It’s been one year since the Supreme Court overturned Roe v. Wade, and conservative states have had plenty of time to enact the policies to support women, children and families that they promised to prioritize once they reached their goal of banning abortion.
Immediately following the June 24, 2022, decision, politicians assured us that their post-Roe plans included supporting women and children. Sen. Bill Cassidy (R-La.) said “Being pro-life means being pro-mothers, pro-babies, and pro-healthy futures,” while Mississippi Gov. Tate Reeves said he was “enthusiastically prepared to take on the challenges ahead and to take every step necessary to support mothers and children.” The Tennessee House Republican Caucus declared their “unwavering commitment to fight for families.”
Having spent decades working to overturn Roe v. Wade, have anti-abortion politicians delivered on their promises to support families one year after their judicial triumph? Spoiler alert: The answer is no.
One marker to consider if a state is supporting families is whether they’ve enacted paid family and medical leave. The research behind this policy shows it improves infant and maternal health and is associated with decreased infant mortality. Notably, only 12 states plus DC have paid family and medical leave laws — and all 12 are states where abortion is legal and accessible. Not a single state that has banned abortion has enacted paid family and medical leave; the only state this year to enact this proven policy is Minnesota, a state that also passed new legislation to protect abortion rights and access.
We can also look to Medicaid expansion, a policy option enabled by the passage of the Affordable Care Act that invited states to expand their Medicaid programs to cover people in households below a specific income level. This development has been a game-changer, contributing to significant health and economic benefits, including improved postpartum health. Now, a decade after Medicaid expansion became available, only 10 states remain that have not yet adopted this policy.
What have these 10 states prioritized rather than expanding Medicaid? Alabama: banned abortion. Tennessee: banned abortion. Wyoming: banned abortion (the ban is currently blocked). Texas: banned abortion. Mississippi: banned abortion. Florida: enacted a six-week abortion ban that will likely take effect in July. Georgia: has a six-week abortion ban in effect. South Carolina: just passed a six-week abortion ban currently being litigated. Wisconsin: legal complexity around the state’s 1849 abortion ban means abortion is unavailable. Kansas: would have likely banned abortion, but voters ensured that couldn’t happen in a news-grabbing ballot measure.
None of this is surprising, of course. Anti-abortion politicians made it abundantly clear that their vows to support families were an exercise in bad faith when their long push for abortion restrictions and an anti-abortion Supreme Court was never accompanied by supportive measures. Nothing was stopping them from enacting policies proven to help families; states could have spent time and political will shoring up all kinds of evidence-based measures to combat things like pregnancy-related deaths and child poverty. They haven’t. Now, people can’t get the abortion care they need, and many of them live in states with a very limited social safety net to fall back on. And some leading abortion opponents are intentionally advocating against any such supports as part of their extreme agenda.
It gets worse. Americans’ ability to access reproductive health care other than abortion is being severely compromised as well. States that have enacted abortion bans saw a sharp decline in OB-GYN residency applications, and hospitals in states with bans are shutting down pregnancy and delivery care units.
When women are denied abortion care in their state, they must find the money and time to travel far distances to obtain care elsewhere, self-manage their own abortion and potentially take on the legal risks that may be associated with doing so, or continue a pregnancy against their wishes. This can be particularly alarming in states with outrageously high maternal mortality rates, like Arkansas, Alabama, Louisiana and Oklahoma — states that have also banned abortion. And this is especially true for Black women, who face disproportionately high rates of maternal mortality. The people and communities already marginalized by structural racism and systemic inequities feel these effects most harshly. Studies tell us that in addition to the harms to autonomy and health that come from being denied an abortion, women who were denied abortion care experience negative impacts to their finances and families; 59 percent of abortion patients are already parents.
In addition to the widespread harm caused by bans, the hostile and confusing legal climate created by state abortion bans has threatened the health and well-being of pregnant women experiencing obstetric emergencies. One Tennessee woman recently underwent a lifesaving emergency hysterectomy after being denied an early abortion due to the state’s abortion ban; two Florida friends detailed their own harrowing health scares as a result of that state’s abortion policy in the Washington Post.
To be clear, banning abortion is flat-out wrong regardless of whether we have a thriving social safety net. Our fundamental human right to make decisions about our own bodies and our reproductive health exists intrinsically, not only because our governments have consistently failed to fully meet the needs of our families and communities.
We all deserve more than lip service. We deserve the ability to have or not have the children we want and to raise our families safely and with dignity, a tenet of the reproductive justice framework so poignantly established by Black women in 1994. Banning abortion doesn’t do that — even when you dress it up with other things. The agenda to end abortion by any means possible, for all people, is not matched by meaningful action to support families and children, making clear that their promises have simply been a cover to advance an extreme agenda.
Kelly Baden is the vice president for public policy at the Guttmacher Institute