specifically, doctors and other health professionals may not want to train or practice in areas that may be prosecuted to provide medical care.

And this is not just a theory. The New England Journal of Medicinereports that in Texas, where abortion after 6 weeks of gestation is virtually banned, the law "has hit the mental health of clinicians. Some doctors report feeling like a "worse doctor," and some have left the state. As a result, clinicians are worried that the Texans during pregnancy have no care options and doctors are left unable to provide them.

KHN(Kaiser Health News) is a national news room that produces detailed journalism on health issues. KHN is one of the three main operational programs of the Kaiser Family Foundation, along with policy analysis and polling,KFF. KFF is a donated non-profit organization that provides the public with information on health issues.