July 6, 2022

One in four women in the U.S. have had an abortion by age 45 according to a study by the Guttmacher Institute, which is based in New York. Nearly two thirds of those undergoing the procedure already have one child. Four percent are below the age of 18.

In 2020, nearly one million American women had abortions at medical clinics for a variety of reasons including medical harm, financial inability to support a child, unwanted pregnancy, rape and incest.

The actual number of American women undergoing abortion each year is likely far higher since all self-managed abortions are likely to not be reported to the clinics. In this medication-based procedure, which currently account for more than half of all abortions, some women take mifepristone and misoprostol to end their pregnancies in the privacy of their homes. These abortion pills are “safe and effective” even beyond the first ten weeks of pregnancy, for which their use has been approved by the Food and Drug Administration, according to the Guttmacher Institute.

In some states, patients can get the pills at a clinic or through the mail. The mail option is useful for patients having to deal with the logistics and costs of child care, time off work and transportation costs, especially in rural or other areas underserved by clinics.  

In the two weeks since the U.S. Supreme Court decision to overturn a woman’s constitutional right to abortion, nine states, including Texas, Ohio and Missouri, have banned all abortions including cases of rape or incest, unless necessary to save the life of the woman or those after six weeks of pregnancy. Similar bans will take effect in four more states in the coming weeks.

Overall, it is anticipated that all 26 states with Republican Party majorities are likely to ban abortions in the near future. These states are home to 40 million American women, including 58% who are of reproductive age in the country.

In many states that have or will ban abortions, any termination of pregnancy, after the first few weeks, can be investigated as a crime. The U.S. is entering an era “of widespread state surveillance and criminalization” of anyone - pregnant women, doctors, pharmacists, clinic staffers, volunteers, friends and family members – “who comes into meaningful contact with a pregnancy that does not end in a healthy birth,” notes The New Yorker. 

Abortion is legal in mostly Democratic run states including California and the western states, New York and the states in the Northeast and in Colorado and Miinnesota. Apple, Amazon, JP Morgan, Disney and other companies have said they will cover the travel costs for employees in states where abortion is illegal so they can terminate pregnancies in states where it is legal. This is helpful for the women working at these companies, who typically earn high incomes.  

However, three out of four women in the U.S. who seek abortions have incomes below $25,000 a year. The bans will prevent most such women with low-income from getting the procedure since they may not have the funds for travel and lodging in a state where abortion remains legal.

In some states, patients can get the abortion pills at a clinic or through the mail. The mail option is useful for patients having to deal with the logistics and costs of child care, time off work and transportation costs, especially in rural or other areas underserved by clinics. More states though are planning to follow Louisiana, where it is a criminal offense, with a six-month prison sentence, to mail abortion pills to a resident in the state.  

In states that have banned abortions, some women may desperately seek to end their pregnancies using unsafe procedures, risking medical injury and even death. Other women in those states, who have the funds, have to travel to a state where abortion is legal, have a medical consultation and then receive the pills in that state. Often, given the trauma of trying to end a pregnancy, she will also need the support from a family member or friend to travel to another state. Time and expenses for travel will become even more difficult as the number and location of states banning abortion increases, making the distance of travel from an abortion-banning to an abortion- providing state even greater.

Abortion clinics and activists and pro-abortion groups in the states where abortion is legal are raising funds to finance the travel and lodging for women seeking abortion in the states that have banned the procedure. They are also expanding clinical facilities to handle an inflow of pregnant women from the states where abortion is banned.

Among the activists is Meera Shah, 38-years-old, who is the Chief Medical Officer for Planned Parenthood Hudson Peconic in New York and the national medical spokesperson of the Planned Parenthood Federation of America. She provides abortions as well as prenatal and sexual and reproductive healthcare. "What we're really trying to do is prepare for this uptick in patients here in New York," she told American Kahani.  

Founded in 1916, Planned Parenthood has a national network of more than 600 health centers operated by affiliates. The centers provide preventive care, including birth control, testing and treatment for sexually transmitted infections, and screenings for cervical and other cancers. 

Shah joined Planned Parenthood in 2018; earlier, from 2015, she was a family physician at the Callen-Lorde Community Health Center in New York, and resident doctor at the Mt. Sinai Health System, New York, from 2012 to 2015. 

In 2020, Shah publshied You’re the Only One I’ve Told: The Stories Behind Abortion. In the book, Shah seeks to humanize abortion and to combat myths that persist in the discourse that surrounds it.

Shah grew up in in Rock Hill, South Carolina raised by conservative Jain parents, migrants from India. While choosing a different medical specialization than her father, she grew up inspired by his “unparalleled work ethic and his genuine desire to help those in need. Supporting people and helping them exercise their autonomy is ethical, and the right thing to do.”

She holds an MPH from Columbia University, 2018; a medical degree from George Washington University, 2012; an MS in Nutrition from Columbia in 2008; and a BS from University of North Carolina, Chapel Hill, 2006.

Public support for legal abortion was high before the Supreme Court’s June 24 decision and continues to remain high - about 62% saying it should be legal in all or most cases, as reported by Pew Research Center..More than two thirds of Americans say the decision to have an abortion should be left to the woman and her doctor, rather than the government, according to a Reuters/Ipsos poll last month before the Supreme Court decision.

Abortion rights groups are hoping that anger over the ban will lead more women to vote for Democrats in the November mid-term elections for the U.S. Congress and state legislatures. The hope is that the Democrats will pass new laws to make abortion legal again.

Yet, inflation – experienced every day while purchasing food items and gasoline for cars - is the most or second most important political issue for 62% of Americans, according to the latest Harvard Harris poll. Abortion rights is most important to only a quarter of the population.    

During her work, Shah faces anti-abortion protestors as well as risk of physical harm. From 1977 to 2000, eleven staff members working at abortion clinics have been killed and there were murder attempts on an additional 26 people.  

Married to Bart Consedine, a software developer, Shah wants children of her own someday. At the same time, she told a reporter, she feels strongly that pregnant women have the right to make decisions about their bodies.

For access to stories each week, follow on: LINKEDIN or TWITTER or FACEBOOK