As an independent health-driven nonprofit, MedShadow’s mission is to ensure that all people have information on the risks and benefits of medicines and treatments, so they can make the best health care choices for themselves and their families. Separate from any personal, political or religious beliefs, the ruling from the Supreme Court on June 24, 2022 overturning Roe v. Wade has far-reaching health implications.
MedShadow considers pregnancy and abortion solely from the perspective of health care. Pregnancy is not a benign process. It changes every system in the body from circulatory (the amount of blood in your body increases by 45%) to digestive (constipation is a common side effect). It changes the pace at which your body absorbs nutrients and medicines. It causes a dramatic weight gain and subsequent loss of 30 or more pounds within a year. Hormones are strongly affected: estrogen surges during the first trimester of pregnancy, progesterone increases and stays high throughout. Estrogen and progesterone both drop dramatically at birth; oxytocin increases at birth for a day or two; and prolactin escalates to allow the body to produce breast milk.
Those undergoing pregnancy and birth need and deserve prenatal and postnatal medical care, along with the time to go to medical appointments and access to high-quality nutrition. These resources are not available to many women in our country.
Radical Change in an Instant
A Supreme Court ruling immediately becomes the law. In an instant on June 24, women and men in 11 states lost their health care option to seek an abortion for themselves and partners. Subsequent state-law changes are expected to severely restrict access to abortion in 15 more states, making abortion difficult or impossible to obtain in more than half of America.
This set of changes will especially affect women who have limited ability to relocate, travel or take time away from home and work to have an abortion. Once again, the heaviest burden will be on poor, marginalized, and women of color. Black women are three times more likely to die in pregnancy than white women in America.
Many women will continue to seek abortions in states which have made abortions illegal, because the underlying causes for them have not been addressed. The reasons could be societal: the financial inability to care for (another) child; a lack of a mate or family and emotional support to aid in raising a child; a pregnancy conceived in violence. In such a case, having the child may threaten the mother’s mental well-being as well as the child’s.
Reluctance to remain pregnant could be based on health concerns: they might be experiencing an ectopic pregnancy or carrying a fetus that is severely compromised; their own medical conditions might put them at even higher than normal risk for complications and mortality; they may need to continue taking medicines that are not proven safe for a fetus.
Medical Solutions to Pregnancy
Some observers claim that the Supreme Court ruling will cause America to go back to the bad old days when women were forced into self-mutilation to end a pregnancy. Fortunately, there are much safer alternatives today. Medical solutions are widely available. The so-called “abortion pill” is a combination of two pills, mifespristone and misoprostol, taken hours apart. Then there’s the “morning-after pill.” After unprotected sex or potentiallly ineffective birth control, there are two such medical solutions on the market. One is the over-the-counter levonorgestrel, which goes by the trade names Plan B, One Step, Take Action, My Way, Option 2, Preventeza, AfterPill, My Choice, Aftera, EContra and many others, which are available by mail and at stores. Another “morning-after pill,” called Ella (ulipristal acetate), requires a prescription. Women need to see a doctor after taking either of these treatments to ensure that the process is safely completed. Health care cannot stop.
Although game-changers, none of these solutions are magic pills, and they must be taken according to a schedule to be effective. As in many such situations when the stakes are high, there is room for fraud: there are those who will sell cheap or fake versions that may not be safe.
There will be women who will not be able to afford medicines or may not have the knowledge to seek them out. They might turn to taking herbs, falling down stairs and other self-harm efforts to induce a miscarriage.
Fear and Uncertainty
There may be damage to the relationship between patient and doctor. Will some states require doctors to question if a miscarriage was induced or came on naturally? Will the law stifle a doctor’s ability to give full and honest health advice to their patients? Where will a woman access the full knowledge of the risks of continuing a pregnancy, the risks of ending one? Will women avoid needed medical care out of fear of criminal charges? If a woman arrives in the emergency room with signs of a miscarriage, will doctors, fearing prosecution, fail to give her the care she needs? Will doctors be required to report suspected cases of self-managed abortions?
No one can answer these questions today, but MedShadow will continue to ask them and to give you the information you need on the risks and benefits of medicines and their alternatives. Last week, we published an article on the side effects of the abortion pill. A few days later, we published an article on the morning-after pill. We will update our existing contraceptive articles. And we will continue to report on what little is known about which meds are safe in pregnancy and which are not.
Your health is our mission. We remain committed to publish articles that bring you the facts and address the health issues you face every day – – unbiased and unbought by any pharmaceutical or political funding or influence. Thank you for your trust.
The article may or may not reflect the views of the editorial staff of MedShadow, the MedShadow Medical Advisory Board or the MedShadow Foundation Board.