With the US Supreme Court’s ruling in Dobbs v. Mississippi, Roe v. Wade has been overturned and decisions about abortion rights have been returned to the states. In some states, the reversal of Roe triggered immediate, near-total bans on abortion. Other states are expected to put in place restrictions that forbid abortions at early stages of pregnancy.
For nearly 50 years, proponents of criminalization have focused on later abortions, in part because Roe explicitly allows more regulations further into pregnancy. This focus has perhaps given people a false sense of when abortions happen: Forty-two percent of Americans incorrectly believe that Roe allowed abortion “up to the moment of birth.” It didn’t. Under Roe, forty-four states had gestational limits — including deep-blue states such as Massachusetts and California.
Abortion bans ignore the realities of pregnancy. At six weeks, most people have only just learned that they are pregnant. Among young people, racial minorities and those living with food insecurity, later confirmation is even more common.
Early symptoms of pregnancy, such as fatigue, can be attributed to something else; a third of women don’t get morning sickness; bleeding during early pregnancy could be mistaken for a period; half of women seeking abortions say they used birth control the month they conceived.
Irregular or long menstrual cycles can also mean that some women might already be five or six weeks pregnant by her first missed period. (Pregnancy is always dated from the first day of the last period.) About 1 in 10 women has irregular cycles, and 1 in 4 has longer-than-average cycles.
Possessing female reproductive parts doesn’t mean women are born knowing how they work. One study showed that fewer than 13% of women trying to get pregnant had successfully timed sex for their fertile window. In a separate study of low-income women, only about half knew what ovulation was, when their next period was due or the average length of a menstrual cycle.
Proponents of criminalization can be quick to point out that even the strictest bans carve out exceptions for the pregnant person’s life or severe fetal defects. Legally, that might sound as if it makes sense. But medically, it’s a mess. Who decides what counts as a “severe” defect? And how sure must that person be? When was the last time a doctor told you there was “zero chance” or a “100% chance” of anything? In countries with strict abortion laws, women have died while their doctors waited for their lives to be sufficiently threatened to end the pregnancy.
Legislation may draw clear and rigid policy lines, but medicine is inexact.
The three-trimester structure of Roe, pilloried though it was, reflected the fuzzy reality that pregnancy is a continuum — that one can, in essence, be a “little bit” pregnant, that many complications aren’t diagnosed until after the first trimester and that different people have different beliefs about when life begins. In a country where a lot of people have opinions about women’s bodies, very few seem to have a grasp of the facts. Losing Roe ought to be a wake-up call.