abortion essay filipino

Unintended Pregnancy and Unsafe Abortion in the Philippines: Context and Consequences

Despite advances in reproductive health law, many Filipino women experience unintended pregnancies, and because abortion is highly stigmatized in the country, many who seek abortion undergo unsafe procedures. This report provides a summary of reproductive health indicators in the Philippines—in particular, levels of contraceptive use, unplanned pregnancy and unsafe abortion—and describes the sociopolitical context in which services are provided, the consequences of unintended pregnancy and unsafe abortion, and recommendations for improving access to reproductive health services. In addition to reading this report, you can also explore its  supporting resources .

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• Many women in the Philippines are unable to achieve their desired family size, and have more children than they want. Unintended pregnancy is common, in part because of the high unmet need for contraception.

• The Philippine government has made efforts to improve access to contraceptive services, but abortion is illegal under all circumstances and is thus highly stigmatized. Nonetheless, abortion is common, but is often performed in unsanitary conditions and using outdated techniques.

• Unsafe abortion carries significant risks for Filipino women: About 1,000 die each year from abortion complications, which contributes to the nation’s high maternal mortality ratio. Tens of thousands of women are hospitalized each year for complications from unsafe abortion.

• Poor women, rural women and young women are particularly likely to experience unintended pregnancy and to seek abortion under unsafe conditions.

• Because of the risks of unsafe abortion, many women need postabortion care, but they face barriers in obtaining such care, including the stigma around abortion and the high cost of medical care.

• Policymakers and government agencies should educate the public about contraception, ensure adequate funding for contraceptive services and eliminate barriers to obtaining methods, particularly among disadvantaged populations. To help destigmatize postabortion care, the government should train more providers in the use of safer and less invasive methods of care.

The Philippines, with a steadily increasing population that is approaching 100 million, faces significant challenges in the area of reproductive health. 1 About 25 million of its citizens are women of reproductive age, and they experience high levels of unintended pregnancy, have relatively low levels of contraceptive use, and frequently experience unsafe abortion and consequently high levels of mortality and morbidity. 2–4 This report summarizes existing evidence on the context and consequences of unintended pregnancy and unsafe abortion in the Philippines—particularly among vulnerable populations such as poor, rural and young women—and highlights key areas in which policymakers and reproductive health advocates can focus efforts to improve the health and well-being of Filipino women and their families.

Access to services is opposed by influential groups

Women’s access to reproductive health services faces challenges or outright opposition from various—often powerful—segments of Filipino society. While contraception is legal in the Philippines, until mounting pressure to reduce maternal mortality and morbidity and to combat poverty in the country arose in recent years, the government had shown only weak support for access to modern contraceptives. 5 Since 1971, much of the free contraceptive supply had been funded by the U.S. Agency for International Development (USAID) and other international donors, but in 2008 USAID discontinued its support to encourage the Philippine government to become self-reliant. 6 Local bans on contraceptives—such as the mayor of Manila’s executive order in 2000 to remove contraceptives from public clinics, and the 2001 ban by the Department of Health on the emergency contraceptive Postinor—created yet more barriers to access, and particularly affected poor women who rely on public services. 7

In the Philippines, the Catholic Church hierarchy wields strong influence on society and on government officials. The church not only condemns abortion, but forbids the use of modern contraceptives. 6 Despite this opposition, recent legislative developments have been supportive of reproductive health. 5 In contrast to former president Gloria Macapagal Arroyo, who opposed public provision of modern contraceptives in favor of promoting natural methods approved by the Vatican, the current president, Benigno S. Aquino III, endorsed the highly debated Responsible Parenthood and Reproductive Health Act of 2012 (commonly known as the Reproductive Health Law), 8 which provides modern contraceptive services, counseling and sex education, particularly for rural and poor Filipinos. 9 This policy was (and still is) strongly opposed by the church hierarchy; however, it is generally supported by the Philippine public. In December 2012, lawmakers passed the bill and President Aquino signed it into law. As of early 2013, implementation of the law was delayed by the Philippines Supreme Court. Nonetheless, passage of the bill represents a historic milestone.

In contrast to the liberalizing trend in contraceptive policy, the Philippines’ abortion law is among the strictest in the world. Abortion remains illegal in the Philippines under all circumstances and is highly stigmatized. While a liberal interpretation of the law could exempt abortion provision from criminal liability when done to save the woman’s life, there are no such explicit provisions. 5,10–12 There are also no explicit exceptions to allow abortion in cases of rape, incest or fetal impairment. The Penal Code considers abortion to be a criminal offense punishable by up to six years in prison for doctors and midwives who perform abortions and by 2‒6 years in prison for women who undergo the procedure, regardless of the reason. A separate set of laws under the Midwifery Act, Medical Act and Pharmaceutical Act permit the revocation or suspension of the licenses of any practitioner who performs abortions or provides abortifacients.

Unmet need is widespread and unintended pregnancy is common

In 2008, there were 1.9 million unintended pregnancies in the Philippines, resulting in two main outcomes—unplanned births and unsafe abortions. 13 In the Philippines, 37% of all births are either not wanted at the time of pregnancy (mistimed) or entirely unwanted (Table 1), 3 and 54% of all pregnancies are unintended. 13 On average, Filipino women give birth to more children than they want (3.3 vs. 2.4 children—Figure 1), highlighting how difficult it is for a woman to meet her fertility desires. This is particularly striking among the poorest Filipino women, who have nearly two children more than they intend to have (5.2 vs. 3.3 children).

Among married women using any method of contraception in 2011, one in four used a traditional, less effective method such as periodic abstinence. 14 Though married women showed a modest increase in modern method use between 1998 and 2011 (from 28% to 37%), this latter rate was still substantially lower than the comparable subregional average in Southeastern Asia (55%) and rates in other populous countries in the subregion, such as Indonesia (57%), Vietnam (68%) and Thailand (79%). 15

Much of the gap between women’s total and wanted fertility rates in the Philippines can be attributed to low contraceptive use and high levels of unmet need for contraception: In 2008, more than 90% of unintended pregnancies occurred among women using traditional, ineffective methods or no method at all. 13 In 2011, only 49% of married women of reproductive age were using any contraceptive method, and this represented a negligible increase since 1998 (Table 2). 14 Poor women are less likely to use a contraceptive method than nonpoor women (43% vs. 51%), and in regions where poverty is common, contraceptive use is substantially lower than the national average—for example, 38% in the Zamboanga Peninsula and 24% in the Autonomous Region in Muslim Mindanao. 14

The proportion of married women with an unmet need for contraception did not decline between 1998 and 2011: At the time of both surveys, one in five married women did not want a child soon or wanted to stop childbearing altogether, but were not using any contraceptive method. In 2011, poor women had much higher levels of unmet need than their nonpoor counterparts (26% vs. 17%). 14 Unmarried women who were sexually active had even more dramatic levels of unmet need for contraception: In 2008, nearly 50% of these women wanted to prevent pregnancy but were not using a family planning method, and nearly 70% were not using a modern method. 3

There are many reasons why, and circumstances in which, Filipino women do not practice contraception. According to the 2008 Demographic and Health Survey, 3 after excluding women who were unable to bear children and those who wanted children soon, the two most commonly cited reasons were fear of side effects or broader health problems (36%) and difficulty obtaining a method (27%). The lack of governmental support for contraceptives, widespread local bans on contraception and the USAID phase-out of contraceptive supplies are major reasons for women’s inability to obtain modern methods and accurate information about their safety and efficacy. 3,7 Despite the strong influence of the Catholic Church hierarchy on policies regarding family planning, few women cited religious or personal opposition as reasons for nonuse (2–4%). Poor women are particularly vulnerable to barriers to access, as the public-sector provision of modern contraceptives has shifted to private, and often more expensive, sources: In 2003, two-thirds of women using a modern method obtained it at a public facility, but by 2008 the proportion had dropped to less than half. 3 Furthermore, more recent data show that 56% of poor women who use hormonal pills (the most commonly used method) obtained them from the public sector in 2006, while 32% did so in 2011. 16

Adolescents and young women and are particularly vulnerable

Sexual activity among young people is becoming more common in the Philippines. The proportion of women aged 15–24 who were sexually experienced increased from 25% in 1998 to 32% in 2008. 3,17 Despite the taboo against premarital sex, many women report such behavior: In 2008, the median age of marriage among young women was nearly a year later than the median age at first sexual experience (22.1 vs. 21.3 years). 3 Filipino women are also giving birth earlier: Among first-time mothers, the proportion who were teenagers increased from 20% in 2000 to 27% in 2010. 18 Adolescent females are particularly at risk of unintended pregnancy because they lack access to comprehensive sex education and contraceptive supplies. 5

Abortion is common in the Philippines

Of the hundreds of thousands of Filipino women who have unintended pregnancies each year, many face a difficult choice: either give birth to a child they are not prepared or able to care for, or obtain a clandestine, and often unsafe, abortion. Because abortion is highly stigmatized and punishable by law, it is extremely challenging to directly estimate the number of abortions in the Philippines, as both women and providers are likely to not report the procedure. The most recent study on national abortion incidence in the Philippines used indirect estimation techniques and hospital records to estimate a rate of 27 abortions per 1,000 women of reproductive age in 2000, with lower and upper estimates of 22 and 31 abortions per 1,000 women. 19 Notably, this rate was considerably higher than a more recent estimate of the unsafe abortion rate in Southeastern Asia as a whole (22 abortions per 1,000 women), indicating that the Philippines may have more unsafe abortions than some neighboring countries.20 Projections based on the 2000 national abortion rate, and taking into account population increases, estimated that 560,000 abortions occurred in 2008 and 610,000 abortions in 2012. 2,5,19

Who has abortions in the Philippines, and why?

According to a national 2004 survey of women of reproductive age, individuals who have abortions are similar to Filipino women overall: They are typically Catholic, are married, are mothers and have at least a high school education. 4 The most common reason women identified for having an abortion—cited by nearly three in four—was the inability to afford the cost of raising a child or an additional child. More than half of those who had had an abortion said they underwent the procedure because they felt they already had enough children or that their pregnancy came too soon after their last birth. Nearly one-third of women felt that their pregnancy would endanger their health, and another third believed that their partner or another family member did not want or support the pregnancy. Perhaps most disturbingly, 13% of women who had had an abortion cited pregnancy as a result of forced sex as their reason for getting an abortion.

Not surprisingly, larger proportions of poor women than of their nonpoor counterparts cited economic reasons for having an abortion, and roughly two-thirds of women who had had an abortion were poor. 4 Women younger than 25, who accounted for 46% of abortion attempts in the 2004 survey, also cited reasons related to their age—they wanted to avoid interrupting their schooling, had problems with their partner or considered themselves too young to have a baby. Among all the women interviewed, economic reasons and being unmarried or too young were cited as the most important reasons for why women obtain abortions, illustrating that many Filipino women who have not had an abortion understand why other women choose to have one. 21

Most women who had had an abortion had discussed the matter with at least one person, but fewer than half had discussed it with their partner, suggesting that in many cases women feel that their partner will not be supportive of their situation or decision. 4 Nearly one-third of women who get an abortion do not tell anyone, highlighting how stigmatized abortion is in the Philippines.

The clandestine nature of getting an abortion often leads to unsafe procedures

The process of obtaining an abortion in the Philippines is often not straightforward, and may involve many methods and attempts, some of which may have serious health consequences. While the skill and training of providers and the safety and effectiveness of methods vary widely, nearly all abortions are clandestine and therefore carry associated risks. Some women seeking pregnancy termination may be able to obtain medically recommended procedures such as manual vacuum aspiration (MVA) or dilation and curettage (D&C), but the providers may be untrained or the settings unsanitary. 22 Conversely, a woman may go through a series of ineffectual methods and steps, only to find herself still pregnant and at a more advanced point in gestation.

According to the 2004 national abortion study, most women who obtain an abortion do so in the first trimester, but a substantial proportion—nearly one in four—do not terminate their pregnancies until later, when risks are greater. 4,23 A higher percentage of poor women than of nonpoor women have abortions after the first trimester, which could be a result of failed or ineffective attempts to terminate the pregnancy or inability to secure the money to pay for the procedure. Surgical methods that are considered relatively safe and effective (when performed by a trained provider) are often expensive, and poor women may resort to dangerous, painful or ineffective means (Figure 2). Particularly dangerous methods include the insertion of a catheter or other object into the uterus, which often causes infection and perforations, and heavy abdominal pressure or "massage" to expel a fetus, which a traditional practitioner ( hilot ) may administer. 4,10,23 An estimated 22% of poor women used massage or a catheter in an abortion attempt, while no nonpoor women employed such methods. Moreover, poor women were far less likely than the nonpoor to use safer methods such as D&C or MVA (13% vs. 55%). 4

Furthermore, poor women are much less likely than nonpoor women to obtain an abortion from a doctor (17% vs. 55%), or seek an abortion in a health facility (21% vs. 60%); instead, they are more likely to self-induce or to employ the help of a friend, acquaintance or partner (44% vs. 30%). 4 In many cases, women are able to self-induce by taking misoprostol (also known by its brand name Cytotec) obtained through street or Internet vendors; however, the drug is expensive and the correct dosage may not be dispensed, which lowers the effectiveness of the method. 4,24 A small study that interviewed young people about their experiences and perceptions regarding abortion found that many issues were involved in both the selection of a method and the perceived level of efficacy. 24 Some participants felt that a method’s effectiveness was due to the position of the fetus, the "will" of the fetus or God’s will.

The health consequences of unsafe abortion are significant

In 2008, an estimated 1,000 maternal deaths in the Philippines were attributable to abortion complications. 13 According to the Philippines Department of Health, the country’s maternal mortality ratio increased from 161 to 221 deaths per 100,000 live births between 2006 and 2011. 25 This ratio is well above the government’s Millennium Development Goal 5 target of 52 maternal deaths per 100,000 live births for 2015. 26 The Department of Health acknowledges that high maternal mortality is preventable through the provision of effective family planning methods to combat unmet need, particularly among poor women, and that access to antenatal care and to care for pregnancy- and abortion-related complications would also help to reduce maternal mortality.

Tens of thousands of Filipino women are hospitalized each year as a result of complications from unsafe abortion, at a rate of 4.5 individuals per 1,000 women, and countless others have complications but do not receive treatment. 4,19 In Manila, the hospitalization rate was nearly double the national average, likely because of better access to care than in rural areas of the country. Projections based on data from 2000, assuming that the rate stayed the same and taking into account increases in population, indicate that 90,000 Filipino women were hospitalized for abortion complications in 2008, and over 100,000 women in 2012. 13,15,19 Furthermore, nearly one-quarter of the 2,039 hospitals included in the abortion incidence study recorded abortion (induced and spontaneous) as among the top 10 causes for admission in 2000. 19 More recently, abortion-related surgeries (surgical completion of incomplete abortion and D&C) were among the 15 most common surgical claims submitted to the national health care system, PhilHealth, in 2011. 27

Women may experience a range of complications from unsafe abortion. More than 80% of Filipino women in the 2004 study who terminated their pregnancies experienced a complication, and 46% of those women (more than one-third of all women) experienced a severe complication. 4 Generally, the most common complications of unsafe abortion are incomplete abortion or retained products of conception, excessive blood loss and infection. 22,23 Less common but more serious complications include septic shock, peritonitis, cervical or vaginal lacerations, and intestinal perforations. In the Philippines, certain methods and providers carry more risk of serious complications: Seventy percent of women who used a massage or insertion of a catheter experienced a severe complication, compared with 13% of those who received a D&C or MVA. 4 As discussed earlier, larger proportions of poor and rural women use unqualified providers or riskier measures than do nonpoor and urban women, and they therefore disproportionately experience more severe complications. Finally, if postabortion care is delayed, inadequate or not administered at all, mild complications can become more serious or acute, and eventually affect long-term health and well-being. Studies have shown that long-term problems may include anemia, chronic pain, pelvic inflammatory disease and infertility. 20,22,23

Providing postabortion care poses serious challenges

Because so many Filipino women experience postabortion complications, the need for early and adequate postabortion care is particularly urgent. However, many women who develop health problems after an unsafe abortion may be reluctant to seek help; about one in three women with complications do not receive postabortion care. 4 Cost can be a significant barrier, particularly for more serious complications in which women may have to receive multiple procedures and medications or stay overnight in a health facility. 5 Some women leave the hospital prior to completing treatment because they fear they will be unable to pay the final bill, leaving them to manage their complications through other means. At the time of the 2004 national study, it was estimated that government hospitals typically charged ₱1,000–4,000 (US$24–94) for postabortion care, and private hospitals charged substantially more, up to ₱15,000 (US$375). 4 In a country in which one in seven people live on less than US$2 a day, postabortion care may be entirely out of reach for many women. 28

In the Philippines, the stigma surrounding abortion is another factor that makes it difficult for a woman to seek postabortion care. Some women report feeling shamed and intimidated by health care workers, and in some cases women are not provided with pain relievers and anesthesia, or treatment is delayed or denied altogether. 4,5 Others report being threatened that they would be turned in to the police. Doctors themselves report having a bias against postabortion care patients, with some believing that these women have committed punishable crimes. Other health care providers may have difficulty properly managing complications when women conceal the cause of their medical emergency.

The Prevention and Management of Abortion Complications program was established by EngenderHealth in 2000, under the approval of the Philippines Department of Health, to strengthen the capacity of the health care system to manage abortion complications by training providers in techniques, counseling and sensitization. 4,29 The pilot program ended in 2002, however, and it was never fully integrated into the health care system. 30 The Department of Health subsequently replaced it with the Prevention of Abortion and Management of Pregnancy Complications program, thus effectively deemphasizing care specific to abortion complications. Currently, postabortion care is subsumed under Basic Emergency Obstetric and Newborn Care guidelines, yet it is not known whether training in counseling and sensitization has been incorporated. A study that interviewed gynecologists who provide postabortion care in Manila found that many preferred using sharp curettage instead of the recommended MVA for terminating early pregnancies, even though it is associated with higher risks and greater pain. 31 The study also found that some doctors were using improper doses of misoprostol, and a small proportion were not using analgesia for surgical uterine evacuation.

Illegal and unsafe abortions carry social and economic consequences

Physical complications are not the only consequence of unsafe abortion. The social and economic costs of clandestine abortion and postabortion care are substantial, to both individual women and the health system as a whole. Because abortion is illegal, many providers charge high fees to compensate for the clandestine nature of the procedure, 4,5 and hence obtaining a relatively safe abortion in a clinic is out of reach for the average Filipino woman. Many women with an unintended pregnancy therefore resort to cheaper and often less safe methods, which may result in complications that ultimately incur significant costs to the woman and to the health care system. Recent costing studies of postabortion care in countries with highly restrictive abortion laws have found that the costs to the health systems, including drugs, supplies and staff time, are substantial. 32–34

In addition to the direct costs of care for abortion-related complications, another cost is the time that women spend in recovering from injuries and ill health. During recovery, women are prevented from fulfilling other responsibilities, such as making a living, attending school and caring for their families. 4,35 The cost of this lost time, when added to the health care costs of treating complications, means that unsafe abortion takes a substantial toll on society as a whole, as well as on individuals and families.

Legal advances and future investment in reproductive health care

The Reproductive Health Law mandates several provisions, including supplying a full range of contraceptive methods, particularly to the poor and marginalized; providing "humane and nonjudgmental post abortion care"; ensuring that health facilities have adequate and qualified personnel to provide emergency obstetric and newborn care; and offering reproductive health education to adolescents. 36 (However, the law offers modern contraceptive methods to minors only if they have parental consent or have had a child or miscarriage.) The law also prohibits private providers, local government officials and employers from banning, restricting or coercing the use of reproductive health services. Overall, these legislative advances have the potential to greatly improve women’s health by reducing maternal mortality and morbidity.

Another recent advance in reproductive rights is the landmark 2009 Magna Carta of Women, which promises to protect Filipino women from measures or practices that have "greater adverse effects" on women than men. 37 This provision could be used to identify and address barriers to the full access of reproductive health services, such as contraception and postabortion care. Furthermore, in 2012, the Philippines Department of Health pledged ₱500 million toward family planning supplies nationwide. 25

Regarding the critical impact of reproductive health care, a 2009 study of the benefits of meeting contraceptive needs concluded that if all Filipino women at risk of unintended pregnancy used a modern method, unplanned births would decline by 800,000 per year and there would be 500,000 fewer abortions. 13 Achieving this goal is not possible without increased financial commitment; however, the reduced need for medical care for those unintended pregnancies and abortions that could be averted would result in a net economic savings and immeasurable social benefits. This study highlights how investing in family planning and contraceptive supplies and services would promote the health and welfare of Filipino women, their children and society.

Recommendations for addressing unsafe abortion and its consequences

The passage of the Reproductive Health Law is a milestone that will help to reduce maternal mortality and improve the overall health and lives of Filipino women and their families. With full implementation of the law, nearly all Filipino women—including young, unmarried, poor and rural women—should have access to reproductive health information and services that help them to plan and care for their families.

To fully realize the potential of the law and to further promote women’s health, Filipino national, regional and local policymakers, as well as government agencies, should:

• Educate the public about modern contraceptives and the risks of unintended pregnancy and unsafe abortion.

• Ensure adequate funding for the full range of contraceptive methods, as well as counseling, so that women can find and use the methods that are most suitable to their needs.

• Eliminate barriers to contraception among vulnerable populations—such as poor women, rural women and adolescents—by making clinics more accessible and youth-friendly and by providing family planning at low or no cost.

• Integrate contraceptive services with other reproductive health services, and provide contraceptive counseling and services for women in postpartum and postabortion care settings.

• Destigmatize postabortion care among providers, to ensure fair and humane treatment, and among the population as a whole, to encourage women to seek timely postabortion care.

• Train more medical providers, including midlevel personnel, in the use of safer and less invasive methods of postabortion care (such as MVA), and ensure availability of these methods in relevant health facilities.

• Ensure that all women have access to emergency obstetric and neonatal care.

• Study the impact of the current abortion ban, and explore allowing abortion at least in exceptional cases, such as to save a woman’s life or preserve her health, in cases of rape or incest, and where there is gross fetal deformity incompatible with life.

In the Philippines, most unintended pregnancies resulting in abortion are preventable, as is nearly all abortion-related mortality and morbidity. Better information on sexual and reproductive health, as well as access to effective contraception, can lower the incidence of unintended pregnancy, thereby reducing the number of Filipino women who resort to unsafe abortion and experience the related health consequences. Investing in women’s health yields enormous benefits not only to women’s status and productivity, but also to their families and society as a whole.

This In Brief was written by Rubina Hussain and Lawrence B. Finer, Guttmacher Institute. It was edited by John Thomas. The authors are grateful for comments provided by Junice Melgar and Mina Tenorio of Likhaan, Quezon City, Philippines, and for contributions made by the following Guttmacher colleagues: Akinrinola Bankole, Jessica Malter and Gustavo Suarez.

Suggested citation: Hussain R and Finer LB, Unintended pregnancy and unsafe abortion in the Philippines: context and consequences, In Brief , New York: Guttmacher Institute, 2013, No. 3. < http://www.guttmacher.org/pubs/IB-unintended-pregnancy-philippines.pdf >

1. Ericta CN, Household population of the Philippines reaches 92.1 million, press release, Manila, Philippines: Household Statistics Department, National Statistics Office, Aug. 30, 2012, < http://www.census.gov.ph/content/household-population-philippines-reaches-921-million >, accessed Sept. 5, 2012.

2. Population Division, United Nations Department of Economic and Social Affairs, File 5B: female population by single age, major area, region and country, annually for 1950–2010 (thousands), medium-fertility variant, 2011–2100, in: World Population Prospects: The 2010 Revision , CD-ROM, New York: United Nations, 2011.

3. National Statistics Office (NSO) and ICF Macro, Philippines National Demographic and Health Survey, 2008 , Calverton, Maryland, USA: NSO and ICF Macro, 2009.

4. Singh S et al., Unintended Pregnancy and Induced Abortion in the Philippines: Causes and Consequences , New York: Guttmacher Institute, 2006.

5. Center for Reproductive Rights ( CRR ) , Forsaken Lives: The Harmful Impact of the Philippines Criminal Abortion Ban , New York: CRR, 2010.

6. Lee R et al., The influence of local policy on contraceptive provision and use in three locales in the Philippines, Reproductive Health Matters , 2009, 17(34):99–107.

7. Likhaan, Reproductive Health, Rights and Ethics Center for Studies and Training (ReproCen), and CRR, Imposing Misery: The Impact of Manila’s Ban on Contraception , Quezon City, Philippines: Likhaan; Manila, Philippines: ReproCen; and New York: CRR, 2007.

8. Weiss KR, Philippines birth control: Filipinos want it, priests don’t, Los Angeles Times , July 22, 2012, < http://www.latimes.com/news/nationworld/world/population/la-fg-population-matters5-20120729-html,0,5897961.htmlstory >, accessed July 28, 2012.

9. Philippines Department of Health (DOH), Passage of Reproductive Health Bill, press release, Dec. 13, 2012, < http://www.doh.gov.ph/content/press-statement-passage-reproductive-health-bill.html >, accessed Jan. 15, 2013.

10. Boland R and Katzive L, Developments in laws on induced abortion: 1998–2007, International Family Planning Perspectives , 2008, 34(3):110–120.

11. Population Division, United Nations Department of Economic and Social Affairs, Abortion Policies: A Global Review, 2002, < http://www.un.org/esa/population/publications/abortion/profiles.htm >, accessed Dec. 15, 2012.

12. Revised Penal Code of the Philippines, Act No. 3815, Dec. 8, 1930, < http://www.un.org/Depts/los/LEGISLATIONANDTREATIES/PDFFILES/PHL_revised_penal_code.pdf >, accessed Jan. 15, 2013.

13. Darroch JE et al., Meeting women’s contraceptive needs in the Philippines, In Brief , New York: Guttmacher Institute, 2009, No. 1.

14. Philippines DOH, NSO and U.S. Agency for International Development, Fertility and family planning: 2011 family health survey, 2012, < http://www.scribd.com/doc/98937655/Fertility-and-Family-Planning-2011-Family-Health-Survey-for-2011 >, accessed Dec. 15, 2012.

15. Population Division, United Nations Department of Economic and Social Affairs, World contraceptive use 2011, < http://www.un.org/esa/population/publications/contraceptive2011/wallchart_front.pdf >, accessed June 19, 2012.

16. Ericta CN, Women in poor households are less likely to practice family planning, press release 2012-45, Manila, Philippines: Household Statistics Department, National Statistics Office, June 18, 2012, < http://www.census.gov.ph/content/women-poor-households-are-less-likely-practice-family-planning-results-2011-family-health >, accessed Sept. 5, 2012.

17. Special tabulations of data from the Philippines National Demographic and Health Survey, 1998 , Manila, Philippines: NSO, DOH and Macro International, 1999.

18. NSO, Teenage pregnancy in the Philippines: facts and figures from NSO data, 2011, < http://xa.yimg.com/kq/groups/22266913/855957053/name/NSO+Teenage+pregna… ;, accessed Mar. 18, 2013.

19. Juarez F et al., The incidence of induced abortion in the Philippines: current level and recent trends, International Family Planning Perspectives , 2005, 31(3):140–149.

20. World Health Organization (WHO), Unsafe Abortion: Global and Regional Estimates of the Incidence of Unsafe Abortion and Associated Mortality in 2008 , Geneva: WHO, 2011.

21. Special tabulations of data from the 2004 Philippines Community-Based Survey of Women, New York: Guttmacher Institute and University of the Philippines Population Institute.

22. Singh S et al., Abortion Worldwide: A Decade of Uneven Progress , New York: Guttmacher Institute, 2009.

23. Grimes DA et al., Unsafe abortion: the preventable pandemic, Lancet , 2006, 368(9550):1908–1919.

24. Gipson J et al., Perceptions and practices of illegal abortion among urban young adults in the Philippines: a qualitative study, Studies in Family Planning , 2011, 42(4):261–272.

25. Philippines DOH, DOH confident of attaining MGD despite increase in maternal deaths, press release, June 18, 2012, < http://www.doh.gov.ph/content/doh-confident-attaining-mdg-despite-increase-maternal-deaths.html >, accessed July 27, 2012.

26. United Nations Population Fund Philippines, Will Philippine women continue to die during childbirth? no date, < http://www.unfpa.org.ph/index.php/mdg-5 >, accessed June 22, 2012.

27. PhilHealth, 2011 stats and charts, 2012, < http://www.philhealth.gov.ph/about_us/statsncharts/snc2011.pdf&gt ;, accessed Feb. 22, 2013.

28. World Bank, Data: poverty gap at $2 a day (PPP)(%), 2013, < http://data.worldbank.org/indicator/SI.POV.GAP2 >, accessed June 18, 2012.

29. EngenderHealth, Changing policies and attitudes: postabortion care in the Philippines, Compass , New York: EngenderHealth, 2003, No 1.

30. Melgar J, Likhaan, Quezon City, Philippines, personal communication, Sept. 21, 2012.

31. Cansino C et al., Physicians’ approaches to post-abortion care in Manila, Philippines, International Journal of Gynecology & Obstetrics , 2010, 109(3):216–218.

32. Vlassoff M et al., The health system cost of post-abortion care in Uganda, Health Policy and Planning , 2012, < http://heapol.oxfordjournals.org/content/early/2012/12/28/heapol.czs133.full.pdf+html >, accessed Dec. 15, 2012.

33. Vlassoff M et al., Estimates of health care system costs of unsafe abortion in Africa and Latin America, International Perspectives on Sexual and Reproductive Health , 35(3):114–121.

34. Vlassoff M et al., The health system cost of postabortion care in Ethiopia, International Journal of Gynecology & Obstetrics , 2012, 118(2):S127–S133.

35. Singh S, Global consequences of unsafe abortion, Women’s Health , 2010, 6(6):849–860.

36. Congress of the Philippines, Republic Act No. 10354, July 23, 2012, < http://www.gov.ph/2012/12/21/republic-act-no-10354/ >, accessed Feb. 22, 2013.

37. Office of the President, Philippine Commission on Women, Republic Act No. 9710, Magna Carta of Women, Implementing Rules and Regulations, Manila: Philippines Commission on Women, Aug. 14, 2009.

Suggested Citation

Hussain R and Finer LB, Unintended pregnancy and unsafe abortion in the Philippines: context and consequences, In Brief , New York: Guttmacher Institute, 2013, No. 3. < http://www.guttmacher.org/pubs/IB-unintended-pregnancy-philippines.pdf

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Abortion in the Philippines: A true story

"I can not forget. I'm trying but I know I can't. I look back, from time to time, sometimes kahit hindi intentional. It makes me sad but it also makes me more determined to make this 'second chance' a better shot at life."

The baby was conceived out of wedlock. The  guy who got her pregnant abandoned her: no phone calls, no messages, just a recent photo of him and his wife uploaded on Facebook. The message was clear: “Stay away from me and my family.” "I hate the word regret. For the longest time, I stand by my decisions however stupid they are. Live and let live. Live and learn. But at that time, I felt remorse and regret. I know I could have made a better decision not to have sex with that guy." Of course she thought of a way out, but abortion wasn’t the first choice. Maybe adoption? She said she could not bear to give her child away to a stranger. Raise the baby with her  beki  friends? Possible. Tell her parents? Not a chance. Her parents would literally have a heart attack on the spot. Her father would lose his position in the church, their family ostracized and detested by their religious community. She said she could handle the pregnancy, even maybe keep the baby for good if her life was the only thing at stake here. But she thought of her parents — surely she would break not only their hearts but their trust as well. She knew that she could never, ever, go back. The thought of losing her family only strengthened her decision. She used to be a strong-willed girl: hard-headed and unafraid to commit mistakes. But on that night, she was weak and vulnerable. And that’s when it happened. -- YA, GMA News  

Hon Sophia Balod is a segment producer for GMA News. She is also a finalist in the 2010 GMA President's Medal Award. A longer version of this article was first published in subselfie.com , a collective blog and a passion project of nine news professionals from GMA Network.

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• v.32; 2023 Mar

The spectre of unsafe abortions in the Philippines

Juan raphael m. perez.

a College of Medicine, University of the Philippines, 1000 Manila, Philippines

Gianica Reena S. Monteagudo

b Department of Family and Community Medicine, Philippine General Hospital, 1000 Manila, Philippines

Pia Juneea C. Nebrada

Ma veronica pia n. arevalo, edelina p. de la paz, frances dominique v. ho, clara rita a. padilla.

c EnGendeRights, Inc., 1105 Quezon City, Philippines

On 24 June 2022, the U.S. Supreme Court overturned Roe v. Wade, the landmark 1973 ruling that protected the constitutional right to abortion, threatening the physical and mental health of millions of pregnant people in the U.S. However, this crisis has long been the reality for pregnant people in the Philippines, a lower-middle income country in Southeast Asia where abortion remains restricted with no explicit exception for high-risk pregnancies, fetal impairment, rape, and incest. 1 Nonetheless, 1.1 million induced abortions occur in the country annually, a number that was estimated to increase by 14.6% in 2020. 2 1000 Filipino women die each year from post-abortion complications. 3

Unsafe abortion contributes significantly to preventable maternal mortality in the country yet remains the sole option for many young, low-income, and rural women, 1 , 3 as 75% of Filipino women seeking abortions are financially unable to raise another child. Disturbingly, over 10% of women are victims of sexual violence. 3 Unsafe abortive methods include unsupervised catheter insertion, abdominal manipulation or massage, and self-induction with unapproved herbs. 3 , 4 Misoprostol, an internationally accepted abortifacient, also remains illegal and inaccessible due to restrictions on abortion. These frequently result in mortality from hemorrhage, sepsis, genital trauma, and bowel necrosis, with many survivors suffering long-term complications (e.g., poor wound healing, infertility, and incontinence). 5

Though the provision of humane post-abortion care is constitutional, Filipino women face both societal stigma and maltreatment from healthcare providers, the latter ranging from verbal abuse and religious sanctimony to outright refusal of care. 4 With over 80% of the Filipino population identifying as Roman Catholic, 6 strong religiosity may be a contributor to societal stigma. This, compounded by fear of legal prosecution, may lead women to delay seeking post-abortion care. Filipino healthcare providers themselves risk criminal prosecution, license revocation, and ostracisation from peers for participating in abortion-related activities. 7

Legal barriers further thwart safe post-abortion care. A 2016 Department of Health Administrative Order (DOH AO), drafted in consultation with reproductive health advocates, provided protections on confidentiality and redress mechanisms for abortion patients. 8 However, a 2018 DOH AO, developed without consulting health advocates, removed these guidelines explicitly maintaining patient privacy. 8

Women who continue with unintended pregnancies are exposed, willingly or unwillingly, to the effects of pregnancy itself, which range from normal physiologic (e.g., increased workload to the heart, hypercoagulable state of the blood) to life-threatening (e.g., preeclampsia, venous thromboembolism). 9 Quality prenatal care manages these risks, but remains out of reach for low-income Filipino women, especially those dwelling in geographically isolated and disadvantaged areas (GIDAs), due to high out-of-pocket costs and concentrated healthcare resources in urban centers. 10

Religious, political, and socioeconomic forces influence the Filipino woman's reproductive freedoms beyond abortion. Unintended pregnancy remains a public health challenge in the Philippines because of limited access to contraception and sexual and reproductive health (SRH) services. Over half of all pregnancies are unintended and over half of these unintended pregnancies end in abortion. 11 Seventeen percent of Filipino women have an unmet need for family planning, an estimate projected to rise by 67% in 2020, due to community quarantine-related service disruptions. 2 Such unmet needs may be partly due to the deep-seated political and cultural power of the Philippine Catholic Church, ineffective widescale implementation of sexuality and contraception education, high rates of gender-based violence, stalled implementation of the Reproductive Health (RH) Law, and the delayed registration of contraceptives due to a former restraining order issued by the national Supreme Court. 1 , 3 , 4 The RH Law, passed in 2012, promises to provide modern contraceptive services, counseling, and sex education, especially for rural and poor Filipinos. 3

We advocate for the decriminalisation of abortion and ensuring access to safe abortion, which begins with halting the prosecution of patients and abortion care providers. Training obstetric and primary care providers for safe abortion care is also critical to expand access, especially in GIDAs. In the meantime, to reduce maternal morbidity and mortality from unsafe abortions, policies addressing post-abortion care should prioritise the expansion of existing treatment options by nurses and midwives according to WHO standards and should be made in consultation with SRH advocates. Legislation should be crafted to protect the privacy of women seeking these services.

The country must address the determinants underlying unintended pregnancies through efforts to promote SRH literacy and universal access to modern contraception, while effectively addressing gender-based violence. Finally, to improve outcomes for people with unintended pregnancies, it is imperative to reduce out-of-pocket costs of prenatal care and mobilise prenatal care providers towards and within resource-limited areas. Ultimately, it is time for the Philippines to rethink its long-standing cultural condemnation of induced abortion and consider how safe abortion access can not only save lives but also defend women's health, security, and dignity.

Contributors

Conceptualisation, resources, writing (original draft), writing (review & editing) - JRMP, GRSM, PJCN, MVPNA, EPDP, FDVH, CRAP.

Declaration of interests

We declare no competing interests.

Acknowledgements

Funding: This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Why decriminalizing abortion is not possible in the Philippines

Before the last national elections, as I was going through the platforms of senatorial and congressional candidates, I noticed that some of them said they will work for the “decriminalization of abortion.”

With the June 24, 2022 landmark decision of the United States Supreme Court on the case of Dobbs v. Jackson, which ruled that there is no such thing as a “constitutional right to abortion,” those intended moves on the part of these now elected lawmakers would seem to be passé. Now, the trend in the United States is to protect the life of the unborn by enacting state laws that will prohibit abortion.

The majority opinion of the US Supreme Court was written by Justice Samuel Alito. It is a masterpiece of philosophical and legal reasoning, and research on the history of the criminal nature of abortion in English and American jurisprudence. We can say that it is common sense which tells us that abortion is the killing of an innocent person who does not even have the capacity to defend himself. In our own language, we call a pregnant woman “nagdadalang-tao” (someone who is carrying within herself another human being). We naturally think she has inside her another person.

Decriminalizing abortion means removing the status of abortion as a crime. Laws have a role to play in the moral education of a society. When the laws remove the criminal status of a crime like abortion, it is teaching society that you may commit abortion and the state will not punish you. Go ahead. You can do it. The act is not banned.

In the context of the Philippines, the decriminalization of abortion is not possible because of our basic law, the Constitution . In Article II Section 12 it says, “[The state] shall equally protect the life of the mother and the life of the unborn from conception.” How else can the state protect the life of the unborn except by banning abortion and imposing penalties on those who take away the life of the unborn? In the same way that Justice Alito repeated several times in his piece that there is no such thing as a right to abortion, it might be worth repeating that it is not possible to decriminalize abortion in the Philippines given our Constitution and given our culture and traditions.

Because abortion is prohibited in the Philippines, it is very difficult to get accurate data on the number of abortions performed in the country. There are only estimates that range from 600,000 to even over a million for the last year. This is not a small number to say the least. This is a real problem for our society. But decriminalizing abortion is not the solution. As the experience of the US shows, decriminalizing it made the problem worse.

Like poverty, abortion is a complex problem that will require a complex and manifold solution. It is above all a moral problem. The Catholic Church has always advocated the moral education of people so that their mores might conform to right reasoning about their sexuality and morality. At the root of the problem about unwanted pregnancies and abortions is difficulty about virtues related to human sexuality. Chastity is the virtue that is at stake here. It is grossly misunderstood and misinterpreted as meaning “don’t do this or that” or “being a killjoy.” Understood well, it means love, affirmation, and happiness in life.

The Church has also fought for the defense of the dignity of each human person. In the case of abortion, she has fought for respecting the dignity of both the mother and the unborn child. What happens in an abortion is that both the mother and the baby are reduced to and manipulated as commodities. Their personhoods are destroyed and eliminated. The existence of the post abortion stress syndrome attests to the destruction of the person of the women who committed abortion. They find it very difficult to live with the thought, “I killed my own baby!”

It might be better for our lawmakers to think about how to help those mothers who are contemplating having an abortion solve their problems and difficulties. They need counseling, financial help, moral support, livelihood, education. They don’t need the decriminalization of abortion.

FR. CECILIO L. MAGSINO [email protected]

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[OPINION] Why we need to decriminalize abortion

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This is AI generated summarization, which may have errors. For context, always refer to the full article.

The restrictive, colonial, and archaic 1930 Revised Penal Code abortion law has never reduced the number of women inducing abortion. It has only endangered the lives of hundreds of thousands of Filipino women who have made personal decisions to induce abortion for various reasons (economic – 75%; too young, under 25 years old – 46%; health reasons – one-third; rape – 13%) but are unable to access safe abortion services. 

No restrictive law nor religious dogma has stopped these Filipino women, especially poor women with at least 3 children, to end their unintended or unwanted pregnancies.                                     

1) To save women’s lives and prevent disability from unsafe abortion complications

The Philippines is complicit with at least 3 women dying every day from unsafe abortion complications.

Some of these women became pregnant as a result of rape, were forced to carry their pregnancies to term, and died due to unsafe abortion complications. One raped by her stepfather died in 2012; one who was a doctor, raped by an older man who funded her medical education, died in 2004. Another one was a rape victim with dwarfism who died in 2015 due to her risky childbirth.    

Complications from unsafe abortion is one of the 5 leading causes of maternal death and a leading cause of hospitalization in the Philippines. 

This bill when passed into law will provide access to safe abortion and save the lives of thousands of women.

2) To reduce maternal deaths related to unintended/unwanted pregnancies and unsafe abortions during humanitarian crises

This public health issue should urgently be addressed especially now with the impact of the COVID-19 pandemic, resulting in higher rates of unintended and unwanted pregnancies due to lack of access to contraceptives and higher incidences of rape, intimate partner violence, and sexual exploitation. During this pandemic, the day-to-day reality of these women is joblessness, hunger, poverty, and being stuck at home with their abusers.

The Population Commission cites that about 40 to 50 adolescent girls aged 10-14 give birth every week. It has been found that many adolescent girls aged 15 and below became pregnant due to sexual assault, highlighting the need to address gender-based violence with due diligence, including by providing access to emergency contraceptives and safe abortion, and in effective prevention by raising the age of sexual consent to 16 as recommended by the Committee on the Elimination of Discrimination Against Women (CEDAW Committee).

Without access to safe abortion, many of these women and adolescent girls would discontinue their pregnancies unsafely and may end up in the estimated 26% increase of 2020 maternal deaths due to the pandemic’s disruption of access to health services.

3)   To repeal a discriminatory law against women and eliminate harmful stigma against women

Not only women who induce abortion of viable pregnancies suffer inhumane and degrading treatment, or are delayed and sometimes denied emergency post-abortion care, a legal procedure to save their lives. The same goes for women suffering complications from naturally occurring medical conditions such as spontaneous abortions/miscarriages, incomplete abortion, and intrauterine fetal demise. 

This discriminatory law against women must be decriminalized to end the harmful stigma women suffer, and the judgmental religious beliefs imposed on women who want to discontinue their pregnancies.           

Children among 22 killed in UK pop concert attack

4) To provide incest and rape survivors and sexually exploited women the opportunity to discontinue unwanted pregnancies

Rape and incest survivors and sexually exploited women must be free to discontinue their unwanted pregnancies without risk to their lives.

A Filipino woman or girl is raped every 75 minutes. About one in every 8 Filipino women who induce abortion are rape survivors.

Some women and girls who became pregnant resulting from rape were forced to resort to clandestine and unsafe abortions, while others have tried to commit suicide.

When one’s daughter, sister, wife, or mother becomes pregnant as a result of rape, there are many Filipinos who will support their female family member’s decision to undergo such therapeutic abortion. However, even rape survivors are not expressly allowed by Philippine law to undergo abortion. 

Without access to safe abortion, a 10-year old girl who became pregnant after being raped by her own father would be forced to carry her pregnancy to term – the rape and forced pregnancy violates her rights, and at the same time she is at high risk of dying, as pregnancy and childbirth at her young age is extremely risky.

Denying safe and legal abortion to rape and incest survivors is torture, a clear injustice, and patently discriminates against women and girls. 

5) To address the social impact of adolescent pregnancies

When young women and adolescent girls are forced to carry their pregnancies to term, the social impact includes disruption of studies, and the lack of job skills and career options due to low educational attainment and low financial capability.

6) To uphold women’s fundamental human rights and confirm that women’s rights prevail over prenatal protection

Decriminalizing abortion upholds women’s rights to life and other fundamental human rights, and confirms that women’s rights – the rights of those with legal personality (Art. 41 of the Civil Code) – prevail over prenatal protection.

Other countries with the same constitutional prenatal protection as the Philippines allow abortion, such as Costa Rica, Hungary, Kenya, Poland, Slovak Republic, and South Africa. These examples show that the Constitution, the law of the people, is justifiably interpreted liberally in favor of women.   

7) To continue the historical fight to uphold women’s rights to equality and non-discrimination and respond to the outstanding clamor to pass the bill into law

This fight to decriminalize abortion is part of the historical fight to uphold women’s rights to equality and non-discrimination, including the fight for women’s right to vote, work, and study; the right against sexual assault, sexual harassment, and trafficking; the right to sexual and reproductive health including the full range of contraceptive methods and maternal care; and the right to sexual orientation, gender identity, and expression (SOGIE). 

Many supporters of this bill – members of the women’s movement and other human rights advocates – have long advocated for pro-women and pro-SOGIE laws and bills, including the Anti-Sexual Harassment Act, Anti-Rape Law and its proposed amendments, Anti-VAWC Act, Anti-Trafficking Act/Expanded Anti-Trafficking Act, Reproductive Health Law, Safe Spaces Act, Quezon City (QC) Gender-Fair Ordinance, the establishment of the QC Protection Center for Women, Children, and LGBT Survivors of Gender-based Violence, divorce, the SOGIE/Comprehensive Anti-Discrimination Bill, gender recognition, marriage equality, the bills raising the age of sexual consent to 16; the repeal of discriminatory laws against women such as the decriminalization of vagrancy (RA 10158; “prostitution” still to be repealed) and the repeal of Art. 351 of the Revised Penal Code imposing penalty on the woman for premature marriage (RA 10655).

When passed into law, this will not force those who oppose decriminalization of abortion to undergo an abortion against their beliefs; however, this will provide access to services for countless women who decide to discontinue their pregnancy. 

Moreover, detractors cannot impose their beliefs on other people, as such imposition of religious morality and beliefs in Philippine law violate the constitutional guarantees of separation of church and state, non-establishment of religion, and freedom of religion or belief. 

It’s time to decriminalize abortion

Every minute counts to save the lives and health of Filipino women who are denied their right to basic health care. 

I urge fellow Filipinos to take a stand and be counted in this fight to save women’s lives by decriminalizing abortion. Together, let’s end discrimination against women and fight for women’s rights to life, health, equality, equal protection of the law, privacy and bodily autonomy, and against torture.                                    

#SaveWomensLives #DecriminalizeAbortionNow

– Rappler.com

Clara Rita “Claire” Padilla is the founder and executive director of EnGendeRights and is Spokesperson of the Philippine Safe Abortion Advocacy Network (PINSAN). She drafted the proposed bill to decriminalize abortion for PINSAN, which has been discussed with various women’s rights and reproductive rights activists, youth groups, and other human rights advocates.

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The independent source for health policy research, polling, and news.

Abortion Experiences, Knowledge, and Attitudes Among Women in the U.S.: Findings from the 2024 KFF Women’s Health Survey

Ivette Gomez , Karen Diep , Brittni Frederiksen , Usha Ranji , and Alina Salganicoff Published: Aug 14, 2024

• Methodology

Key Takeaways

• Among women of reproductive age, one in seven (14%) have had an abortion at some point in their life. Larger shares of Black (21%) and Hispanic (19%) women report having had an abortion compared to 11% of White women. Across partisanship, similar shares of Republican women, Democratic women, and independents report having had an abortion.
• Nearly one in ten (8%) women of reproductive age personally know someone who has had difficulty getting an abortion since Roe v. Wade was overturned, including 11% of Hispanic women and 13% of women living in states with abortion bans.
• Among women of reproductive age who report knowing someone personally who has had difficulty getting an abortion since Roe v. Wade was overturned, many say they had to travel out of state for care (68%), did not know where to go (40%), and/or did not have the money to cover the cost (35%).
• More than six in ten women of reproductive age are concerned that they, or someone close to them, would not be able to get an abortion if it was needed to preserve their life or health (63%) and that abortion bans may affect the safety of a potential future pregnancy for themselves or someone close to them (64%).
• Less than half of reproductive age women in the United States are aware of the current status of abortion policy in their state (45%). Nearly a quarter describe the status incorrectly (23%) and a third are unsure about the status of abortion in their state (32%).
• One in four (26%) reproductive age women say if they needed or wanted an abortion they would not know where to go nor where to find information.
• Nearly one in five women (17%) of reproductive age report they have changed their contraceptive practices as a result of Roe being overturned. Actions taken include starting birth control, getting a sterilization procedure, switching to a more effective method, or purchasing emergency contraceptive pills to have on hand.
• While two-thirds of women have heard about medication abortion pills, only 19% of women say people in their state can get medication abortion pills online.
• Three in four reproductive age women in the United States think abortion should be legal in most or all cases (74%). The majority support a nationwide right to abortion (70%), oppose a nationwide abortion ban at 15 weeks (64%), and oppose leaving it up to the states to determine the legality of abortion (74%). This is the case for the majority of women who are Democrats and independents as well as smaller but still substantial shares of Republicans.

Introduction

In the two years since the Dobbs decision, which overturned Roe and eliminated the federal standards that had protected the right to abortion for almost 50 years, the abortion landscape in the United States has drastically changed. Abortion is banned in 14 states and an additional six states have implemented early gestational limits between 6 and 15 weeks.

Abortion will likely be a key issue in the upcoming 2024 election . The Democratic and Republican parties have starkly different visions of what access to abortion in the U.S. should look like. Vice President and Democratic Nominee Kamala Harris has been an outspoken advocate of abortion rights and has thrown her support behind efforts to restore Roe v. Wade’ s abortion standards in all states. Former President Donald Trump endorses leaving abortion policy up to states, allowing full bans to stay in effect, although he has also previously said he would consider a 15 or 16-week national ban on abortion. At the state level, voters in up to 11 states will vote on abortion-related ballot initiatives that will shape access to abortion in their states.

This brief provides new information about women’s experiences with abortion, the fallout of overturning Roe v. Wade , women’s knowledge about abortion laws in their states including medication abortion, as well as their opinions on the legality of abortion. The 2024 KFF Women’s Health Survey was fielded from May 15 to June 18, 2024, before President Biden withdrew from the 2024 Presidential race, and was developed and analyzed by KFF staff. It is a nationally representative survey of 5,055 women and 1,191 men ages 18 to 64, and the findings in this brief are based on a sample of 3,901 women ages 18 to 49. See the methodology section for detailed definitions, sampling design, and margins of sampling error.

Women’s Experiences With Abortion

Among women of reproductive age, one in seven (14%) report having had an abortion at some point in their life. Larger shares of Black (21%) and Hispanic (19%) women report having had an abortion compared to 11% of White women ( Figure 1 ). A higher share of women with lower incomes had an abortion (17%) compared to women with higher incomes (13%).

Smaller shares of women living in rural areas report having had an abortion compared to those living in urban/suburban areas (7% vs. 15%, respectively). Many rural women face long travel distances to access abortion services.

Similar shares of Republican women (12%), independent women (15%), and Democratic women (14%) say they have had an abortion. Throughout this brief, partisans include independents who lean to either party, while independents are individuals who say they do not lean toward either political party. Nearly one in 10 women (8%) who currently identify as pro-life say they have had an abortion compared to almost one in five (17%) who currently identify as pro-choice.

Smaller shares of women living in states with abortion bans or gestational limits between 15 and 22 weeks have had an abortion compared to women living in states with gestational limits at or after 24 weeks or without any gestational limits. Even before the Dobbs decision, abortion access was very limited in many of the states that currently ban abortion or have gestational limits before viability. Most of these states had laws restricting access to abortion, including waiting periods, counseling and ultrasound requirements, and insurance coverage restrictions which resulted in the closure of many abortion clinics in the years preceding the Dobbs decision.

Among women who say they have ever wanted or needed an abortion, 15% (2% of all reproductive age women) report that at some point in their lives, they have wanted or needed an abortion that they did not get ( Figure 2 ). A larger share of Black women (24%) (5% of all Black women of reproductive age) who have ever been pregnant and have wanted or needed an abortion report that they have wanted or needed an abortion they did not get compared to White women (12%) (1% of all White women of reproductive age). When asked why they did not get a wanted or needed abortion, a third (33%) report access and affordability issues, with affordability issues making up the majority of the category. One in five women also identify religious, moral, or societal pressures as the reason why they did not get the abortion, and another 16% say they changed their mind or couldn’t go through with the abortion. One in 10 women say they were too far along to end the pregnancy. Among the women who report ever wanting or needing an abortion they did not get, 31% say they had an abortion at some other time (data not shown).

In their own words: There are many reasons why someone may not get an abortion. What was the reason you did not get the abortion(s)?

“Unable to afford the procedure and would be reaching [the] point where it would be too late to complete if able.”

“Was a day over the amount of days in order to have an abortion. I waited too long to get it.”

“Changed my mind. Decided to keep the baby but was initially scared and unsure of what to do.”

“I decided I wanted to keep and raise my child despite societal pressures that would advise against it (I was a minor).”

“My family made me feel like I couldn’t and I was scared so I followed through with my pregnancy.”

“I was intimidated by the child’s father showing up at the clinic.”

“I could not afford to go out of state and had no way out of [the] state.”

“Ended up miscarrying before proceeding with appointment.”

“I was too far along in the pregnancy when I found out I was pregnant”

“Religious reasons. We are Catholic and it’s not an option for us.”

“The service wasn’t easily accessible to me, and my partner’s family pressured me into having the child.”

“Guilt, moral compass”

“Nurse convinced me not to get it.”

“I could not afford it at the time and unsure if I really wanted to do it.”

“Family pressure, difficulty finding a place to perform an abortion.”

“I lived an hour and a half from the location and my ride didn’t show up.”

The Impact of Overturning Roe

Two years after the Supreme Court overturned the constitutional right to abortion, 14 states have banned abortion, and 11 states have implemented gestational restrictions between 6 and 22 weeks LMP (last menstrual period). Nationally, 8% of reproductive age women say they personally know someone, including themselves, who has had difficulty getting abortion care since Roe was overturned due to the restrictions in their state ( Figure 3 ). Larger shares of Hispanic women (11%) than White women (8%) report knowing someone who has experienced difficulty getting an abortion. Similarly, larger shares of women living in states with abortion bans (13%) and women living in states with gestational limits between 6 and 12 weeks (11%) report knowing someone who has experienced difficulty compared to women living in states with gestational limits at or after 24 weeks or without gestational limits (6%). Even in states with few abortion restrictions, access to abortion services can be limited by lack of providers, poor coverage, and other factors.

Among those who say they know someone (including themselves) who had difficulty getting abortion care since Roe was overturned, the majority report they (or the person they knew) had to travel out of state (68%) ( Figure 4 ). Women with higher incomes who say they or someone they know had difficulty accessing abortion care are more likely to report that they or the person they know had to travel out of state compared to women with lower incomes (75% vs. 62%). Many abortion patients living in states with abortion bans or restrictions have to travel to neighboring states to get abortion care, while others may need to travel farther .

Among women who say they or someone they know had difficulty accessing abortion, four in ten women say they or a person they know did not know where to go when trying to get an abortion (40%), three in ten women say they could not afford the cost (35%), and nearly three in ten say they had to take time off work (28%).

When asked about women’s ability to get abortion services in their state, more than half of women residing in states with abortion bans (57%) and over four in ten women in states with gestational limits say it is difficult to access abortion care in their state (Figure 5). Notably, one in five (21%) women residing in states with gestational limits at or after 24 weeks or without gestational limits say it is difficult to get abortion services in their state. While abortion may not be restricted, limitations on Medicaid and insurance coverage of abortion, the scarcity of abortion providers in rural communities, stigma, and other factors (such as the need to take time off from work and childcare costs) are still barriers to abortion.

O ver six in ten reproductive age women in the U.S. (63%) are concerned that they or someone close to them would not be able to get an abortion if it was needed to preserve their life or health (Figure 6). While all states with abortion bans and abortion restrictions have an exception in their law to “prevent the death” or “preserve the life” of the pregnant person, six states with abortion bans or early gestational restrictions do not have health exceptions. In general, health exceptions have often proven to be unworkable except in the most extreme circumstances. The abortion policies in these states are generally unclear about how ill or close to death a pregnant person would have to be to qualify for the exception.

With the exception of Republican women, a majority of reproductive age women in all subgroups report that they are very or somewhat concerned about access to abortion if it was needed to preserve their life or health. Larger shares of Asian or Pacific Islander women (75%) than White women (61%) are concerned, and smaller shares of women residing in rural areas (52%) are concerned compared to those residing in urban/suburban areas (65%). Compared to Democratic women (78%), smaller shares of women who identify as independent (61%) are concerned that they or someone close to them would not be able to get an abortion if it was needed to preserve their life or health; however, less than half of Republican women report being somewhat or very concerned (41%).

Similarly, over 6 in 10 (64%) reproductive age women say they are concerned that abortion bans may affect the safety of a potential future pregnancy for themselves or someone close to them ( Figure 7 ). Across most subgroups—except across party affiliation— majorities of women say that they are somewhat or very concerned. Four in ten (39%) Republican women say they are concerned about the impact of abortion bans on the safety of potential pregnancies for themselves or someone close to them, compared to almost eight in 10 Democratic women and six in 10 independent women.

Nearly one in five women (17%) of reproductive age report they have changed their contraceptive practices as a result of Roe being overturned. Larger shares of Asian or Pacific Islander, Black, and Hispanic women report they started to use birth control (9%, 10%, and 7%, respectively) compared to White women (3%) ( Table 1 ). A higher share of Asian or Pacific Islander women report that they have switched to a more effective method of birth control compared to White women (6% vs. 3%), and 7% of Hispanic women report that they have gotten emergency contraception to have on hand compared to 4% of White women.

Awareness of Abortion Availability and Policy

Nationally, most women of reproductive age are unaware of the status of abortion legality in the state they live in. While 45% can correctly describe the status of abortion in their state, 23% of reproductive age women could not answer correctly and another third (33%) say they are not sure ( Figure 8 ). Awareness is highest among women who live in states where abortion is fully banned (51%) or in states with gestational limits at or after 24 weeks or without bans (47%). Smaller shares of women living in states with gestational limits at 15 to 22 weeks (33%) and limits at 6 to 12 weeks (38%) are aware of the status of abortion in their state. Consistently across state abortion groupings, about a third of women say they are not sure on the status of abortion in their state.

One in four (26%) women of reproductive age in the U.S. report that if they needed or wanted an abortion in the near future they would not know where to go or where to find the information (Figure 9). A quarter of women say they would know where to go for an abortion and half (49%) say they would not know where to go, but would know where to find that information. Since the Dobbs decision, websites like abortionfinder.org and ineedana.com provide individuals seeking abortion services with directories of abortion clinics and services that provide medication abortion via telehealth.

Over a third of Hispanic women (37%) and a third of Black women (33%) report that if they wanted or needed an abortion in the near future, they wouldn’t know where to find information compared to 23% of White women. More women with lower incomes (37%) and women living in rural areas (35%) report they wouldn’t know where to go or find that information compared to women with higher incomes (19%) and women living in urban/suburban areas (25%). Over four in 10 (43%) women living in states where abortion is banned say they wouldn’t know where to find information compared to 17% of women in states with gestational limits at or after 24 weeks or without gestational limits. Women living in banned states seeking abortion services must either travel out of state or obtain medication abortion drugs from companies that will ship pills without requiring a clinician visit or from clinicians practicing in states with shield-laws, which offer clinicians a measure of legal protection from attempts by law authorities in abortion ban states to enforce bans in states that support abortion access.

In the United States, medication abortion is the most common abortion method. It involves taking two different medications, mifepristone and misoprostol, and it has been approved by the FDA to end pregnancies up to 10 weeks gestation. Two-thirds (67%) of women of reproductive age report that they have heard about medication abortion ( Figure 10 ). While still majorities, relatively smaller shares of Asian or Pacific Islander (62%), Black (64%), and Hispanic (59%) women report having heard about medication abortion compared to White women (72%). Similarly, smaller shares of women with lower incomes (60%) have heard about medication abortion compared to women with higher incomes (74%). Compared to women who identify as pro-choice (72%) and women who are Democrats (77%), smaller shares of women who identify as pro-life (56%) or are Republican/Republican leaning (62%) or independents (60%) report hearing of medication abortion.

The majority of women are unsure of the legal status of abortion in their state. While neither mifepristone nor misoprostol are explicitly banned in any state and the drugs can still be used for miscarriage management treatment, their use for abortion is banned in the 14 states with abortion bans. Medication abortion, for the purposes of abortion, is legal in all states with gestational restrictions as well as states without any limits, but is not legal to use for abortion after the state’s gestational limit (for example, after 6 weeks LMP in Iowa, Florida, Georgia, and South Carolina).

The majority of women of reproductive age are unclear about the legal status of medication abortion in their state, regardless of the legal status of abortion in their state ( Figure 11 ). A larger share of women living in states with gestational limits at 24 weeks or without gestational limits (43%) report that medication abortion is legal in their state compared to women living in states with gestational limits between 6 to 12 weeks (19%) and gestational limits between 15 to 22 weeks (18%). Among women living in states where abortion is banned, 6% say medication abortion is legal in their state and 27% say it is illegal. Regardless of the status of abortion in their state of residence, majorities of women of reproductive age are not aware of the legal status of medication abortion in their state or have never heard of medication abortion.

Overall, only one in five (19%) women of reproductive age are aware that medication abortion pills are available online. Since state abortion bans and restrictions have gone into effect, new online services have been created that sell medication abortion pills through online organizations. Among women of reproductive age, 10% say individuals in their state cannot get medication abortion pills online and about three-quarter (71%) were unsure or had never heard of medication abortion ( Figure 12 ). Small shares of women living in states where abortion is banned or states with gestational limits know that people in their states can get medication abortion pills online compared to women living in states without any gestational limits or limits after 24 weeks.

Opinions on Abortion Policy

Three in four (75%) women of reproductive age in the United States, the age group that is most directly impacted by state abortion policies, think that abortion should be legal in most or all cases—38% say legal in all cases and 37% legal in most cases. Only 8% of women say that abortion should be illegal in all cases. This trend is consistent with prior polls which have found that the majority of Americans believe that abortion should be legal.

Across various subgroups, except those who identify as Republican or pro-life, majorities of reproductive age women think abortion should be legal in all or most cases. Among those ages 18 to 49, over eight in 10 Black women (83%) and Asian or Pacific Islander women (83%), and almost three-quarters of Hispanic women (73%) and White women (72%) think abortion should be legal ( Figure 13 ). In contrast, slightly less than half (48%) of Republican women of reproductive age think abortion should be legal, 36% say abortion should be illegal in most cases and 17% say abortion should be illegal in all cases. Not surprisingly, among women who identify as pro-life, 74% say that abortion should be illegal in all or most cases, but one in four (25%) believe that abortion should be legal in all or most cases.

Seven in ten reproductive age women (70%) support a law guaranteeing a federal right to abortion, with half (50%) saying they strongly support this (Figure 17) . While similar shares of Asian, Black, Hispanic, and White reproductive age women support a nationwide right to abortion, support varies widely by income, urbanicity, and party affiliation ( Figure 14 ). Though still a majority, smaller shares of reproductive age women with lower incomes (64%) and women who live in rural communities (62%) support a nationwide right to abortion compared to their urban/suburban (71%) and higher income counterparts (74%). Support is strongest among Democratic (84%) women, but two thirds (64%) of women who identify as independents and nearly half of Republican women (48%) strongly or somewhat support establishing a federal right to abortion. More than three times as many Democrats (71%) than Republicans (22%) strongly support a law that would guarantee this right.

More than half of all women of reproductive age support a law establishing a nationwide right to abortion, regardless of the abortion status in their state of residence. While there are smaller shares of support among women who reside in states with bans and gestational limits before viability, over four in 10 women in these states strongly support a law guaranteeing a federal right to abortion.

On the issue of abortion, former President Trump has previously said he would consider a national ban at 15 or 16 weeks, a position also proposed by other Republican elected officials. Overall, six in ten women of reproductive age (63%) oppose a law that would establish a nationwide ban on abortion at 15 weeks ( Figure 15 ). While still a majority, smaller shares of those with lower incomes (58%) and those who reside in rural areas (55%) oppose a national abortion ban at 15 weeks. Six in ten women in states with abortion bans and gestational limits before viability oppose a national ban on abortion at 15 weeks.

Most recently, former President Trump announced he supports leaving abortion policy up to the individual states, allowing the current bans and restrictions to stay in effect across half the country. Overall, nearly three in four women of reproductive age (74%) oppose this approach ( Figure 16 ). Similar shares of Asian (72%), Black (75%), Hispanic (75%), and White (72%) reproductive age women oppose leaving abortion policy up to the states. Compared to their counterparts, larger shares of women with higher incomes (76%) and those who live in urban/suburban communities (74%) oppose having states decide whether abortion should be legal or illegal in their states.

At least half of all women oppose this approach regardless of party affiliation, but opposition is highest among Democratic women (88%). While there is slight variation in support/opposition by abortion status in a woman’s state of residence, over two thirds of those in states with abortion bans and gestational limits oppose leaving the legality of abortion up to individual states.

• Women's Health Policy
• Women's Health Survey
• Women and Girls/Gender
• Reproductive Health
• TOPLINE & METHODOLOGY

Also of Interest

• Women and Abortion in Florida: Findings from the 2024 KFF Women’s Health Survey
• Women and Abortion in Arizona: Findings from the 2024 KFF Women’s Health Survey
• Abortion in the United States Dashboard
• 2024 Women’s Health Survey

• Project 2025
• Kamala Harris
• Supreme Court
• Abortion Bans
• Women in Politics
• Masculinity

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Gun Violence—A Black Feminist Issue: An Excerpt From Roxane Gay’s New Essay, ‘Stand Your Ground’

“in some ways, feminism and gun ownership seem like a good fit. … but guns can be as disempowering as they are empowering.”.

Bold and personal, Roxane Gay unpacks gun culture and gun ownership in America from a Black feminist perspective in her latest work, “Stand Your Ground.” The essay is the capstone to  Roxane Gay &, a curated series of ebooks and audiobooks that lift up other voices , available exclusively on subscription hub Everand. 

In “Stand Your Ground,” Gay writes about power, agency and gun ownership: “I own a gun, but I have more questions than answers,” as she acknowledges the complexity of these issues through Audre Lorde’s famous quote: “There is no such thing as a single-issue struggle because we do not live single-issue lives.” 

The following is an excerpt from “Stand Your Ground: A Black Feminist Reckoning with America’s Gun Problem” copyright © 2024 by Roxane Gay, used by permission from Everand Originals and available exclusively through Everand .

Too many politicians made no efforts to codify [the right to abortion] federally. They assumed they were standing firmly on solid ground when such was not the case.

I’m a Black feminist, a bad feminist, a woman who believes a more equitable present and future are possible.

I’m not an optimist, but I have seen the change we are capable of when people work together and persist. I have also seen what we lose when we take the ground upon which we stand for granted or we don’t stand our ground firmly enough.

In 2022, the Supreme Court ruled 5-4, in Dobbs v. Jackson , that the Constitution does not endow people with a right to abortion. Many Americans were shocked because the right to abortion was the law of the land for nearly 50 years. An entire generation grew up understanding that they could make choices for their bodies without legislative intervention, though in more conservative states, that right was always contingent. And then, in an arbitrary legal decision, a judicial body took that right away from millions of people with uteruses. It happened because too many Americans assumed that the right to abortion was unimpeachable. Too many politicians made no efforts to codify that right federally. They assumed they were standing firmly on solid ground when such was not the case.

It is appalling that women and people with uteruses have lost such a fundamental right to bodily autonomy. And it is not lost on me that women in many states have more rights as gun owners than they do as women. The power to take a life is more constitutionally and culturally valuable than a woman’s right to live freely. I do not know how to reconcile this reality with my feminism.

I have no fondness for guns. They are, in most hands, incredibly destructive. Every year, the number of mass shootings increases. With each new atrocity, the details are more horrifying.

A concert in Vegas. An elementary school in Connecticut. An elementary school in Texas. Staggering numbers of young children, dead before they know what it means to live. A parade in a Chicago suburb. A synagogue. A grocery store. A gay nightclub. A church. Another church. So many high schools. Shopping malls. Movie theaters.

With each successive tragedy, the details become more lurid, haunting, devastating, grim. And with each passing year, it feels more dangerous to spend time in public places, wondering if you are on the precipice of becoming a statistic. 

It has not always been this way. It shouldn’t be this way. It does not need to be this way. 

The power to take a life is more constitutionally and culturally valuable than a woman’s right to live freely. I do not know how to reconcile this reality with my feminism.

There is no single reason for mass shootings, though there are a few common denominators. The vast majority of mass shooters are men. Nearly 60 percent of mass shooters have a history of domestic violence. It feels like we cannot understand or predict mass shootings, that we cannot unravel the tangled threads of violence on a massive scale, but that isn’t necessarily true. And even if these crimes were unpreventable (they aren’t), we could certainly make it far more difficult for mass shooters to have access to the weapons that make their paths of destruction possible.  

In some ways, feminism and gun ownership seem like a good fit.

A lot of feminist rhetoric centers on empowerment— creating opportunities and conditions that allow women to use their power, be treated with respect, have bodily autonomy, live on their own terms. A lot of gun rhetoric is also centered around empowerment—guns as a means of taking back power after trauma or claiming power in the name of self-defense or embracing the power of keeping our families safe.

But feminists must also grapple with the reality that however empowering guns may be, they are used against women at alarming rates—whether women are being threatened, injured or killed by a gun. The statistics are even more dire for Black, Latina and other women of color. Guns can be as disempowering as they are empowering. 

Throughout the trial, and the many months leading up to the trial, Megan Thee Stallion was defamed and discredited for standing her ground and demanding justice.

On a July evening in 2020, rapper Megan Thee Stallion was in Los Angeles, sitting in a car with rapper Tory Lanez outside a party. There was some kind of disagreement that ended with Lanez shooting at Megan Thee Stallion’s feet multiple times, and taunting her, after she got out of the vehicle. Her injuries required surgery and a lengthy recovery.

Hours after the shooting, Lanez left a meandering voicemail for Kelsey Harris, Stallion’s former friend. In the message, he said, “I was just so fucking drunk, nigga, I just didn’t even understand what the fuck was going on, bruh. […] Regardless, that’s not going to make anything right and that’s not going to make my actions right.” Though he didn’t explicitly admit he shot Stallion, the implication of and the regret for his actions were there. 

Two years later, Lanez was found guilty of assault with a firearm, illegal possession of a firearm, and negligent discharge—and sentenced to 10 years in prison. But the damage was done. Throughout the trial, and the many months leading up to the trial, Megan Thee Stallion was defamed and discredited for standing her ground and demanding justice. The severity of her injuries and the aftermath of the crime were doubted and dismissed. Hip-hop journalists, radio hosts and bloggers spread lies and misinformation and came up with all kinds of conspiracy theories to believe anything but the truth—that a Black woman was harmed and deserved justice. Rapper 50 Cent, in social media posts, doubted Stallion’s story, though later apologized. In “Circo Loco,” Canadian rapper Drake said, “This bitch lie ‘bout getting shots, but she still a stallion.” Eminem also had bars for Stallion when, in “Houdini,” he said, “If I was to ask for Megan Thee Stallion, if she would collab with me, would I really have a shot at a feat?”  

These incidents bring Malcolm X’s prophetic words into stark relief: “The most disrespected person in America is the black woman. The most unprotected person in America is the black woman. The most neglected person in America is the black woman.” Culturally sanctioned misogynoir clarifies why addressing gun violence is not just a criminal justice issue—it is very much a Black feminist issue.

Women Rap Back: ‘It’s My Dance and It’s My Body’

The Abolitionist Aesthetics of Patrisse Cullors, Co-Founder of Black Lives Matter

Kamala Harris and the Legacy of Black Women’s Leadership

U.S. democracy is at a dangerous inflection point—from the demise of abortion rights, to a lack of pay equity and parental leave, to skyrocketing maternal mortality, and attacks on trans health. Left unchecked, these crises will lead to wider gaps in political participation and representation. For 50 years, Ms . has been forging feminist journalism—reporting, rebelling and truth-telling from the front-lines, championing the Equal Rights Amendment, and centering the stories of those most impacted. With all that’s at stake for equality, we are redoubling our commitment for the next 50 years. In turn, we need your help, Support Ms . today with a donation—any amount that is meaningful to you . For as little as $5 each month , you’ll receive the print magazine along with our e-newsletters, action alerts, and invitations to Ms . Studios events and podcasts . We are grateful for your loyalty and ferocity .

About Roxane Gay

You may also like:, kentuckians sound the alarm: abortion bans are driving doctors out of state, abortions up over 20 percent since dobbs, driven by telehealth.

After Iowa abortion ruling, should voters boot Justice David May? Rekha Basu weighs in.

Opponents of same-sex marriage waged ideological warfare against the courts in 2010. this time, kim reynolds, lawmakers and justices are responsible for the ideological warfare..

• Rekha Basu is a longtime syndicated columnist, editorial writer, reporter and author of the book, “Finding Your Voice.”
• She retired in 2022 as a Des Moines Register columnist.

In 2010, a group of evangelical political activists, furious over the Iowa Supreme Court’s unanimous ruling for same-sex marriage, plotted revenge. Led by Bob Vander Plaats of the The Family Leader, they formed the ironically named “Iowans for Freedom.”

Funded partly by out-of-state money, it campaigned against three of the Supreme Court justices who happened to be up for retention elections. And it succeeded in unseating three fine ones:  Chief Justice Marsha Ternus and Justices Michael Streit and David Baker .

Fast forward to this year, when a reconstituted Iowa Supreme Court, a majority hand-picked by Iowa’s anti-abortion Gov. Kim Reynolds, turns back the clock 50 years with a 4-3 ruling effectively outlawing abortions after six weeks into a pregnancy. In doing so, the justices overturned their own court's precedent, deciding that abortion laws should not be assessed under the strict-scrutiny standard previously invoked .

And now, in response, some women are taking a cue from what Iowans for Freedom accomplished in 2010. They’re encouraging others to turn the page on the November ballot — literally — to the side where judicial retention votes are, and vote against Justice David May . He’s the only one who voted for the six-week ban who’s up this year.

So, how could anyone who opposed the 2010 campaign support the same tactic? Comparisons between the two efforts get complicated. Retention elections used to be mostly pro forma shows of support for sitting judges appointed on a nonpartisan basis, who were doing their jobs properly. In 2010, same-sex marriage opponents couldn’t accept that their religious-based agenda had lost in a court of law bound by the Iowa Constitution. So it used the elections to wage ideological warfare. 

This time the ideological warfare has been waged by the governor, state lawmakers and the court’s new majority, by tampering with the once nonpartisan, constitutionally based process. Reynolds, an outspoken abortion opponent, called a special one-day session of the Legislature last summer to vote on the ban. Six weeks is before most women even know if they’re pregnant. Iowa’s Republican-led Legislature complied by passing it, though a nearly identical 2018 law had been permanently blocked . Reynolds had over the years appointed four new justices, including May, who could reliably be predicted to vote as they did.

More: Kim Reynolds picked this Legislature, and it steamrolled an extreme path for Iowa

The victims now will be untold numbers of pregnant women and girls, and children born to people ill-equipped to care for them.

“The ideological bias of this court does not reflect the will of most Iowans, and I’m not sure how far it follows the constitution,” said Des Moines’ Lea DeLong, the reproductive rights advocate who penned a letter making the case for opposing May’s retention. “My reading of the constitution is that it is intended to expand the rights and liberties of people.”

Her letter is being widely circulated by email. It points out that, as Reynolds’ appointee, May helped give Iowa “one of the most restrictive rulings in the nation against the rights of women.” It goes on to say, “It is an unfortunate development in our society that these kinds of actions against judges must happen, but I'm afraid we have had to learn some sad lessons from those who deny the rights of women. It is well known that most Iowans do not support these draconian restrictions on women's lives and decisions.”

That’s true: 61% of Iowans polled support abortion rights in all or most cases . Still, the governor saw fit to impose her personal beliefs over the will of the majority.

DeLong is co-founder with Charlotte Hubbell of a group of some 15 women known as Iowans for Reproductive Freedom (one word but light years away from the group that waged the 2010 ballot battle). Formed in November, 2022, it has placed billboards defending reproductive rights on display around Des Moines.

They carry such captions as:

•   Reproductive Freedom Is KEY to a Strong Family .
•  Keep Government OUT of Women's Health Care .
• If Men Got Pregnant, We Wouldn't Be Discussing This .

Though individual members support the ballot idea and are circulating DeLong’s letter, the organization isn’t officially involved in the effort. DeLong herself doesn’t doubt May is a good person. And she’s mindful that Reynolds would likely replace him with another justice of the same ideological bent. But she wants this to be a wake-up call. “It sends a message,” she said. “Maybe it will encourage people to think very seriously about what this court is doing to women.”

Unlike Vander Plaats’ well financed and heavily publicized initiative, she says, “We’re not trying to organize a campaign. We will do what women have always done before: Spread information to our friends.”  

More importantly, the goal this time is protecting rights, not undermining them.

“Much as I don’t like the fundamental concept of doing this,” DeLong said, “I think so many destructive lines have been crossed.”

And she’s right. They have been.

Rekha Basu is a longtime syndicated columnist, editorial writer, reporter and author of the book, “Finding Your Voice.” She retired in 2022 as a Des Moines Register columnist. Her column, “Rekha Shouts and Whispers,” is available at basurekha.substack.com .

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Fact-Checking Claims About Tim Walz’s Record

Republicans have leveled inaccurate or misleading attacks on Mr. Walz’s response to protests in the summer of 2020, his positions on immigration and his role in the redesign of Minnesota’s flag.

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By Linda Qiu

Since Gov. Tim Walz of Minnesota was announced as the Democratic nominee for vice president, the Trump campaign and its allies have gone on the attack.

Mr. Walz, a former teacher and football coach from Nebraska who served in the National Guard, was elected to the U.S. House of Representatives in 2006 and then as Minnesota’s governor in 2018. His branding of former President Donald J. Trump as “weird” this year caught on among Democrats and helped catapult him into the national spotlight and to the top of Vice President Kamala Harris’s list of potential running mates.

The Republican accusations, which include questions over his military service , seem intended at undercutting a re-energized campaign after President Biden stepped aside and Ms. Harris emerged as his replacement at the top of the ticket. Mr. Trump and his allies have criticized, sometimes inaccurately, Mr. Walz’s handling of protests in his state, his immigration policies, his comments about a ladder factory and the redesign of his state’s flag.

Here’s a fact check of some claims.

What Was Said

“Because if we remember the rioting in the summer of 2020, Tim Walz was the guy who let rioters burn down Minneapolis.” — Senator JD Vance of Ohio, the Republican nominee for vice president, during a rally on Wednesday in Philadelphia

This is exaggerated. Mr. Walz has faced criticism for not quickly activating the National Guard to quell civil unrest in Minneapolis in the summer of 2020 after the murder of George Floyd by a police officer. But claims that he did not respond at all, or that the city burned down, are hyperbolic.

Mr. Floyd was murdered on May 25, 2020, and demonstrators took to the streets the next day . The protests intensified, with some vandalizing vehicles and setting fires. More than 700 state troopers and officers with the Minnesota Department of Natural Resources’ mobile response team were deployed on May 26 to help the city’s police officers, according to a 2022 independent assessment by the state’s Department of Public Safety of the response to the unrest.

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One of the Most Conservative State Supreme Courts in the Country Just Rebuked Dobbs

The Utah Supreme Court, a body with a clear conservative majority , surprised many observers last week when it handed down a ruling blocking enforcement of the state’s new abortion ban , which criminalizes virtually all abortions from the moment of fertilization . The law, which was set to go into effect in 2022, was blocked by a trial court while the litigation continued, a decision affirmed by the state Supreme Court last week. The Utah decision is not just a reminder that conservative judges faced with the prospect of retention elections may be afraid to gut abortion rights; it also spotlights the chaos and confusion produced by the U.S. Supreme Court’s decision undoing a right to choose abortion—and problems with using history and tradition as the only guide to identifying our most cherished rights.

Utah fought the lower court injunction by stressing the kind of argument the U.S. Supreme Court’s supermajority made in reversing Roe v. Wade : arguing that there could be no right to abortion rooted in Utah’s history and tradition because Utah law had long criminalized abortion, and that the rationale of the Dobbs ruling dismantling the federal right to abortion applied here at the state level. The judges of the Utah Supreme Court agreed that the state’s constitution should be interpreted as conservative judges often suggest—in line with “what constitutional language meant to Utahns when it entered the constitution.” But the fact that the state court embraced originalism did not mean that it was ready to let Utah’s ban go into effect.

The relevant question, the court asked, was which broad principles would have been recognized by state residents when the state’s constitution was established. Utahans might not have recognized or even thought about a right to abortion per se, but that was not the point. Looking for too direct an analogue, the court reasoned, was unnecessary or even perverse. “Failure to distinguish between principles and application of those principles,” the court reasoned, “would hold constitutional protections hostage to the prejudices of the 1890s.”

Even the U.S. Supreme Court’s conservative supermajority seems aware of the problem that Utah’s high court identified. In Rahimi v. United States , the court dodged a potentially disastrous ruling that the Second Amendment made it unconstitutional to deny access to a firearm to someone who posed a credible threat of violence to his partner or minor child. The question was not whether the United States could identify a regulation exactly like the one Zackey Rahimi was challenging; instead, the court would focus on whether the “challenged regulation is consistent with the principles that underpin the Nation’s regulatory tradition.”

The Utah decision shows that the Supreme Court may have assigned itself a sort of Hobson’s choice: binding itself to the biases of the 19 th century or embracing a looser, principle-driven approach that is quite different from the vision of history and tradition the conservative justices have embraced.

The Utah court also highlighted how much the Supreme Court hasn’t told us about how a history-and-tradition test works—and how differently judges can approach it. Dobbs suggests that there can’t be a right to abortion given that states in the 19 th century criminalized abortion (albeit, in some cases, many years after the relevant constitutional provision came into effect). The Utah court thought that it isn’t so simple. The judges tried to account for what regular people, including those who could not vote at the time, thought about which rights were protected. The majority, for example, stressed evidence including a book written by a female doctor about the beliefs and practices of Utah women in the 1890s, and acknowledged that regular Americans might have believed that abortion was moral and even legal before quickening, the point at which fetal movement could be detected, even as criminal laws sometimes eliminated that distinction. There are other unanswered questions too. What is the relationship between originalism or history and tradition—and how much do the conservative justices care about history from after the relevant constitutional provision is put in place? What kinds of evidence count—and from which time periods? Can a court pay attention to those who were marginalized at that time or only those with power in the era to write their views into law?

The Utah decision shows how unstable Dobbs is—and how easy it is for courts to use historical evidence to reach their preferred results. Looking to history and tradition does not absolve judges of responsibility for making decisions that are unpopular or unjust because, as the Utah court recognized, historical analysis allows courts so much flexibility to decide whose history matters and why. It is not the founders who make choices about when and how to look at the past. It is the judges faced with the critical questions of today. Dobbs promised that history would constrain a court that might want to dabble in politics. In truth, as the Utah decision implies , Dobbs treats history as “a type of Rorschach test where we only see what we are already inclined to see .”