Abortion Will Not Be Stopped, Or Even Slowed Down

 

Back in 2022, before the Dobbs decision, abortions in the United States occurred at the rate of 79,600 per month. Put a pin in that number.

When Dobbs ended Roe, it triggered a cornucopia of draconian laws banning — to one degree or another — abortion in most red states. One of the worst judicial decisions in history, Dobbs led almost immediately to a raft of high-profile atrocities, making simple pregnancy a high-risk proposition for both women and doctors.

The Republicans running those states are now defined — politically and morally — by their anti-woman, anti-family policies. On their watch, long-standing, globally-accepted medical standards and practices are being rejected, not on the basis of science, but of ideology and, even worse, religion.

The results are stunning. While I couldn’t possibly scan the entire landscape of reproductive issues, there are others doing that full time. Jessica Valenti and her new partner Kylie Cheung do deep dives into everything I might touch on here.

But I’ll simply say that the spike in the rates of both maternal and infant mortality speaks for itself. The numbers are so dramatic, and so damning, many red state governments are trying to mess with the data, how it gets reported, crunched, and disseminated. This speaks volumes about their real morality.

And there’s plenty of collateral damage, especially to women who miscarry, or who want their babies but whose pregnancies aren’t viable. Women in such circumstances now regularly die of sepsis, some in the back of their cars, waiting outside the hospital for the heart of their doomed baby to stop beating so their doctors can get permission from the hospital board, or maybe even a judge, to remove a dead body from a live one before, oops, too late, sorry.

The goal of these red state legislators has been to put so many obstacles in the way of abortion access that women would give up in despair and, however reluctantly, have the child. After which, it must be said, the state’s interest in that child ends, possibly forever. Republican-run governments are scandalously stingy with prenatal care, parental training, childhood nutrition, affordable daycare, or any sort of social service that might actually help the family of a non-aborted baby survive in their deeply benighted states. Family values, my ass.

But you would think that with all the restrictions, all the crazy laws designed to keep women from accessing abortion — and to punish them if they do — you would think this would have an effect on the number of abortions women are getting.

And indeed it has. Abortions have gone up. Not down.

Since Dobbs, the numbers have grown over 24 percent, to 98,800 per month. And that could be way low. Think about that. The more restrictions placed on abortion, the more abortions are sought and completed. Is that cause and effect? What’s going on here?

A big part of it is technological. Even as the laws have changed for the worse, the ability to circumvent those laws has improved dramatically. Most abortions are now chemical. They involve the delivery of two abortion pills to the patient, who uses them under the supervision of a remote telehealth doctor.

The abortion pills themselves make this remarkably easy. They’re cheap to make — most of them are manufactured in India, China, and Vietnam — and they’re distributed in bulk all over the world. They move readily up and down the global supply chain, and across legal jurisdictions. They’re small, easily shipped, easily smuggled, and easily hidden. 

Pair them with remote telehealth services — whose exponential growth is directly attributable to Covid — and you have a powerful engine for delivering abortion services over long distances, from smart states to stupid ones.

Which is exactly what is happening, and stupid-state Republicans are losing their shit over it. They’re working overtime to restrict the movement of the pills across state lines. They’re suing telehealth providers in blue “sanctuary” states. They’re indicting blue-state healthcare providers and demanding extradition. And yes, they’re pressuring the FDA to withdraw its approval of the two drugs, which would be an atrocity on many levels, as both have other important medical uses. The good news is, as I’ve written previously, there are multiple legal barriers to doing any of these things. At least, for now.

For now, the anti-abortion forces have no effective answer to the abortion pill. But even in the (still) unlikely event that a national abortion ban were put into effect — or if the Supreme Court were to intervene with some new thirteenth-century ruling — it’s hard to see the flow of pills stopping, or even slowing down. The pills don’t care if they’re legal or not.

But let’s game that out a little. Let’s assume abortion is banned altogether, that it has to go completely underground.

The abortion market is demand-driven, and the demand is always there. Even in Honduras — the gold standard for total abolition and harsh punishment of both women and doctors — an estimated 80,000 women per year find a way to end their pregnancies, most of them in relative safety.

Just because the government pulls out of the market doesn’t mean the market goes away. When demand is that persistent, a supply will always rise to meet it. The question becomes what kind of supply. The two pills would now be black market commodities, which is to say they’ll be significantly more expensive, with no quality control or accountability for the supplier.

This opens the market to all sorts of shady characters, most likely with the blessing, or active participation, of the Republicans in the legislatures that banned abortion in the first place. Black market economics requires some degree of corruption at one or more points in the supply chain.

That’s a worst-case scenario, however. The history of clandestine abortions tells us that women, both individually and in groups, will develop ways to keep those pills flowing, no matter what obstacles are put in their path. Even if telehealth were somehow removed from the equation, they will surely learn to help each other obtain the pills and use them in the safest manner available.

Because, as the numbers now clearly confirm, abortion always finds a way.