While wealthy women may have an easier time accessing abortion after the fall of Roe v. Wade, money can't protect them from medical emergencies criminalized by abortion bans

·3 min read
Abortion-rights advocates gather outside a the Kansas Statehouse to protest the Supreme Court's ruling on abortion Friday, June 24, 2022, in Topeka, Kan
Abortion-rights advocates gather outside a the Kansas Statehouse to protest the Supreme Court's ruling on abortion Friday, June 24, 2022, in Topeka, KanAP Photo/Charlie Riedel
  • Some politicians say rich women will maintain access to abortions, even in states where they're banned.

  • But where abortion is restricted, even wealth won't be able to protect patients from emergencies.

  • One in 50 pregnancies is ectopic and requires abortion to save the life of the mother, regardless of finances.

As five states implement near-total abortion bans following the fall of Roe v. Wade, politicians and abortion advocates argue the bans disproportionately impact low-income women and suggest wealthy people will be able to skirt restrictions with ease.

"If an extremist Supreme Court overturns Roe, wealthy women will still get safe abortions — by traveling to another state or country," Democratic Senator Elizabeth Warren tweeted in May. "But women of color, those with lower-incomes, and victims of abuse will suffer the most. Congress must eliminate the filibuster and protect Roe."

While abortion will be easier to access for those with the funds to travel across state lines or ship medication across the country, even the rich will not be protected against medical emergencies that require abortion and are being limited in states like Missouri and Arkansas.

The statutory language in the Missouri abortion ban, for example, is "incredibly narrow," Lisa Larson-Bunnell, a Kansas City area health care regulatory attorney, told the St. Louis Post-Dispatch, and has doctors worried that they won't be legally able to intervene in a medical emergency requiring an abortion until a pregnant woman is close to certain death.

"This is a really serious issue," Larson-Bunnell told the St. Louis Post-Dispatch. "This is something that physicians and attorneys all throughout the state are trying to wrap their minds around."

Ectopic pregnancies, which occur when a fertilized egg implants outside the uterus, are a leading cause of maternal mortality in the first trimester. Nearly 2% of pregnancies — or 1 in 50 — are ectopic, according to statistics published by American Family Physician and in virtually all cases, the embryo will not survive past the first trimester. Such pregnancies are emergencies that require an abortion to save the life of the mother and delaying treatment may result in sepsis or other internal infection and death.

Similarly, placental abruptions are a time-sensitive medical emergency wherein the placenta separates from the wall of the uterus before birth. To avoid extensive bleeding, kidney failure, and possible death, medical treatment — sometimes including abortion — must be administered immediately.

Regardless of the wealth of a patient or their ability to finance an out-of-state trip for an abortion, such medical emergencies will impact women across the country. And, as physicians are required to navigate the legal logistics of determining whether a patient meets the criteria for a medical exemption, the lives of their patients are at significant risk.

"It's very frightening and confusing for physicians and the whole team that cares for patients to know, what can we do, what is OK and what's not OK?" Dr. Lisa Harris, an ob-gyn and professor at the University of Michigan, told NPR.

"How imminent must death be? There are many conditions that people have that when they become pregnant, they're OK in early pregnancy, but as pregnancy progresses, it puts enormous stress on all of the body's organ systems – the heart, the lungs, the kidneys. So they may be fine right now – there's no life-threatening emergency now – but three or four or five months from now, they may have life-threatening consequences."

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