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The right to an abortion can be saved

4 things we can do right now at the federal, state, and community level to protect women’s right to choose, says Harvard public health dean

An abortion-rights activist listens to speakers before a march to the White House to denounce the U.S. Supreme Court decision to end federal abortion rights protections.Probal Rashid/LightRocket via Getty Images

This is what’s egregiously wrong: In a nation that does not mandate paid family leave, a nation where it’s acceptable for states to hoard billions in federal welfare money instead of giving it to needy families, a draft U.S. Supreme Court opinion cavalierly dismisses a woman’s interest in controlling her reproductive future.

In a nation that does not guarantee universal health care, a nation that tolerates Black women dying in childbirth at the same rate as women in Uzbekistan, a U.S. Supreme Court justice declares it’s really not much of a burden to carry an unwanted pregnancy to term because some states have “safe haven” laws allowing parents to give up their newborns without repercussions.

I’m speaking, of course, of the draft opinion written by Justice Samuel Alito and apparently supported by at least five justices. If finalized, it would overturn the right to abortion. Alito says that’s justified because Roe v. Wade was “egregiously wrong from the start.”

From a public health perspective, from a humanitarian perspective, from an equity perspective, it is his opinion that is “egregiously wrong.”

Congress must immediately codify the right to abortion into federal law — a move that will likely require the U.S. Senate to lift the filibuster, as it has so far proved impossible for that deeply divided chamber to muster 60 votes to protect the right to choose.

Alito argues that Roe v. Wade has only “enflamed debate and deepened division.” What’s truly divisive is denying tens of millions of women the right to control their own bodies. Stripping pregnant people of access to fundamental healthcare. Perpetuating a dangerous history of structural violence against women. Exacerbating deep health and economic disparities, and pushing women of color farther and farther behind.

Women turned away from getting a wanted abortion are more likely to struggle afterward, according to an eye-opening study from the University of California, San Francisco. They have difficulty paying for food, housing, and transportation for years — years — after such an experience, compared with peers who were able to terminate pregnancies. Their credit scores are lower. Their debt is higher. Their children are more likely to live in poverty. They’re more likely to suffer from health problems and to experience physical violence from a male partner.

This does not sound like a prescription for healing divisions in our society.

Time to evolve

The draft opinion also approvingly cites the discredited argument that abortion has disproportionately hurt Black women by serving as a tool for eugenics. This argument implies, offensively, that Black women can’t decide for themselves whether they want to carry a pregnancy to term and are easily manipulated into seeking abortions.

Overturning Roe would disproportionately harm Black women and other women of color, widening the already gaping wealth and health gaps that cleave our society. More than 4,000 women in the U.S. die each year from cervical cancer, for example, and a disproportionate share are Black women. These deaths could largely be prevented with screening and early treatment. Yet states across the South refuse to extend Medicaid coverage, with the result that far too many Black women, poor women, and rural women do not have access to that care.

These are the same women who would be disproportionately harmed by abortion bans. Again and again, our society freezes them out, pushes them down, denies them dignity, equality, and now, bodily autonomy.

Now, the heart of Alito’s argument is his view that a right to abortion is not “deeply rooted in the Nation’s history and tradition.”

That standard is both egregious and absurd.

Here’s what else our forefathers did not see fit to embed in our nation’s foundational norms: Treating Black people as full and equal human beings. Prohibiting husbands from beating their wives to keep them in line. Allowing women to vote and hold office. Permitting individuals to express their complete, authentic selves, including allowing same-sex couples to marry.

Society evolves, thankfully. Our laws evolve as well. They have tended to evolve — thankfully — toward granting more people liberty, dignity, and equality. This decision would do the reverse.

If this draft opinion is finalized, at least 26 states are likely to ban abortion. That would make abortion illegal in huge swaths of the country: Across an entire band of the South, from Texas to South Carolina. Across much of the Midwest. And across much of the mountain West. Some legislatures are even likely to try to bar pregnant people from traveling to more permissive states. Just this spring, Missouri considered a bill that would have made it illegal to aid or abet any resident seeking an abortion, even by something as simple as sharing a list of clinics in neighboring states.

Even if the language is softened a bit, a decision upholding the cruel restrictions on abortion enacted in so many conservative states in recent years would be devastating. This ruling is humanitarian malfeasance.

The pandemic and resulting economic disruptions have been painfully hard on women around the globe. The World Economic Forum says the cause of gender equity has been set back by nearly 40 years as girls and women lose ground on education, income, political participation, bodily autonomy, and more. The U.S. is now adding fuel to that rollback.

This is just the start: Although Alito takes pains to say the ruling applies only to abortion, he caustically dismisses precedents overturning antisodomy laws and affirming the right to same-sex marriage as based on the same “right to autonomy” he eviscerates in his opinion overturning Roe. This is a dangerous path. When rights for some are abridged, rights for all are at risk.

Time to get loud

In addition to protecting abortion access with a new federal law, there’s work to do at the state level. States with progressive legislatures and governors must move quickly to protect rights within their borders.

Advocacy groups must mobilize to support women in the vast stretches of this country where abortion is likely to be banned.

And voters must work tirelessly to elect candidates who support true equality.

We must start by raising our voices now, today. And we must not stop. That’s how we begin to right this egregious wrong.

Michelle A. Williams is Dean of the Faculty at the Harvard T.H. Chan School of Public Health.