A recent analysis conducted by NBC News conducted with the non-profit Gender Equity Policy Institute (GEPI) has found that the rate of pregnant women dying in Texas has risen dramatically since the abortion ban went into effect. They wrote, “From 2019 to 2022, the rate of maternal mortality cases in Texas rose 56 percent, compared with just 11 percent nationwide during the same period.”
Nancy L. Cohen, president of GEPI, said, “There’s only one explanation for this staggering difference in maternal mortality. All the research points to Texas’ abortion ban as the primary driver of this alarming increase. Texas, I fear, is a harbinger of what’s to come in other states.”
Presently, 14 states have a total ban on abortion, including Texas. Four other states, Florida, Georgia, South Carolina and Iowa have a six-week ban from a woman’s last menstrual period (LMP), which means that by the time a pregnancy has been confirmed and an abortion is sought, the allowed time has expired. Nebraska and North Carolina have a 12-week LMP ban in effect.
As the Guttmacher Institute, a research and policy NGO that aims to improve sexual health and expand reproductive rights worldwide, has found, the number of brick-and-mortar clinics providing abortion care in the US has declined 5 percent—from 807 to 765 or a loss of 42 clinics—between 2020 and 2024.
Much of the decline occurred in states where total bans have gone into effect. Yet, in the same period, the demand for abortions has risen 11 percent to a national total of just over 1 million. For states that offer legal abortions like Colorado, where the number of clinics has remained unchanged, the number of abortions they are performing has increased by 88 percent (an increase of almost 12,000). New Mexico has doubled its clinics from six to 13, but the number of abortions rose by 256 percent or an increase of 15,000. In Kansas, the number of clinics has increased from four to six, but rates of abortion performed rose by 152 percent or an increase of 12,440.
It is worth noting that in states that have instituted a total ban on abortion, there were only 63 abortion clinics in 2020, before the Supreme Court decision in Dobbs, underscoring efforts over the last several decades to subvert women’s democratic rights to abortions.
Out-of-state abortions have risen from 9 to 17 percent as more women seek such treatments where they remain legal. Yet, due to logistical complexities, these patients are also arriving at these clinics later in their pregnancy, when complication rates are higher and health risks grow exponentially. Furthermore, these efforts require tremendous economic resources and work schedules that allow those that can afford an abortion to obtain it. More than half of women seeking an abortion paid out of pocket. The class dimensions of the abortion bans cannot be ignored.
Meanwhile, physicians who provide obstetric and gynecologic care in the states with draconian bans in place are finding it difficult to protect the life and well-being of their pregnant patients with medical complications or significant health issues. On the one hand they have a duty to their profession to care for their patients, but on the other, they face the threat of criminal prosecution and severe fines if they proceed with delivering lifesaving treatments.
Dr. Nisha Verma, a consultant for the American College of Obstetricians and Gynecologists and an Ob-Gyn in Georgia, speaking to Politico, said, “There’s not a line in the sand where someone goes from being totally fine to actively dying. It’s a continuum and it’s often unclear when in that continuum we can intervene. … I know how to decide with my patient at that moment, taking in their specific situation, but what does the attorney general, or some politicians intend?”
Dr. Caitlin Gustafson, an Ob-Gyn in Idaho, explained, “If you make standard medical care a crime when folks in all kinds of difficult medical situations present, especially in emergency situations, we are always going to see some type of delay. Because [it has] criminalized care, physicians are going to naturally hesitate.”
The recent news report in ProPublica of two black Georgia women whose tortured deaths from septic abortion, both preventable had appropriate and timely care been administered, underscore the barbarism and cruelty of these medieval laws. Both capitalist parties share responsibility for these conditions, despite Vice President Kamala Harris’s posturing as a defender of abortion rights.
Under the Biden administration, maternal mortality in 2021 had peaked at 32.9 deaths per 100,000, more than 60 percent above 2019, just before the COVID pandemic. Much of the maternal mortality was attributable to deaths from COVID and the impact of drug overdose. However, in 2022, maternal deaths continue to outpace their pre-pandemic rates up 28 percent from 2018 when rates were at 17.4 per 100,000 nationally. Currently, they stand at 22.3 per 100,000, one of the highest rates among high-income countries.
As the World Socialist Web Site wrote on July 1, 2022, the repealing of Roe v. Wade, “Having done nothing for decades to codify the now-overturned constitutional right to abortion or stop the packing of the Supreme Court with far-right Republicans, the Democrats are seeking to exploit the court’s devastating attack on democratic rights and women’s health to hustle votes for the November congressional elections.” And now Harris is hustling to win the votes in this year’s presidential elections.
One year after the Supreme Court’s abolition of the constitutional right to abortion, the WSWS said then:
The Democratic Party is concerned not for the democratic rights of the people, but for the collapse in public confidence in the cabal of unelected and unaccountable justices, appointed for life terms, who have served for more than two centuries as enforcers of capitalist rule.
The assault on democratic rights cannot be separated from the vicious, bipartisan attacks on social programs, record levels of social inequality and unending war. The irreconcilable conflict between the working class and the ruling elite is what underlies the turn to dictatorship. The Democratic Party, which is spearheading the US-NATO war against Russia over Ukraine, is not opposed to, but rather part of this process.
Roe v. Wade has long served as the signal achievement of American bourgeois liberalism under conditions of the unwinding of all previous social reforms. Now its demise will fuel the awareness within the working class, being driven into mass struggles, that it must defend democratic rights by mobilizing its great social power to put an end to capitalist rule and establish socialism.
Returning to the impact of the abortion bans in Texas, the jump in maternal mortality has only confirmed concerns raised by clinicians and epidemiologists that these abortion bans would fuel a surge in maternal deaths. And the association between states that have had bans and restrictions in place and higher maternal mortality has been known for some time as the figure below annotates this relationship.
It also raises to the fore the important construct that it is class and not race that is at the heart of the maternal mortality crisis in the US that has privatized and economized healthcare to the detriment of its population.
When the maternal mortality figures are analyzed by their racial category, while blacks/African Americans saw these figures rise from 31.6 in 2019 to 43.6 per 100,000 in 2022, and for Hispanics 14.5 to 18.9 per 100,000, for whites it jumped the most, from 20 to 39.1 per 100,000, or almost doubled. Essentially white maternal deaths are on par with blacks. This only confirms that not race but class is the fundamental division in society.
As the dissenting justices, Kenji Brown Jackson, Sonia Sotomayor and Elena Kagan wrote in their opinion on June 24, 2022, on Dobbs v. Jackson Women’s Health Organization, “Some women, especially women of means, will find ways around the State’s assertion of power. Others—those without money or childcare or the ability to take time off from work—will not be so fortunate.”
The Center for American Progress said at the time, “While denial of the right to an abortion has nationwide consequences, the effects on women and families’ economic security will be particularly devastating in the 27 states that have at least one abortion ban on the books. Many of these states already have some of the worst economic and health outcomes for women and families across the country.”
These include:
None guarantee paid family and medical leave.
Eighteen have gender wage gaps above the national average.
Twenty-two have poverty rates for women above the national average.
Seventeen have poverty rates for children above the national average.
Nineteen have not extended Medicaid coverage to 12 months postpartum.
Only four legally require insurers to cover an extended supply of contraceptives.
Lack of access to abortions causes well-known harm to women financially. Women who are forced to carry a pregnancy to term against their will face consequences that include lower credit scores, increased debt and higher rates of bankruptcies and evictions. As for their children, they can expect worse developmental outcomes and greater chance of languishing in poverty. Many of these women find themselves pushed out of the labor force and relying on low-paying jobs. These same states with abortion ban in place also promote inadequate workplace protections and make a hostile place for women and their families to thrive, let alone survive.
The right to paid, safe and legal abortion is a fundamental democratic right of women. However, it is a social issue that impacts all society for which neither of the two parties of imperialism hell-bent on war have the stomach or good-will to address. However, it is also the first volley in the attack on democratic rights that have far-reaching implications.
As the WSWS noted at the time of the repeal:
The decision is the opening salvo in an historically unprecedented attack by the ruling class on all democratic rights. The concurring opinion by Clarence Thomas announces that the court will now begin to revisit all prior cases in which the Supreme Court protected the substantive due process rights of the population. “In future cases,” Thomas wrote, “we should reconsider all of this Court’s substantive due process precedents, including Griswold, Lawrence, and Obergefell.” These decisions, respectively, protected the right to contraceptives, overturned laws criminalizing sodomy, and legalized same-sex marriage.