January 22 will mark the 51st anniversary of Roe v. Wade, which established federal protection of the right to abortion in the United States. Since June 2022, when the Supreme Court reversed Roe, at least 14 states have adopted abortion bans imposing severe civil and criminal penalties on clinicians for providing abortion except in very narrow circumstances.
Health and human rights advocates across the United States – including Physicians for Human Rights (PHR) – oppose these bans and the profound harm they cause, to patients and clinicians alike. Read on for a recap of PHR’s work on reproductive justice at the national and international arenas, and a look at how we’re gearing up for the year ahead.
Exposing a Health and Human Rights Crisis in the United States
Since Roe was overturned in 2022, PHR has worked with partners across the country to document the harm of abortion bans in the United Staes and bring evidence of the resulting health and human rights crisis to state legislatures, courts, the U.S. Congress and federal agencies, and regional and international human rights mechanisms. Our message is clear: State bans criminalizing abortion are incompatible with medical standards of care and the ethical practice of medicine, and therefore must be overturned.
Drawing on our research, including our groundbreaking April 2023 report “No One Could Say: Accessing Emergency Obstetrics Information as a Prospective Prenatal Patient in Post-Roe Oklahoma,” jointly published with the Center for Reproductive Rights and the Oklahoma Call for Reproductive Justice, we have called for recognition of the human rights violations caused by criminalizing abortion and the need for urgent reform. Our research revealed that due to abortion bans, no hospital in Oklahoma appeared able to articulate clear, consistent policies that empower clinicians’ to use their medical judgement nor support pregnant patients’ stated preferences and needs. The report was read into the Congressional record on April 27, 2023.
We continue to document clinicians’ and patients’ experiences under such bans and are pursuing accountability with key decision-makers. In November 2023, we submitted an amicus brief to the Texas Supreme Court in the case Zurawski v. State of Texas originally filed by the Center for Reproductive Rights on behalf of 20 people denied abortions under Texan law and two physicians. The PHR amicus brief argues that Texas statutes do not align with medical standards, thereby placing clinicians’ medical and ethical duties to their patients in direct conflict with the law; the penalties for performing an abortion, which a clinician deems medically necessary, can result in a jail term up to 99 years, $100,000 fines, and the potential loss of one’s medical license. Ultimately, this case will determine whether Texan clinicians are granted greater autonomy when deciding whether to provide care or will worsen the environment of fear and confusion within the medical community.
Advocacy at the International Level
PHR submitted evidence to the United Nations special procedures as well as the United Nations Human Rights Committee as part of its periodic International Covenant on Civil and Political Rights (ICCPR) review of the United States’ human rights record. The Committee found that abortion bans violate the rights to “life, privacy, and not to be subject to cruel and degrading treatment” and called on the United States to end the criminalization of abortion, remove barriers to care, and strengthen privacy protections for patients and clinicians.
We also worked with partners to share the experiences of abortion patients and providers with the Inter-American Commission on Human Rights (IACHR), a regional human rights body in the Americas, in November. During the hearing, PHR and our partners called on the federal government to end the criminalization of abortion, strengthen privacy protections, and combat maternal morbidity and mortality. The commissioners strongly condemned state-level abortion bans as constituting ill-treatment and torture and expressed concerns that criminalizing abortion would exacerbate health inequities and maternal mortality rates, particularly for communities of color. By denying necessary health care to pregnant persons and imperiling their physical and mental health and safety, abortion bans rise to the level of torture and ill-treatment.
By denying necessary health care to pregnant persons and imperiling their physical and mental health and safety, abortion bans rise to the level of torture and ill-treatment.
We reiterated the concern that the costs of abortion criminalization disproportionately affect communities of color to various special mandates of the United Nations, including the Special Rapporteur on Contemporary Forms of Racism and the Expert Mechanism to Advance Racial Justice and Equality in Law Enforcement. Notably, communities of color in the United States already experience reduced access to quality reproductive health care and women of color are more likely to fall below the poverty line than white women, therefore feeling the costs of interstate travel for health care acutely.
A Look Ahead
The reversal of Roe v. Wade and 51 years of protection for abortion rights underscores the critical need for a holistic approach to enshrining sexual and reproductive health and rights. These rights remain under threat, including two looming legal challenges before the U.S. Supreme Court this year. Negative rulings on these cases would restrict Emergency Medical Treatment and Labor (EMTALA) guidance that protects the rights of patients in emergency rooms, and limit access to mifepristone for medication abortion. EMTALA guarantees all Americans emergency care at Medicare-participating hospitals with emergency departments and requires that hospitals stabilize patients when detecting a medical emergency.
Ultimately, these broad attacks on abortion present an urgent health care crisis; clinician and patient autonomy is at risk, barriers in access to reproductive health care are increasing, and maternal mortality rates will likely rise significantly. As this crisis unfolds, PHR has been working with partners to interview clinicians at the state level in Louisiana to understand how medical personnel navigate bans in their practice and to assess the implications for human rights and health.
This year promises to be another pivotal year for reproductive rights in the United States as the public goes to the polls to vote, including on state level ballot initiatives concerning reproductive rights. Other opportunities for reform, through state ballot measures, strengthening Health Insurance Portability and Accountability Act (HIPAA) protections that would safeguard the confidentiality of patient records, and more proactive measures from the Executive Branch, are all avenues available to reproductive rights advocates to use in the upcoming year. PHR is committed to building evidence of the health and human rights harms of abortion bans and will continue to push for reform.