Even though abortion is both an extremely common and an incredibly safe procedure, public perception is pretty much the opposite. Likely because still-widespread stigma against female sexuality, polling shows that Americans drastically underestimate how common abortion is and drastically overestimate how dangerous it is. Popular media contributes to these misconceptions, with TV and movies portraying abortion as so dangerous that even thinking about it can hurt you.
Anti-choice activists and legislators have long abused these misconceptions about abortion safety, exploiting misinformation and fear to pass restrictions that only serve to make the procedure more difficult and expensive for women to legally obtain. Since 2011, states have adopted 401 abortion restrictions, and most — such as waiting periods, mandatory ultrasounds and age restrictions — are based on the false notion that abortion is a serious and dangerous procedure.
But after the 2016 Supreme Court decision in Whole Woman's Health v. Hellerstedt, which overturned a series of Texas regulations on abortion providers that had no basis in medical necessity, pro-choice activists have a new mission: Get the word out about how safe abortion actually is, and overturn the multitude of laws based on the false notion that it's not. They have a growing body of research to point to, which makes clear that abortion tops the list of safe medical procedures, especially when compared to the alternative of carrying an unwanted pregnancy to term.
On Thursday, the women behind the Whole Woman's Health case — lawyer Stephanie Toti and clinic owner Amy Hagstrom-Miller — announced, with a team of reproductive rights activists, an ambitious new litigation strategy aimed at rooting out years worth of abortion restrictions in Texas, most of which predate those struck down by the Supreme Court in 2016. The suit challenges an array of restrictions, including limits on medication abortion, age restrictions and a mandatory waiting period that comes with a state-required script that deliberately exaggerates the medical risks of abortion.
"Justice Breyer’s majority decision [in Whole Woman's Health] clearly stated that politicians can’t just claim their anti-abortion restrictions improve women’s health and safety," Hagstrom-Miller said in a press call about the lawsuit. “With this lawsuit today, we hope to leverage the Whole Woman’s Health standard even more, to bring a comprehensive challenge that rolls back dozens of bad laws that have harmed Texans for decades.”
In the same call, Toti noted that "many states have a vast infrastructure of unreasonable and medically unnecessary abortion regulations on the books that cannot withstand constitutional scrutiny," hinting that activists hope this approach can help reverse the nationwide tide of bad abortion laws.
Aiding this effort is continued research showing exactly how safe abortion actually is. On Thursday evening, the research group Advancing New Standards in Reproductive Health (ANSIRH) added another study to the growing body of medical literature that demonstrates that patient risks in abortion are startlingly low. Using data from the Nationwide Emergency Department Sample, researchers found that out of 190 million emergency department visits by women of reproductive age between 2009 and 2013, fewer than 30,000 of those visits were for abortion-related reasons.
In statistical terms, that means that 0.01 percent of women between 15 and 49 who went to the emergency room — one out of every 10,000 women -- were there because they had an abortion and are worried that something is going wrong. The emphasis on "worried" is not just spin, because even among the small number of women who did go to the hospital after having abortions, most were just fine.
In more than half of such visits, “women were being observed and then released," Dr. Ushma Upadhyay, the lead researcher, told Salon. "So they never actually received any treatment.”
In many cases, she added, such women may decide to go to the hospital because they have absorbed the myth that abortion is dangerous and therefore react negatively to symptoms that might not be alarming.
Of women who went to the emergency room after an abortion, about 5,600 women had serious complications. That number is out of more than 5 million abortions provided nationwide during that time, which means that 0.1 percent of abortions result in serious complications. Not only is this rate tiny compared to the rate of serious complications related to pregnancy — which is about 1.4 percent — but it's also dwarfed by the risks of other procedures most people understand as safe.
That rate of serious complications for abortion "is lower than colonoscopy, wisdom tooth removal and tonsillectomy," Upadhyay said.
The real risk to women, she added, lies in the medically unsound restrictions that led to the closure of so many abortion clinics: "It’s really detrimental to women’s health to lose another abortion clinic."
Texas activists are hoping that the solid science behind their case can finally begin to reverse the pileup of regulations that do nothing to improve medical care but have been effective at limiting women's access to abortion and other reproductive care.
Nan Little Kirkpatrick, executive director of the Texas Equal Access Fund, wrote in an emailed statement that she had spoken to people in Amarillo, Texas, who drove a woman four hours each way to Albuquerque, New Mexico, for an abortion appointment, because all providers in the Texas Panhandle had been closed down. "The group of laws being challenged may seem on the surface to be a hodgepodge of random requirements," she continued, "but together they weave a huge barrier to abortion access for thousands of people in Texas, especially low-income people, people of color, and people in our vast rural areas."
For decades, Americans have been subject to misinformation and stereotypes that paint abortion as some kind of dangerous and gruesome medical intervention born out of desperation. The truth is that abortion is common — despite declines in the abortion rate, one in four women will still have one in her lifetime — and, as this new research shows, represents no real danger to women's health It remains to be seen if activists can undo America's widespread misconceptions about abortion, but this aggressive new legal strategy, coupled with research and public education, creates a possible path forward.
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