It is frightening to contemplate a future that prevents people from accessing abortion, a health service that for almost fifty years has been considered constitutionally-protected. There are so many aspects of the Dobbs decision that are excruciatingly painful – including its implications for other bedrock principles of our legal system. (Read or listen to this eye-opening interview with Dahlia Lithwick for her trenchant analysis of the decision and what it reveals about the direction of the current Supreme Court.)

One of the most striking things about the decision is its failure to acknowledge that a pregnant person’s health and well-being and life itself should be considered when it comes to abortion. The landmark ruling in Roe v. Wade was about balancing the interests of the pregnant woman and the fetus. Dobbs rejects this approach and focuses only on the fetus – with no recognition that taking away the choice of abortion can result in longstanding physical and behavioral health impacts, no recognition that women have a right to control their own bodies, and certainly no recognition that in this pluralistic society, others may view the choice of abortion differently from the Supreme Court justices who signed the majority opinion.

As the other three justices recognized in their powerful dissent, “[The majority] says that from the very moment of fertilization, a woman has no rights to speak of. A State can force her to bring a pregnancy to term, even at the steepest personal and familial costs. Under those laws, a woman will have to bear her rapist’s child or a young girl her father’s—no matter if doing so will destroy her life.”

Beyond these tragic consequences, there are those who, without access to abortion, may suffer dire mental health impacts in places where abortion is illegal, and some may attempt to end their lives. It will be vitally important to provide support to individuals seeking abortion as pressure intensifies. 

The dissenting justices recognized the impact on the tens of millions who will be harmed by the Dobbs decision, especially those without the resources to travel to obtain abortions:

“Above all others, women lacking financial resources will suffer from today’s decision. After this decision, some States may block women from traveling out of State to obtain abortions, or even from receiving abortion medications from out of State. Some may criminalize efforts, including the provision of information or funding, to help women gain access to other States’ abortion services.” 

What can we do as health advocates to address a future without Roe v. Wade? Advocates around the country are developing both federal and state strategies to mitigate the impact of Dobbs, ranging from practical assistance to those seeking abortions, to longer-range strategies to pursue constitutional amendments, defend against regressive state laws, advocate for stronger legal protections in the future, and engage in voter awareness campaigns. In the private sector, some employers including many in Washington are announcing their coverage of abortions including travel assistance – but others have not.

Thankfully, in Washington state the right to access abortion is firmly established in state law.  The state’s Apple Health program that provides health coverage for low-income Washington residents covers abortions using state funds. Additionally state law establishes the fundamental right to choose abortion including parity in insurance coverage and other protections. Efforts here center on making Washington a welcoming state for patients seeking abortions – we expect a large influx from other states – and on expanding provider capacity while protecting them and their patients. 

NoHLA is part of a regional coalition of legal advocacy and grassroots organizations across the Pacific Northwest that is sharing information, making policy recommendations to the State of Washington regarding access to reproductive health and justice, and working to change the public discourse about abortion. Read these posts by our colleagues at Legal Voice and the ACLU of Washington for more information about these efforts and recommendations about what you can do. 

At the national level, President Biden signed an executive order last week focused on protecting access to abortion and care (in the very limited ways the executive branch can). The order directs the Department of Health and Human Services to take steps to:

·         protect access to abortion medications;

·         protect access to medical care for people experiencing miscarriages;

·         expand access to contraception;

·         protect patient privacy regarding reproductive health care services; and

·         ensure the safety of patients and providers of reproductive health services.

Abortion is health care. Let’s do all we can to make it accessible for all who seek it.

And Vote!