Abortion restrictions have been on the rise since the end of 2011. In just the past few weeks, several states’ legislative chambers have passed bans on abortions after approximately six weeks gestation. Here in Ohio, the Senate passed one of these bills (Senate Bill 23), and it is now being heard in the House Health Committee. S.B. 23 is likely to pass and to be signed into law by the governor. While these laws will be challenged in the courts, they are still troubling because they ignore the evidence that abortion care is critical for public health.

According to the Centers for Disease Control, approximately 16,000 Ohioans had an abortion for a pregnancy that was at seven weeks’ gestation or later in 2015. That amounts to 78 percent of all women who had abortions in Ohio that year.

Currently, the overwhelming majority of women in Ohio can have safe abortions. If abortion were prohibited at seven weeks, who would be affected? What would happen to these 16,000 Ohioans?

I am in a unique position to consider this question because I study abortion here in the U.S., where it is legal and safe, and in Tanzania, where it is illegal and unsafe. As a result of my scholarship, I know what happens for pregnant women and families when legal abortion is not available.

When legal abortion is not available, many women still have abortions. From data compiled from across the world, we know that the frequency of abortion is similar in places that have the most restrictive laws as it is in places that have the least restrictive laws. In the most restrictive contexts, 37 out of 1,000 women have an abortion. In the least restrictive, 34 out of 1,000 women have an abortion.

If legal abortion is not available, abortions are much more likely to be unsafe, with consequences to the health and life of the pregnant woman. Abortion tends to be the safest where it has been legal for a long time. In the United States, where abortion has been legal for two generations, serious complications occur in less than one-quarter of 1 percent of pregnant women. This rate of complication is similar to colonoscopy, another common medical procedure in the United States.

In contrast, in parts of the world where abortion is not legal, 40 percent of women who have an abortion require medical attention for the complications they develop. This adds up to more than 6 million women annually who are treated for complications after unsafe abortions.

In Ohio, public health leaders are working desperately to reduce maternal mortality. Dramatically restricting abortion access in Ohio will make abortion less safe and risk increasing the number of Ohio women who have a preventable death. This in turn jeopardizes the well-being of Ohio’s families.

If legal abortion is not available, there also will be some pregnant women who will not be able to obtain abortions. The negative consequences of unintended births for children, families and communities are well-documented.

Abortions are sought for varied reasons. They are sought for maternal and fetal health and life considerations and to care for existing children. They are sought because the pregnant woman does not want to raise a child (or another child) at that time. Other times they are sought to avoid social stigma of mistimed pregnancies or loss of opportunities for education. These reasons compel many pregnant women to seek an abortion even when it may not be safe.

We rarely see pregnant women in Ohio and the United States turn to unsafe abortion, since it has been legal since 1973. As the Beacon Journal editorialized on Dec. 29, "One step forward of the past five decades, or since the Supreme Court affirmed abortion rights … involves the understanding that abortions will take place. The imperative is to ensure the procedure is safe.” Making abortion illegal does not make it go away. Where abortion is legal, it is safe. Ohio should be moving in the direction of advancing public health through preserving abortion access.

 

Norris is an associate professor in the College of Public Health and the College of Medicine at Ohio State University.