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After 100 years of considering abortion a criminal offense, Argentina underwent a major change in the legal framework on December 30, 2020, when Congress approved Law 27.610, Acceso a la Interrupción Voluntaria del Embarazo (Access to Voluntary Interruption of Pregnancy). With enactment of this law, the country transitioned from criminalization to legalization of abortion on request up to 14 weeks’ gestational age while keeping the legal indications for abortion (ie, rape or risk to life or health of the pregnant person) as before.
Every year, thousands of women and girls are denied their rights and choices by El Salvador’s total ban on abortion and its criminalization. Women and girls who are carrying an unwanted pregnancy are confronted with two options: commit a crime by terminating the pregnancy, or continue with the unwanted pregnancy. This report details the pervading cultural and institutional barriers that women and girls in El Salvador face in exercising their human rights, particularly those barriers that obstruct the realization of their sexual and reproductive rights.
This essay explores prisons as sites of reproductive injustice by focusing on barriers to abortion and safe childbirth. Published in RADICAL REPRODUCTIVE JUSTICE: Foundations, Theory, Practice, Critique, edited by Loretta J. Ross, Lynn Roberts, Erika Derkas, Whitney Peoples, and Pamela Bridgewater Toure (New York: The Feminist Press, 2017).
Early in the COVID-19 pandemic, medication abortion, which typically includes mifepristone (ie, progesterone receptor antagonist) and misoprostol (ie, prostaglandin), gained prominence because it can be provided without physical contact. The American College of Obstetricians and Gynecologists and other professional organizations quickly endorsed telehealth and no-test abortion care. These protocols omit Rh testing and use patient history, rather than routine ultrasonography, to assess pregnancy duration and screen for ectopic pregnancy risks. To mitigate potential risk of complications, US Food and Drug Administration (FDA) Risk Evaluation and Mitigation Strategy (REMS) require that mifepristone be dispensed in a medical office, clinic, or hospital, prohibiting dispensing from pharmacies. Between a federal judge’s ruling that suspended enforcement of this requirement in July 2020 and a reversal by the Supreme Court in January 2021, clinicians could offer medication abortion via telehealth and dispense from mail-order pharmacies where not prohibited by state law. During this period, a virtual clinic called Choix began providing medication abortions in California. We assessed safety and efficacy outcomes of a telehealth medication abortion model, which could inform the FDA’s decision regarding removal of the REMS.
People have always and will always find ways to try to end their pregnancies when necessary. Many do so safely without the involvement or direct supervision of healthcare professionals by self-managing their abortions. In 2022, the well-established safety and efficacy of abortion medications prompted WHO to fully endorse self-managed medication abortion as part of a comprehensive range of safe, effective options for abortion care. But despite robust evidence supporting the safety and effectiveness of the self-use of medications for abortion, abortion laws and policies around the world remain at odds with clinical evidence and with the realities of self-managed medication abortion in the present day. The present article considers legal issues related to self-managed abortion and addresses the role of obstetricians, gynecologists, and other healthcare professionals in promoting clinical and legal safety in abortion care through support of self-managed abortion.
To summarize clinical outcomes and adverse effects of medical abortion regimens consisting of mifepristone followed by buccal misoprostol in pregnancies through 70 days of gestation. We used PubMed, ClinicalTrials.gov, and reference lists from published reports to identify relevant studies published between November 2005 and January 2015 using the search terms "mifepristone and medical abortion" and "buccal and misoprostol." Studies were included if they presented clinical outcomes of medical abortion using mifepristone and buccal misoprostol through 70 days of gestation. Studies with duplicate data were excluded.
This Litigation Manual was developed by NACDL’s Criminalization of Reproductive Health Task Force to serve as a comprehensive resource to effectively litigate abortion cases. As the nation’s preeminent criminal defense bar, we are deeply committed to ensuring that the defense community is fully equipped to represent all accused persons at the highest level. This resource is restricted to defense attorneys. It is not to be used by those employed by prosecution or law enforcement organizations or otherwise involved in the prosecution of criminal cases or law enforcement. [Released Nov. 2023]
This shadow report focuses on the punishment and criminalization of individuals for abortion, stillbirths, miscarriages, and adverse pregnancy outcomes. In the U.S., human rights violations occur when states pass laws that explicitly criminalize performing abortions and when state officials misuse other laws to surveil, investigate, arrest, detain, and prosecute pregnant individuals based on the perceived impact of their actions on their pregnancy.
Pregnant people have been criminalized for their pregnancy outcomes even after Roe v Wade established some rights to reproductive autonomy. Fetal personhood theory, changing societal conceptions of motherhood, and existing racial and class-based biases have fueled an increasing and complex patchwork of punitive policies and interpretations. This study analyzed 35 well-documented cases of modern pregnancy criminalization to categorize this complicated phenomenon, seeking to clarify potential policy areas that may help address this issue more broadly. This study resulted in four categories of actions that have led to arrests and forced interventions into pregnant people’s lives: refusing medical care, substance use, personal injury, and self-managed abortion. In the shadow of the Dobbs decision, this categorization allows for clarification of which areas of policy may require targeted advocacy for the development of true reproductive justice. In addition, this study investigated several common factors in pregnancy criminalization- such as racial inequality, poverty rates, drug criminalization, etc- to determine risk factors and high-risk states.
The Supreme Court decision to overturn Roe v. Wade and the growing onslaught of state laws that criminalize abortion are part of a long history of maintaining White supremacy through reproductive control of Black and socially marginalized lives. As public health continues to recognize structural racism as a public health crisis and advances its measurement, it is imperative to explicate the connection between abortion criminalization and White supremacy. In this essay, we highlight how antiabortion policies uphold White supremacy and offer concrete strategies for addressing abortion criminalization in structural racism measures and public health research and practice.
Women experiencing incarceration have higher rates of unmet contraceptive needs and rates of abortion than the public. Incarceration presents multiple potential barriers to accessing abortion and contraception care, including prison security protocols, prison locations, lack of access to care providers, stigma, and low health literacy. The objective of this scoping review is to understand the extent and type of evidence in relation to contraception and abortion access for people experiencing criminalization and incarceration.
With abortion remaining legal in over half of the country and a proliferation of websites offering information on how to access abortion medications, for those who know where to look, there are sound options for safely ending an unwanted early-stage pregnancy. But not all patients have equal access to reliable information. This Article addresses the urgent downstream harms caused by the lack of access to abortion information, and argues that in view of these consequences, regardless of abortion’s legal status, clinicians have a duty to provide their patients with abortion information. We begin by documenting clinicians’ hesitation to share abortion information, drawing on our interviews with 25 doctors practicing medicine in a state where abortion is criminalized. Next, we explain why clinicians are duty-bound to provide all-options counseling. We then consider whether such duties shift where abortion is criminalized. After identifying the limited legal risks associated with supplying abortion information, and showing how, by requiring all-options counseling, professional societies might reduce risks to patients and clinicians, we conclude that, regardless of the legal status of abortion, clinicians have a professional responsibility to share basic abortion information – including treatment options and how to access those options.
This research brief provides preliminary findings from a multi-year research project to understand who has been targeted by criminalization for self-managing their abortion and how these cases make their way into and through the criminal system. From 2000 to 2020, we identified 61 cases of people who were criminally investigated or arrested for allegedly ending their own pregnancy or helping someone else do so. Cases occurred across 26 states, most of which emerged in Texas, followed by Ohio, Arkansas, South Carolina, and Virginia. Understanding self-managed abortion criminalization over the last twenty years, lends insight into what the criminalization of abortion is likely to look like in a post-Roe America.
In my dissertation I conduct an inquiry into the legal phenomenon of pregnancy-specific crime. I discuss my theory of pregnancy exceptionalism in US jurisprudence, explore whether these laws are applied evenly in the population, and if not, why, and ultimately ask how, when, and if the law matters in practice. In order to answer these questions, I analyze pregnancy related US Supreme Court opinions to understand the court’s interpretation of the constitution as it relates to pregnant or potentially pregnant women. Next, I conduct a systematic analysis of state bills and statutes creating pregnancy-specific crimes, with an emphasis on the prosecution of pregnant women for crimes against the fetuses they gestate. Then, I examine arrest cases of pregnant women for crimes against their fetuses in the three states where such crimes have been officially codified: South Carolina, Alabama, and Tennessee. Next, I present my analysis of interviews with prosecutors involved in developing these punitive policies, in order to understand their motivations for doing so. This project addresses the treatment of pregnant women as a separate class of person with reduced legal status. While pregnancy exceptionalism defines all pregnant women as a separate class, it is clear that some women are targeted more than others.
As a partner to the Society for Family Planning’s #WeCount effort, we created an open-access longitudinal dataset of state laws that impact abortion service delivery and access after the Dobbs v Jackson Women’s Health Organization decision. The dataset captures restrictions related to abortion bans, self-managed abortion, medication abortion, and criminal penalties, and protections such as interstate shield laws, data privacy, ballot measures, and expanded provision. The dataset also tracks litigation relevant to the impact on abortion provision. We explore state-level trends in the dataset findings, describe the study’s empirical methods, and discuss implications of an uncertain legal landscape on the quality and availability of reproductive healthcare.