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A draft Supreme Court (SCOTUS) majority opinion was leaked on Monday May 1, 2022. In it, it is suggested that SCOTUS will overturn Roe v. Wade, which will have substantial implications for access to abortion in the US.
Let’s be clear: restricting access to safe and legal abortion is not aligned with science or public health.
Research from around the world has shown that banning abortion does NOT stop abortions from happening, it just leads to an increase in unsafe abortions. Unsafe abortions have a much greater risk to the life of the pregnant person compared to safe abortion provided by trained professionals.
When abortion is heavily restricted or banned, women from poor, rural and marginalized communities are at the greatest risk, as they may not be able to afford to travel to places where abortion is legal, or pay what it costs. In contrast, affluent people will still be able to find resources to access abortion.
If we really want to prevent the need for abortion, outlawing abortion is not the way to do that. To tackle this, we have to provide access to affordable and effective contraception, comprehensive sex education, access to prenatal care, affordable childcare, and paid parental leave. Unfortunately, the US does not offer these things.
Let’s discuss some common contraception methods. It is important to remember that even though some contraception methods have smaller failure rates, pregnancies can still happen. No method is 100% in preventing pregnancies, even the most effective methods.
Most effective methods are categorized as tier 1, with an average failure of 1 pregnancy per 100 women in one year. These include:
Hormonal IUD: releases a small amount of progestin over the years. Typical Failure rate: 0.1-0.4%
Copper IUD: Typical failure rate: 0.8%
Implant: releases progestin over the years. Typical failure rate: 0.1%
Permanent methods can still fail
Tubal ligation: Typical failure rate 0.5%
Vasectomy : Typical failure rate 0.15%
Tier 2 methods report 4-7 pregnancies per 100 women in one year, and these include:
Injection/the “shot”: progestin injection every 3 months. Typical failure rate: 4%
The pill: Typical failure rate 7%
Progestin only pill: Typical failure rate 7%
The patch: Typical failure rate 7%
Hormonal vaginal contraceptive ring: Typical failure rate 7%
Tier 3 methods are considered less effective, and lead to more than 13 pregnancies per 100 women in one year:
Barrier methods:
Male condoms: Typical use failure rate 13%
Female condoms: Typical use failure rate 21%
Fertility awareness based method: keeping track of your period, ovulation and fertility patterns. Typical failure rate 2-23%
Pull-out method : 22 out of 100 women get pregnant
Even the most responsible people can still have an unplanned pregnancy. No method of contraception is 100% effective. It is estimated that nearly half of all pregnancies are unintended, and 45-49% of the time they are unplanned. Women will still need abortions. But if laws penalize people from seeking abortion, these will happen behind closed doors, and more women and girls will be injured or die.
Abortion is safe when it is legal, accessible, and carried out by qualified professionals. According to the WHO, “abortions are safe when they are carried out with a method that is recommended by WHO and that is appropriate to the pregnancy duration, and when the person carrying out the abortion has the necessary skills.” Unsafe abortions are considered one of the most easily preventable causes of maternal mortality.
In countries with the fewest abortion restrictions, only 1% of abortions were considered “least safe” from 2010 to 2014. That number jumps to 31% in the most restrictive countries. However, abortions happened roughly as frequently in the most restrictive countries as they did in the least restrictive: 37 versus 34 abortions each year for every 1,000 women aged 15 to 44. Again, restrictions aren’t stopping abortion, they’re only making them less safe.
Unsafe abortion can lead to immediate health risks – including death – as well as long-term complications, affecting women’s physical and mental health and well-being throughout her life-course.
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