Overturning of Roe V. Wade
What It Means for Public Health
As all are now aware, the U.S. Supreme Court has officially overturned Roe v. Wade on the grounds that the right to abortion was not "deeply rooted in this nation's history or tradition". This landmark decision was originally enacted in 1973, protecting, at the federal level, a pregnant woman's right to choose to have an abortion.
Despite one’s point of view on the decision, it is imperative to understand the impact that this decision will have on broader public health, women, and families. While it is understood that the overturning of Roe v. Wade directly impacts access to abortion, it will also greatly affect the area of contraception, high-risk pregnancies, mental health for women and families across the nation, and our already-strained healthcare system.
Contraception:
With abortion care no longer protected in certain states, it is not out of the question that emergency contraception such as Plan B, and even IUDs, may also be banned in these areas. This puts all women who are not ready for motherhood, especially those in poor socioeconomic situations or without an involved father, at a much greater risk. Research shows that access to contraception has proven to reduce the probability that women will live in poverty and increase their earning potential. This forces females who are not ready to become mothers into motherhood which can directly, and negatively, impact the health and well-being of not only themselves, but the child as well. Unfortunately, the unmet need for contraception will result in several health challenges such as unintended pregnancies, unwanted births, and unsafe abortions.
High-Risk Pregnancies:
The overturning of Roe v. Wade does not only impact women seeking abortion, but it also impacts all pregnant women. Adverse pregnancy-related conditions such as ectopic pregnancies and miscarriages can be misconstrued for abortion. Doctors may delay care for these conditions now, and seek legal advice first, putting the mother’s well-being, and even life, at risk due to potential hemorrhaging. Roe v. Wade further protected the termination of embryos during unsuccessful IVF attempts. The U.S. already has one of the worst maternal mortality rates among developed nations, and this decision can potentially lead to even higher rates.
A study at the Bixby Center for Global Reproductive Health at the University of California, San Francisco observed 1,000 women who sought abortions across various facilities in the United States. Results showed that women who were denied abortions had more serious health problems, such as high blood pressure or seizures, than those who had abortions. A few of the women who were denied abortions died from conditions related to their pregnancies. This study gives potential insight as to what can happen as a result of the overturning of Roe v. Wade.
Infant Health
Infant health goes hand-in-hand with maternal health and high-risk pregnancies. High-risk pregnancies coupled with poor socio-economic conditions impose even more demand on an already stressed public health system. Babies born from high-risk pregnancies have a higher risk for both physical and cognitive long-term health problems. This can mean a lifetime of complications, treatments, or management- for both the mothers and babies.
Mental Health:
The existence of the Supreme Court’s decision alone adds to the already-existing stigma against abortion. Women will possibly be more inclined to feel ashamed of their choice to abort the pregnancy even if it is the best choice for their circumstances or health. In general, there is a greater risk for a sense of dissociation amongst many women, as they have lost complete autonomy to their own bodies.
In one of the more severe examples, women who are raped in certain states or are not prepared for motherhood will have to go through a full-term pregnancy, despite wanting to keep the baby or not. Pregnant and post-partum women in any of the above scenarios will likely suffer from increasing mental health issues- which is already generally on the rise in the United States. Not only will this lead to emotional distress but can impact financial and physical well-being.
Health systems may not be able to keep up with the increased demand for mental health care.
Access to Healthcare
Women who cannot easily access abortions in their home state will need to travel elsewhere, delaying both care and the abortion. In most cases, the woman may need to take time away from work, secure childcare for other children when applicable, get a hotel, food, gas, and other trip-related expenses.
Various states across the country have found themselves turning into potential safety nets for abortion care. In states where abortion is permitted, clinics are preparing to see a surge of patients from neighboring areas where it is now banned. This is not a long-term solution as many clinical sites are not logistically equipped to handle this surge- greatly impacting patient care and safety.
How can the public health sector equip itself to tackle the demanding implications of this decision?
The public sector must increase its capacity to care for communities around the country by adding more trained clinicians and by utilizing and collaborating with supportive technologies. There was already a shortage of healthcare workers prior to 2020, and it has only worsened as a result of the pandemic, exhaustion, and burnout. This directly impacts safe clinician-to-patient ratios, patient safety, and care. While addressing the healthcare shortage issue is a long-term solution, technology adoption can address the gap in the meantime and in the future.
Digital technology in healthcare and medicine could potentially transform inadequately resourced healthcare systems into adequately functioning ones, provide cheaper, faster, and more effective solutions for diseases, and equalize the relationship between professionals and medical patients. The effects of the overturning of Roe v. Wade have just begun and will only continue to ripple across healthcare - impacting the underserved population the most.
Here are some examples of technologies that can help increase healthcare capacity and equity to address the impacts of reproductive health resulting from this decision:
Digital assessment and educational tools can help inform women of their choices when it comes to preventing pregnancy and allow them to choose the best option.
Those who are experiencing high-risk pregnancies will also need dependable information on what to do in the event of an emergency.
Poor mental health outcomes are projected to rise as women feel the effects of lost autonomy over their bodies and rights. Proper assessment tools can trigger alerts to clinicians, provide customized education, and more.
Technology can improve pre-hospital care, alert medical staff, and reduce the time for initiating management-- improving health outcomes for both mothers and babies.
Technology can help woman in reproductive health areas such as contraction tracking, pregnancy and baby tracking, fetus development, weight management, newborn care, and more.
Observation and data collection can foster enhanced care for reproductive health and alleviating an already- burdened healthcare system.
Technology provides tools that help many manage important daily tasks that help improve and maintain people’s mental health.
Aztute is a public health platform that enables community organizations to keep their communities safe & healthy with a comprehensive set of both educational and assessment tools designed to DETECT, RESPOND to, RECOVER from, and PREVENT health crises' using real-time, secure collaboration with community partners and stakeholders. Our educational collection is designed for a consumer audience and is science-based, up-to-date, and expertly vetted —helping to integrate wellness into daily life. For more information, visit: https://www.aztute.com/public-health
References
Bailey, M. J. (2012). The Opt-In Revolution? Contraception and the Gender Gap in Wages. American Economic Association. https://www.aeaweb.org/articles?id=10.1257/app.4.3.2255
Health Worker Shortage Forces States to Scramble. (2022). PEW.
High-Risk Pregnancy: Risk Factors, Complications & Treatment. (2022). Cleveland Clinic.
https://my.clevelandclinic.org/health/diseases/22190-high-risk-pregnancy
McGovern, T. (2022a). Overturning Roe v Wade has had an immediate chilling effect on reproductive healthcare. BMJ, o1622. https://doi.org/10.1136/bmj.o1622
McGovern, T. (2022b). Overturning Roe v Wade would be an unprecedented attack on the bodily autonomy of women, girls, and pregnant people. BMJ, o1019.
Silumbwe, A., Nkole, T., Munakampe, M. N., Milford, C., Cordero, J. P., Kriel, Y., Zulu, J. M., & Steyn, P. S. (2018). Community and health systems barriers and enablers to family planning and contraceptive services provision and use in Kabwe District, Zambia. BMC Health Services Research, 18(1).
The Turnaway Study. (2021). ANSIRH.