The Texas ban on abortion after six weeks of pregnancy has been a long time in the making, but when it went into effect on Wednesday, it surprised many who believe they support reproductive autonomy. Ignorance at this point is tantamount to complicity: for many years, abortion has been inaccessible to and unaffordable for millions, rendering the right allegedly ensured by Roe v. Wade more theoretical than actual. Now, the country is staring down the barrel of more sadistic anti-abortion legislation, which is almost certain to coincide with increased violence against doctors, patients, and clinic staff, and the liberal refrains from previous decades have proven useless. Rising to this horrible moment requires a better way of talking and thinking about abortion, because those thoughts and messaging are the foundation from which we act.
For starters, no more foregrounding doctors. The idea that abortion is “a decision between a woman and her doctor” is paternalistic, infantilizing, and corrosive to the very notion of bodily autonomy. A pregnant person has the right to terminate their pregnancy on their own terms, which includes using pills, herbs, or even devices outside a formal medical setting, and while medical advice can be crucial to the decision to terminate, it need not factor in at all. Abortion providers are indispensable allies who perform their work at great risk and personal sacrifice. but this isn’t about doctors, or their right to practice: this is about the autonomy of pregnant people.
Decentering doctors is also an essential step toward recognizing that abortion is not something magnanimously granted to a pregnant person by an official third party, as the state would have us believe. I grew up with a fuzzy idea of abortion as a complicated surgical procedure, something that could only be accomplished with sharp, invasive implements, and was therefore often lethal when performed outside a clinic. It suits the government for people to believe this, because it minimizes what we can do for ourselves and for each other. But abortion is as old as pregnancy, and not every method requires expensive technology, pointy objects, or a practiced hand. Especially now, with the advent of mifepristone, self-managed abortion can be extremely safe, with minimal to no complications.
One of the inadvertent consequences of emphasizing the horror of coat-hanger and knitting-needle abortions is this legacy of abortion as scary procedure, both dangerous to the point of being life -threatening and impossible to undertake on one’s own. Many medical procedures can be fatal if attempted without proper education or tools, but illegality does not make abortion risky in and of itself. The Jane Collective, a group of self-taught laypeople operating in the ’70s, administered abortions with a safety rate on par with those in legally operating clinics, and underground groups today are reviving the tradition of extra-clinic abortions using herbs and manual vacuum-aspiration devices. Furthermore, in spite of a predictable and protracted smear campaign, the “abortion pill” (mifepristone, usually combined with misoprostol) is exceedingly safe.
It’s a crucial distinction that when the state passes laws around abortion, it is intentionally trying to make abortion dangerous. I want to say it again: lawmakers are not keeping doctors from making an inherently dangerous act safe, they are actively trying to turn a safe procedure into a dangerous one. Criminalization creates conditions that amplify and generate risk, including but not limited to the elimination of options; lack of information, support, and guidance; and a reluctance to go to a hospital in the event of complications. When not legislated as an exceptional event and simply regarded as the healthcare that it is, abortion is twice as safe as a shot of penicillin and 14 times safer than giving birth. Anti-abortion lawmakers are willing, perhaps even eager, to kill pregnant people who seek abortions, and we should say so. But that message must come with reiteration of how safe abortion should be, and usually is, even outside of a clinical setting. The laws are the danger, not abortion itself.
And yes, that’s laws, plural, because there’s more legislation at play here than the legendary Supreme Court decision of Roe v. Wade. As the Texas ban so grotesquely illustrates, abortion is a local issue, not just in terms of state by state regulations, but city by city and county by county. When Roe v. Wade is overturned (arguably, it has been) the states will decide if those within their borders can legally obtain one. States have already been deciding as much through the deployment of Targeted Regulation of Abortion Providers (TRAP) laws and exclusion of abortion from Medicare coverage. A fixation on the Supreme Court not only misses where the war is actually being waged, it tends to preclude analysis around accessibility and affordability, without which legality is of dubious worth. In doing so, it creates a false idea of how abortion rights are or can be secured at the political level. It also, often, accepts the legitimacy of court rulings instead of asking what is desirable or defensible about allowing nine people to decide the fate of 328 million.
Polling of the American public consistently demonstrates support for abortion rights, especially in the first trimester, and a recent report from Gallup confirmed 58% don’t want Roe v. Wade to be overturned. (That’s stayed above 50 percent since 1989.) As lawyer and President of the NAACP’s Legal Defense Fund Sherrilyn Ifill put it, the Texas law “is part of a desperate effort to do by harassment, intimidation, and menacing what could not be accomplished by regular channels of democratic engagement.” As commonly happens in the U.S., a vehement and vocal minority of zealots has exercised a disproportionate amount of political power, in part through overrepresentation in national narratives. They cannot be allowed to bury the fact that many Texans and most Americans do not support these cruel and draconian measures. (Not only were Texas voters far from unanimous on the post-six week abortion ban, “voters” are not synonymous with any state’s population as a whole, particularly not in Texas.)
The fact is, abortion is not actually controversial. It is popular. Famously, somewhere between one in three or one in four women have had an abortion, with some of those women having more than one. Between 800,000 and a million happen per year. And while people may seek care in isolation, many enlist the help and support of partners, friends, and family members in the decision-making process and aftercare. Even self-identified pro-lifers avail themselves and their loved ones of abortion. (Anecdotally, providers sometimes share stories of protestors who’ve had an abortion at the same clinic they regularly harass.) It is infuriating that the general public has been cowed into treating abortion as political kryptonite when it is, in reality, a common and unremarkable aspect of life.