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How Abortion Access Can Save Women From Violence

In America, pregnancy is a uniquely violent and sometimes deadly time. Abortion can be a lifeline.

a women's rights protester wears a mask reading "bans off our bodies"
ED JONES/AFP/Getty Images
A participant in the Women’s March and Rally for Abortion Justice in Wilmington, Delaware, on October 2

There was a particularly revealing exchange at the Supreme Court last week, during arguments over Mississippi’s 15-week abortion ban, in a case with grave implications for abortion rights nationwide. Justice Amy Coney Barrett brought up safe haven laws—which allow babies to be surrendered for adoption shortly after birth without criminal penalties—and suggested that abortion is no longer necessary since women can just give up their babies for adoption. If abortion rights advocates are concerned about the burdens of forced motherhood, Barrett asked, “Why don’t the safe haven laws take care of that problem?”

Barrett’s comments reflect complete disregard for the ordeal of pregnancy itself and the impact of making people endure an unwanted pregnancy. It’s heinous enough to suggest that safe haven laws somehow negate the horror of forced pregnancy by offering an illusion of choice at the end, but there’s an even more tragic fact behind Barrett’s callous false compromise: A nontrivial number of people will never even make it to the end of pregnancy. In America, pregnancy is a uniquely dangerous, and often violent, time. Abortion can be a lifeline, but Barrett and other anti-abortion advocates appear poised to cut it off.

This isn’t the first time that anti-abortion activists have pushed adoption via safe haven laws as a replacement for abortion. Groups like Family Council have promoted nearly identical talking points, and lawyers for the state of Texas wrote in recent filings in support of its six-week abortion ban, “Abortion is permanent. Pregnancy lasts months.”

What Barrett and her fellow anti-abortion advocates are promoting is not just an assault on abortion rights but an actual assault on pregnant people—a form of state-sanctioned violence that would bring with it life-altering, and for some, life-ending consequences.

In the popular imagination, pregnancy means baby showers and gender reveals and yoga classes for the glowing mom-to-be (all presupposing that she is financially comfortable and enjoys high-quality health care and flexible work hours). But for a devastating number of people in the United States, pregnancy is not a happy experience or even a safe one. The U.S. has the highest maternal mortality rate in the developed world, and maternal deaths are still on the rise. Over the past two decades, maternal mortality has increased almost 60 percent. Black women face the greatest risk of pregnancy-related death, with a maternal mortality rate three to four times that of white women.

The causes of pregnancy-related deaths are varied, but recent changes in death certificate reporting practices have pulled back the curtain on something that domestic violence advocates have long known, but which has often gone unsaid and unseen otherwise: Access to abortion can mean the difference between life and death.

In a first-of-its-kind study comparing homicides and pregnancy-related deaths nationwide, researchers found that the number one killer of pregnant women is not infection or hemorrhage or cardiovascular conditions. According to the November study, more pregnant women in the U.S. die by homicide than by pregnancy-related causes. Homicide “exceeded all the leading causes of maternal mortality by more than twofold,” the study authors concluded. The statistics are particularly bleak for young pregnant women (ages 24 and under) and for pregnant Black women, who face three times the risk of dying by homicide of their white counterparts. Compared to other women of the same age who aren’t pregnant, pregnant women face a 16 percent increased risk of dying by homicide. Most are killed by a partner.

Being pregnant, in other words, significantly increases a woman’s risk of being murdered, and restricting access to abortion will only exacerbate the danger. An expansive body of research shows that women in abusive relationships are more likely to need abortion services, and making it harder to access abortions can trap women in violent relationships during a time when the severity and frequency of violence often escalates.

In Texas, where state lawmakers passed an anti-abortion bill in 2013 that led to the closure of nearly half of Texas abortion clinics within one year, researchers found a causal relationship between abortion access and violence against women. Specifically, “a one minute increase in time needed to reach the nearest abortion clinic is estimated to increase the number of reported cases of gender violence per municipality by 0–0.16 percent,” the study found.

Data from the Turnaway Study, a project examining the health and social outcomes of women seeking abortions at 30 facilities across the U.S., shows that being able to access abortion is associated with a reduction in physical violence from the man involved in the pregnancy, while women who are turned away and denied an abortion do not experience a reduction in violence. Women who are denied access to abortion are also more likely to be trapped in abusive relationships for longer.

Despite Justice Barrett’s suggestion, these are not just trivial experiences that can be undone by abandoning the baby after birth. Tragically, we know that some people won’t even make it to birth. People like Shaterica Anderson, a pregnant mother of five who was shot to death by her partner in Texas last month. Or like Jessica Covington, a 32-year-old pregnant woman who was shot to death in a “domestic” incident while walking home from her own baby shower in Philadelphia last month, or Akeila Ware and Meghan Santiago, both of whom were pregnant when their husbands—active duty soldiers in the U.S. Army—murdered them in separate incidents just over a week apart this past fall. Safe haven laws didn’t save them or their unborn babies.

For abuse victims who do survive pregnancy, intimate partner violence has severe and long-lasting health effects, as well as devastating social, economic, and psychological impacts. Women who experience violence during pregnancy also have a higher risk of preterm birth and low-birth-weight deliveries, as well as fetal and neonatal death.

According to the right-wing Mississippi legislators behind the extreme anti-abortion bill, women have no one to blame but themselves for being in such a situation in the first place. The Mississippi law’s proponents argued that, with the availability and effectiveness of contraception, there really shouldn’t be a need for abortion anymore. “Contraceptive advances ‘undercut’ the claim that a constitutional right to abortion is necessary for women to ‘control their reproductive lives’ and participate fully in economic and social life,” Mississippi Attorney General Lynn Fitch’s team argued in its legal briefs.

But for victims of intimate partner violence, contraception is neither readily available nor reliably effective. An estimated 16 percent of women ages 18 to 44 have experienced reproductive coercion—a “hidden form” of violence against women characterized by behaviors intended to exert power and control over another person’s reproductive health and decisions. These behaviors may include birth control sabotage, forced unprotected sex, pressure to get pregnant, or controlling the outcome of a pregnancy through threats or other means.

Depending on the setting and the population, as many as 30 percent of women will experience some form of reproductive coercion in their lifetime, with the highest rates reported among Black, Latina, and mulitracial women, young women, and poor women. Reproductive coercion also commonly occurs alongside other forms of abuse. According to one study, women in abusive relationships are five times as likely to be forced or coerced into not using a condom and eight times as likely to be pressured to become pregnant. In these relationships, women are rarely successful at preventing unintended pregnancy in the long run, which is why victims of intimate partner violence are significantly more likely to experience multiple unintended pregnancies and to seek abortion care as a result.

As pointed out in a court filing submitted on behalf of Jackson’s Women’s Health Organization, the clinic that brought the challenge to Mississippi’s law, “While this reality seems to be lost on the State and their amici, the availability of contraception means little if one cannot access it.”

But the state knows that. It knows exactly what it is doing. This has never been about contraceptive access, maternal health, or even fetal health, and it has certainly never been about protecting women and children. This has always been part of a larger movement aimed at using the levers of government to control women—and trans and nonbinary people—through force, guilt, coercion, restrictions on bodily autonomy, and, indeed, threats and violence.

Mainstream anti-abortion groups and politicians like those involved in the Mississippi abortion case often work directly with militant anti-abortion extremists and other violent organizations that are responsible for the vast majority of harassment, violence, and terrorism aimed at abortion clinics and those who enter them. Meanwhile, right-wing politicians use dog whistles and medically inaccurate, graphic language about abortion to further instill the idea that legal abortion is a violent crime deserving of punishment. Texas’s new law, which turns citizens into bounty hunters and promises a $10,000 reward for reporting anyone who aids or abets someone seeking an abortion, is an extension of that same logic.

Of course, the conservative Supreme Court justices danced around this subtext of violence. As long as they are debating safe havens and opining on the exact moment in time that a fetus becomes viable—all of which is often irrelevant to the experience of the pregnant person—they can avoid saying the thing that is too extreme even for them: They believe the government should have the power to force pregnancy on someone against their will.