The anticipated US Supreme Court decision that is expected to overturn Roe v. Wade is about far more than just abortion, and the potential ramifications of the Dobbs v. Jackson Women’s Health Organization ruling were the subject of a School of Public Health conversation on Thursday, June 9.

Moderated by Nicole Huberfeld, Edward R. Utley Professor of Health Law at the School of Public Health, and professor of law at the School of Law, the virtual event “Roe in the Balance: The Future of Reproductive Health in the United States” drew legal and public health scholars to discuss the real-world consequences of a post-Roe America.

Huberfeld said the right to privacy does not simply protect the right to an abortion, but is a “part of a web of rights pertaining to intimate relationships in the United States,” including marriage, raising children, contraception, access to reproductive care, even in vitro fertilization.

“When we talk about the right to privacy, even though abortion gets all of the light and heat, it is actually a much broader concept than that, and I think it’s important to understand everything that’s at stake, even though we sometimes I think use abortion as a proxy for all of the different features of what the umbrella of reproductive justice covers.”

Panelist Jacqueline Ayers, senior vice president of Planned Parenthood Federation of America, said we’re already getting a preview of what a post-Roe US will look like because of the September 2021 Texas ban prohibiting abortion after six weeks gestation.

People seeking abortion healthcare are struggling to travel and cannot; it’s particularly dangerous for undocumented immigrants, Ayers said. She shared the story of a domestic violence victim who said they barely made it to a healthcare center near their home without their partner knowing, and wouldn’t be able to travel out of state for care. And providers in Massachusetts, New York, and other states where access is less restricted are becoming overwhelmed with patients from Texas.

 “We’ve seen patients with intended pregnancies who aren’t able to get care after they have had complications with that pregnancy and the fetus is no longer viable because doctors in the state of Texas right now are afraid to help,” Ayers said, adding that patients are being told to return home until they may be facing sepsis or death themselves.

The panel also included Benjamin Brown, assistant professor at the Warren Alpert Medical School at Brown University; Rebecca Hart Holder, executive director at Reproductive Equity Now, and Desireé Luckey, director of policy at URGE: Unite for Reproductive & Gender Equity.

Luckey recounted a personal story about accessing abortion care in Texas just before the September 2021 ban went into effect. Luckey said it felt like a full-time job, even for someone like her with knowledge of the system and an early positive pregnancy test due to the care she received following a sexual assault.

“The state of Texas really tried to strip me of my right to bodily autonomy and reproductive freedom.…I was fortunate to be able to overcome the many obstacles that the state put in place to harm me. But I know that’s not the reality for everyone.”

The panelists also highlighted how important it is to humanize the stories of those affected by reproductive health policy restrictions, particularly people who are already marginalized.

Brown, an attending physician practicing obstetrics and gynecology at Women & Infants Hospital of Rhode Island, described abortion bans as “definitionally unjust.”

“We know that abortion bans disproportionately harm communities that have been historically marginalized and excluded because of racism, misogyny, transphobia, homophobia, classism,” Brown said. “And so, by definition when abortion gets banned, that burden is going to be unjust because it is going to fall on folks and on communities that have historically already suffered exclusion and oppression in our health care system.”

Holder’s organization – Reproductive Equity Now – changed its name and shifted to language like reproductive equity and reproductive justice, which more broadly describes the current landscape than “choice,” which inaccurately suggests there is only one moment of choice.  

“This is not just a fight about abortion, abortion is what’s in the news right now, and it is what is being used as a political wedge issue,” Holder said. “Really it’s about the full spectrum of reproductive health care and ensuring that everyone has equitable access.”

Looking toward action, the panelists encouraged participants to donate money, get involved in policy work, and to lift up those who need help the most.   

“When we see this opinion, I hope all of you will be talking to your friends, neighbors and asking yourself, what can I do when Roe falls?” Ayer said.

Watch the full recording of Roe in the Balance: The Future of Reproductive Health in the United States.