Supreme Court overturns Roe v. Wade

The Supreme Court ruled 6-3 to uphold the Mississippi law limiting abortion access in the Dobbs v. Jackson Women’s Health Organization case on Friday, overturning the precedent set by Roe v. Wade.

Specifically, the Mississippi law — the Gestational Age Act signed in 2018 — prohibits abortion after 15 weeks’ gestation, except in the case of medical emergencies. The ruling was anticipated in the wake of a majority opinion draft leaked at the beginning of May to Politico.

“Fifteen weeks is a point early in the second trimester,” Jessie Hill, JD, the associate dean for research and faculty development and a professor at the Case Western University School of Law, told Healio. “Though the overwhelming majority of patients who have abortions get the procedure before 15 weeks, there are still people who need abortions after 15 weeks. This may be because of a fetal diagnosis, which may not be known until later in pregnancy; because the person doesn't discover she's pregnant until later in pregnancy (which is particularly common with minors); or because the patient needs time to raise the funds and make work and child care arrangements, and maybe travel to access the procedure.”

According to a syllabus of the opinion, “The Constitution does not confer a right to abortion.” It also states that “Roe was egregiously wrong from the start. Its reasoning was exceptionally weak, and the decision has had damaging consequences.”

Justices Stephen Breyer, Sonia Sotomayor and Elena Kagan wrote in the dissenting opinion that the restrictions were “draconian” and that the court’s decision “says that from the very moment of fertilization, a woman has no rights to speak of.”

As Healio previously reported, the Mississippi law is not the most restrictive abortion law that has been passed recently; Texas passed a law banning abortions after 6 weeks’ gestation in September 2021. Because of so-called “trigger laws” — some of which have been in place for more than a decade — abortion will be almost entirely banned in states such as in Arkansas and South Dakota, according to CNN. Others are in the process of creating such laws.

“Some states are going beyond the 15-week limit and even beyond Texas's 6-week limit to ban abortion in all circumstances,” Hill said. “If this happens, I think we will see some people traveling out of state to access abortion and more people managing their own abortions without medical supervision. There are already online sources for obtaining abortion-inducing drugs, and this method of abortion can be safe and effective even without medical supervision. But it is only available up until about 10 or 11 weeks of pregnancy, so I think we'll see less-safe methods of self-managed abortion happening as well.”

Leading medical organizations like the American College of Physicians, the AMA and ACOG all oppose laws that restrict access to abortion care. The official policy position of ACOG, revised in May, says that “all people should have access to the full spectrum of comprehensive, evidence-based health care. Abortion is an essential component of comprehensive, evidence-based health care.”

In a statement, ACOG President Iffath A. Hoskins, MD, FACOG, said the court’s decision “is a direct blow to bodily autonomy, reproductive health, patient safety and health equity in the United States. Reversing the constitutional protection for safe, legal abortion established by the Supreme Court nearly 50 years ago exposes pregnant people to arbitrary, state-based restrictions, regulations and bans that will leave many people unable to access needed medical care.”

Hoskins vowed that the organization “will continue to support our members, our community partners and all people in the ongoing struggle against laws and regulations that violate and interfere with the patient-physician relationship and block access to essential, evidence-based health care.”  

The court’s decision forces U.S. health care providers to navigate a shifting and uncertain legal landscape. ACOG created a resource center for its members with questions about abortion and miscarriage management — from clinical topics to logistical challenges to practice management.

References:

• ACOG. Abortion policy. https://www.acog.org/clinical-information/policy-and-position-statements/statements-of-policy/2022/abortion-policy. Accessed June 22, 2022.
• ACOG. A message to the ACOG community regarding the future of abortion care and ACOG’s role. https://www.acog.org/news/news-articles/2022/05/a-message-to-the-acog-community-regarding-the-future-of-abortion-care-and-acogs-role. Published May 3, 2022. Accessed June 22, 2022.
• Gerstein J, et al. Supreme Court has voted to overturn abortion rights, draft opinion shows.
• Hines R. These 13 states have abortion ‘trigger laws’ — here’s what that means. Today. https://www.today.com/news/news/13-states-abortion-trigger-laws-roe-v-wade-overturned-rcna27268. Published May 4, 2022. Accessed June 20, 2022.
• Politico. https://www.politico.com/news/2022/05/02/supreme-court-abortion-draft-opinion-00029473. Published May 2, 2022. Accessed June 20, 2022.
• Supreme Court of the United States. Syllabus. Dobbs, State Health Officer of the Mississippi Department of Health, et al v. Jackson Women’s Health Organization et al. https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf. Accessed June 24, 2022.
• Westwood S. What to know about Dobbs, the biggest test for abortion rights in years. The Washington Examiner. https://www.washingtonexaminer.com/politics/what-to-know-about-dobbs-the-biggest-test-for-abortion-rights-in-years. Published Dec. 1, 2021. Accessed June 20, 2022.
• Wolfe E. 13 states have passed so-called ‘trigger laws,’ bans designed to go into effect if Roe v. Wade is overturned. CNN. https://www.cnn.com/2022/05/03/us/state-abortion-trigger-laws-roe-v-wade-overturned/index.html. Published May 3, 2022. Accessed June 21, 2022.