The Faculty of Public Health (FPH) joins more than 100 global healthcare organisations in condemning the US Supreme Court decision to overturn the 50-year-old landmark Roe v. Wade ruling on the constitutional right to abortion. We stand with The Royal College of Obstetricians and Gynaecologists (RCOG) and the Faculty of Sexual and Reproductive Healthcare (FSRH), who have issued a joint statement with a global list of organisational signatories.
In June 2022 the Supreme Court effectively ended the constitutional right to an abortion for millions of women and pregnant people across the US meaning that abortions can now be banned or effectively banned by individual states. This has now become the case in at least nine states and several more are expected to follow in the coming weeks.
Access to safe and legal termination of pregnancy is an essential part of reproductive health care and a staple of the human right to bodily autonomy. This ruling will cost lives.
In 2020 the World Health Organization (WHO) published guidance on essential health services to maintain during the Covid-19 pandemic and comprehensive abortion care was included on this list in recognition of its vital importance. Abortion is safe when it is carried out using a recommended method by a professional with the skills to provide the care. When people are unable to access safe abortion care, for reasons such as discrimination, affordability, or legal restriction, they often have little choice but to resort to unsafe methods. Globally, unsafe abortions are a leading cause of preventable maternal death and morbidity. 47,000 women across the world die each year as a result and many more suffer serious mental and physical consequences.
This ruling will undoubtedly widen health inequalities. Women and pregnant people in the most deprived groups in society will suffer disproportionately from the lack of safe abortion care. Whilst the US ruling has far-reaching implications for all, it is likely that those from less deprived backgrounds will still be able to access abortion despite state bans, since they have the resources to travel and pay for care. However, those living in deprivation, who we know need to access abortions more frequently, will have far more limited options, and may resort to unsafe abortion practices with their attendant risks. The greatest burden of the consequences of this ruling will fall upon those who are already most disadvantaged in society.
Furthermore, by criminalising the provision of essential abortion care, health care workers will be at risk of harm or prosecution, and the safe management of miscarriages, ectopic pregnancies and other obstetric emergencies will be impacted. In the US, there have been incidents of health care professionals being murdered for supporting abortion care. These new bans will further increase the risk to those who strive to support reproductive healthcare and fight for human rights.
While abortion is legal in the UK, issues accessing services remain, particularly in Northern Ireland and for second trimester abortions in Scotland. Patients seeking abortions and the staff providing them continue to be subject to harassment and intimidation by anti-abortion campaigners who position themselves outside abortion clinics. This has led to a call for the widespread implementation of so-called buffer zones, the first of which was set up in Ealing in 2018. However, only two more have been set up since. There is a concern that the US ruling will embolden anti-abortion protesters in the UK.
The FPH recognises that we must stand together with global organisations to urge all governments to allow the provision of safe, affordable, and accessible abortion care because it is an essential part of healthcare that saves lives. In addition, the right to reproductive and bodily autonomy is a fundamental human right which must be preserved at all costs.
The FPH welcomes blogs from our members on their opinions and any work related to abortion care as well as comments or recommendations for how we can support and raise awareness of this issue.
Written by Faculty of Public Health Sexual and Reproductive Health Special Interest Group Co-Chairs: Rachael McCarthy and Natalie Daley.
With thanks to members of the SIG for their contributions.