What would happen to women if the U.S. Supreme Court overturned Roe v. Wade?
For years, the question was more of a rallying cry than an imminent possibility. But on Wednesday, after Justice Anthony Kennedy announced his plans to retire from the bench, the question became a lot less rhetorical. Kennedy, in his 30 years on the bench, frequently provided the swing vote that prevented the court from overturning the 1973 decision that established a right to abortion. And President Donald Trump is expected to nominate a surefire opponent of Roe in his place.
The potential impact of overturning the right to abortion is not a big mystery.
Already today the cost and difficulty of obtaining an abortion in a clinic are forcing an unknown number of women to get the procedure elsewhere. One recent study estimated that up to 4.1 percent of Texas women of reproductive age, at least 100,000 or up to 240,000, have at some point in their lives tried to self-induce an abortion. Multiple abortion providers have recounted to reporters how recent patients have tried to perform abortions on themselves. Amy Hagstrom Miller, who operates several abortion clinics in Texas, where the procedure is highly restricted, said patients frequently call her staff to ask for instructions on how to perform their own abortion. “When we tell them we can’t, they say, ‘How about if I tell you what’s in my medicine cabinet and under the sink?’” she has said. Renee Chelian, an abortion provider in Michigan, says her clinic treated a woman who tried to open her cervix with a sharp object.
In 2015, Women on Web, a group that mails abortion-inducing medication to women in countries where the procedure is illegal (so not, currently, the United States), received more than 600 requests for the medication from women in the U.S. Dozens of the women indicated they could not afford an abortion in a clinic. Many said they feared that their abusive husbands, boyfriends or exes would hurt them if they found out they were pregnant or would use the pregnancy to stay in their lives. One woman became pregnant from being raped, but her government-provided insurance refused to pay for a termination because she’d never called the police.
Some letter writers were minors whose parents were preventing them from having an abortion. Two women lived on the Big Island in Hawaii, a place of roughly 180,000 where there is no abortion clinic. Several indicated that without the help of Women on Web, they would keep Googling. All of them were willing to take matters into their own hands.
A Supreme Court that was suddenly much more favorable toward abortion restrictions could set the stage for cases like these to become much more common. Roughly a third of states have laws on the books that would or could outlaw abortion the moment Roe is no longer the law of the land. Short of overturning Roe, the court could greenlight attempts to restrict abortion much earlier than is currently legal or permit regulations intended to make it impossible for abortion clinics to operate.
What’s gotten lost in the history is how many women died trying to give themselves abortions.
Renee Chelian, an abortion provider
Researchers are still not clear which anti-abortion laws, precisely, drive women to attempt their own abortions. But in the past seven years, states have enacted more than 400 restrictions on abortion ― so many that some states have begun to replicate the difficulties of obtaining an abortion in a pre-Roe era. Some of those restrictions have forced clinics to close ― one in five women now lives 43 miles from the nearest abortion clinic ― while others make abortion more costly or time-intensive for the patient. Some of the journeys women have taken in the shadow of these restrictions are daunting. A Texas nonprofit that funds abortion travel reported arranging trips of 350, 600 and even 800 miles.
Abortion providers and researchers have begun to see evidence that, alongside these new restrictions, the number of women who attempt their own abortions is growing. Seth Stephens-Davidowitz, an economist who analyzes Google searches, found that online searches about self-induced abortion almost doubled from 2008 to 2011, when the economy got worse and many new abortion restrictions were taking effect. Many of them were seeking online places to buy the abortion pill, which is vastly safer than the coat hanger in theory; in practice, it can be difficult for women to know how to use the medication properly and impossible to tell if they’ve purchased the real product.
And there’s evidence that laws which drastically increase the distance between a woman and her nearest provider by closing clinics reduce the number of legal abortions. This was precisely the type of law the Supreme Court declared unconstitutional in 2016 when Kennedy cast the deciding vote against a set of clinic restrictions in Texas.
Self-induced abortion is in a murky legal area. More than 20 women have been jailed or prosecuted for attempting to induce their own abortions since Roe.
But there are still sobering parallels between today, when abortion rights are being squeezed, and the 1970s, when abortion was only legal ― or in the immediate aftermath of Roe, only available ― in a handful of places. One of Louisiana’s only remaining abortion providers recalls how he was galvanized to start offering abortions because, as a medical student, he saw so many women harm themselves by trying to self-induce. Many of the women tried using turpentine, either by injecting it or attempting to place it in their wombs.
In 2016, a reproductive rights activist reported that her group prevented a woman from trying to cause an abortion by drinking turpentine with sugar.
“What’s gotten lost in the history is how many women died trying to give themselves abortions,” Chelian has said. Several years ago, she asked a group of college freshmen what they would do if abortion became illegal again. A woman replied, “We’d use a coat hanger, like our grandmothers did.”
CORRECTION: A previous version of this story indicated that according to a recent study, up to 4.1 percent of Texas women, or 100,000, have at some point in their lives tried to self-induce an abortion. That figure is 4.1 percent of Texas women of reproductive age, or 100,000 or up to 240,000.