On June 24, 2022, the Supreme Court issued its ruling in Dobbs v. Jackson Women’s Health Organization. This ruling overturned decades of legal precedent, including Roe v. Wade and Planned Parenthood v. Casey and asserted that Americans did not have the right to have an abortion. Unsurprisingly, many states immediately moved to impose abortion restrictions and outright bans; the state where I live immediately triggered a 19th century law that essentially banned all abortion within our borders. Understanding the impacts of Dobbs is a complex task that I suspect that scholars will be engaged in for decades to come.
Yet, the media (and I would argue) maternal and child health researchers, advocates, and funders tend to emphasize a very narrow understanding of why these abortion bans matter. Many advocates and policymakers share stories almost exclusively from people who experienced miscarriages or non-viable (but much wanted) pregnancies but were turned away from multiple emergency rooms or physicians’ offices. Researchers have written countless peer-reviewed articles about the potential impacts of Dobbs on birth outcomes and pregnancy-related morbidity and mortality. The problem? Focusing primarily on these narratives falls into the anti-abortion trap of reducing pregnant people’s value to their roles as gestational incubators and birthing parents/mothers rather than humans who deserve the right to bodily autonomy.
To be sure, pregnancy loss is common. Estimates suggest that about 15 percent of all pregnancies end in miscarriage, though the true occurrence is almost certainly far higher because most people manage pregnancy loss outside of clinical settings. Yet, some of these people experiencing pregnancy loss will need abortion care. We also know clinicians practicing in states with heavy abortion restrictions express uncertainty and fear about whether they would be criminally liable for providing abortions. Thus, they sometimes choose not to do so (or more importantly, hospital systems prevent them from doing so) at great cost to pregnant people experiencing pregnancy loss.
Researchers’ concerns about the potential impacts of abortion restrictions on birth and pregnancy-related outcomes are not misplaced. After the passage of SB8 in Texas in 2021, infant mortality rates dramatically increased, as did sepsis rates among people who experienced 2nd trimester pregnancy losses. After Dobbs, we learned about the tragic case of Amber Nicole Thurman, a 28-year old Georgia resident who died of septic shock in 2024 after clinicians refused to provide her with timely care after an incomplete abortion. The Trump administration’s decision to undermine Biden-era directives that obligated physicians to provide abortion care for individuals experiencing a medical emergency will likely create more such tragedies.
While these birth- and pregnancy-related outcomes are devastating, focusing on them misses the larger point. We should care about abortion restrictions primarily because they represent a fundamental violation of a person’s bodily autonomy. When we frame abortion bans primarily as a threat to infant health or pregnancy-related morbidity and mortality, we unconsciously asset that birthing people’s value lies in their ability to remain healthy enough to parent. Frankly, there is not a lot of daylight between this viewpoint and many anti-abortion stances.
Further, we know that abortion restrictions affect people’s lives in countless ways. The Turnaway Study, for example, examined the impacts of being denied a wanted abortion on (cisgender) women’s lives. The results were stunning: women were unable to obtain a wanted abortion were more likely to experience increases in household poverty, be unable to have enough money for basic living expenses, and stay in contact with a violent partner. (And they were more likely to have worse health outcomes overall.)
If the interest and participation in the 250-member AcademyHealth post-Dobbs research community is any indication, there is a new generation of researchers that is incredibly excited about applying their skills to understanding abortion. But our community will soon hold our final scheduled event, with funding constraints complicating our ability to plan for future convenings and support the career development of this pivotal segment of the health services research workforce. Will these young scholars interested in birth equity and bodily autonomy feel welcome outside of our community in maternal and child health research spaces? Or will they feel marginalized?
Science will always reflect our underlying values and assumptions. This includes the questions that researchers ask and the projects that funders choose to support. As my year as an AcademyHealth Senior Scholar in Residence concludes, I would ask that every funder and scientist in the maternal and child health space treat the human right to bodily autonomy as central to their science and their mission.
The opinions expressed in this blog post are the author's own and do not necessarily reflect the view of AcademyHealth or of their respective affiliated employers/organizations.
This post has been authored by one of AcademyHealth’s Reproductive Health Senior Scholars in Residence, Dr. Tiffany Green, who provides thought leadership on reproductive health issues within the health services research field and provides expert guidance to the Research Community on the Equity Impacts of Dobbs.