CAR Statement on the Reversal of Roe v. Wade

Eliza Williamson, Brenna McCaffrey, Ashish Premkumar, Joanna Mishtal, Megan Cogburn, Becca Howes-Mischel, and Lucy Lowe

Introduction

“Restricting access to safe and legal abortion forces pregnancy-capable people to make the difficult decision between continuing with an unintended pregnancy, expending needed resources to travel to areas where abortion is more readily available, or undergoing a clandestine and potentially unsafe abortion procedure. By undermining each person’s ability to determine what is best for themself, their family, and their future, laws restricting access to abortion do harm to women and other people who can become pregnant, their families, and their communities.” [Council on Anthropology and Reproduction Policy Statement; quote edited for gender-inclusive language]

These words could have been written now, in the aftermath of the U.S. Supreme Court (SCOTUS) decision that overturned Roe v. Wade; however, they were written almost eight years ago by anthropologists studying reproductive politics.

On June 24, SCOTUS decided in favor of the Mississippi Department of Health (Dobbs) in a case that challenged Roe v. Wade, the historic SCOTUS ruling almost 50 years ago that established the right to abortion at the federal level. The ruling effectively overturned Roe, leaving millions of people without reliable access to legal abortion care. The Dobbs decision has an immediate impact by restricting abortion care access in at least 26 states, and activating trigger bans—abortion restriction laws that automatically took effect when Roe was overturned—in 13 states. Clinics in 8 states (at the time of this writing) have closed, although some are in the process of raising funds to move to more abortion-friendly bordering states. In states where legal challenges have delayed the enactment of these bans, clinic workers and people seeking abortions have been forced to make care plans knowing that they might be abruptly canceled. These bans and their effects in delaying care harm both people seeking elective abortions and people facing obstetrical emergencies. The immediate impacts of these bans also extend beyond these states, as clinics in states without restrictive bans work to meet the needs of people traveling for care along with their existing patient communities.

The U.S. has the highest maternal mortality rate among high-income countries, and this rate will likely increase even further as a result of Dobbs.¹ Recent data demonstrate the health ramifications of near-total abortion bans in states that already heavily restrict the practice, including a high incidence of maternal morbidity (health problems resulting from pregnancy and birth). Other studies show that abortion restrictions can lead to higher maternal mortality.

As many others have pointed out, the Dobbs decision will have a disproportionate impact on those who are already marginalized and vulnerable. Black and Brown communities, poor and rural communities, incarcerated people, and immigrants will all be more heavily affected by the ruling than those who have the privilege of being able to travel with relative ease to other states for abortions, navigate the process of ordering misoprostol, a pharmaceutical drug used in medication abortions, by mail (and take the legal risk of doing so), and mobilize other resources to obtain abortions when needed. Recent research shows that these marginalized communities are already experiencing the criminalization of reproductive health, and that the majority of those criminalized for self-managing their abortions were reported to law enforcement by their own healthcare providers.

As members of the Council on Anthropology and Reproduction (CAR), we are devastated and outraged at the tragic reversal of this country’s most important court decision on abortion, and we are in solidarity with all those impacted by the SCOTUS decision. We believe anthropology can learn a great deal from abortion politics and that the discipline has much to contribute to the struggle for reproductive justice more broadly, in the U.S. and beyond. We therefore call on anthropologists to research and teach on abortion and abortion politics, mentor students studying reproductive justice topics, mobilize anthropological insights for policy and advocacy efforts by translating research into accessible, inclusive language, and get involved in abortion activism.

Who we are and why we care

The Council on Anthropology and Reproduction (CAR) is a special interest group in the American Anthropological Association. We are a group of scholars and practitioners at various stages of our careers, primarily but not solely in academic institutions, studying a wide range of topics in reproduction, including abortion. Many of us engage in activist and/or advocacy work, allowing this work to infuse our scholarly insights and vice versa. Some of us are also clinicians (midwives, nurses, physicians), doulas, counselors, or other professionals working directly with people seeking abortions.

As experts on reproduction, and especially on the social impacts of reproductive injustices, we were well aware that existing abortion rights under based on the historic Roe v. Wade decision were in imminent danger. In 2016, CAR members published a policy statement in Medical Anthropology Quarterly denouncing state and federal legislation limiting access to abortion. The authors noted the accelerated proliferation of laws limiting the essential work of abortion providers, requiring women and pregnant people seeking abortions to wait a certain number of days and/or be shown their ultrasounds prior to the procedure, and making abortion illegal ever earlier in gestational development. In 2017, CAR members Elise Andaya and Joanna Mishtal published their article “The Erosion of Rights to Abortion Care in the United States” in MAQ, urging anthropologists to turn our attention and our methodological and analytical tools to the politics of abortion.

Most of us are also teachers, and we are preparing to engage with students who can no longer count on their right to abortion being protected by federal law. Those of us who teach courses on the anthropology of reproduction often have students who self-disclose and ask us for help in navigating available health resources at higher rates than our colleagues in other disciplines and areas of study. As a number of authors have argued in The Chronicle of Higher Education, the fall of Roe is likely to affect incoming students’ college choices, introduce new barriers into medical training, and deepen the already-critical mental health crisis on college campuses.

Those of us working in public institutions in states hostile to abortion face additional consequences, since our teaching and scholarship are subject to potential bad faith attacks from outside the academy (such as from legislators or politically appointed advisory boards). And, of course, those of us living in states with abortion bans will face increased difficulty getting abortions ourselves if needed. The impact will be felt most poignantly among adjuncts and other contingently employed and underpaid higher education workers, who may not be able to afford travel to other states for procedures.

We also know that what happens in the U.S. often reverberates elsewhere in the world. Scotland’s first minister warned that the SCOTUS decision would embolden anti-abortion activists, whose intensified protests outside medical facilities have driven authorities to legislate “buffer zones” outside abortion clinics to protect patients. Anti-abortion activist groups are directly influenced—and sometimes funded—by U.S. organizations. The rolling back of abortion rights in the U.S. will likely mean the rolling back of abortion rights elsewhere, and anthropologists are well positioned to study these processes and their impacts.

What anthropology contributes

We assert the importance of mobilizing anthropology’s unique tools to attend to abortion politics. This is especially vital now that the U.S. no longer guarantees the right to pregnancy termination.

What epidemiological data on abortion access and maternal health don’t tell us is how women and pregnant people, as well as abortion providers, experience such restrictions. Deep ethnographic engagement can shed light on what it means to conceive, carry, and deliver under a political regime that, in no uncertain terms, endorses forms of pronatalism strongly linked to classist, racist, ableist, and misogynist notions of personhood and citizenship. A number of physicians have presented their perspectives in newspapers and medical journals.² However, although one recently published volume brings together scholars from diverse disciplines to weigh in on abortion care as “moral work,” we still know much less about abortion care provision from the perspectives of people in allied reproductive health specialties, such as midwives and nurses.

Producing ethnographically grounded knowledge with and about those seeking abortions, providing abortion care, and making abortion law and policy is crucial to understanding the human consequences of legal abortion restrictions. What we’ve learned in other country contexts can shed light on what’s in store for the U.S. Anthropologists such as Silvia de Zordo and colleagues, and Joanna Mishtal have shown that women and pregnancy-capable people living in places where abortion is restricted often travel across international and regional borders to seek the medical care they need, or pursue clandestine abortions, which can put their health at risk. Those with limited resources to access abortions or to cross borders suffer most from the restriction of abortion health services. Many incarcerated women in the U.S. are already forced to continue pregnancies since they face numerous monetary and bureaucratic barriers to obtaining abortion care, as Crystal Hayes, Carolyn Sufrin, and Jamila Perritt’s research demonstrates. In her recently published book, Lawful Sins, Elyse Singer shows that the legalization of abortion in Mexico City has been accompanied by increased state vigilance and religious control of women’s reproductive lives. Risa Cromer demonstrates how U.S. anti-abortion activists’ cooptation of racial justice language to assert fetal personhood misleads the public and endangers both reproductive and racial justice. Whitney Arey’s work on “pro-life” protest speech in the U.S. shows how anti-abortion activists mobilize gender stereotypes to shame men accompanying their partners to abortion clinics (and how male companions sometimes reproduce similar stereotypes when they defend themselves and their partners against this protest speech). Finally, a forthcoming issue of Feminist Pedagogy features a piece by Becca Howes-Mischel on using ethnographic empathy to teach students about reproductive rights by centering the intersectional contexts in which people make reproductive decisions.

Of course, abortion access is only one facet of reproductive justice, which is defined by women of color activists in SisterSong as “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” There is a wealth of excellent anthropological scholarship on reproduction that contains relevant insights for developing a critical understanding of abortion politics. Khiara Bridges’ Reproducing Race, for example, examines how race is constructed in U.S. hospitals through interactions between racialized women and clinical staff, focusing especially on the implications for racial disparities in infant and maternal mortality. Dána-Ain Davis’ Reproductive Injustice draws our attention to how medical racism shapes the experiences of Black mothers of premature and low-birthweight infants. Both of these volumes highlight the nefarious consequences of enduring disparities in maternal health even when access to health services is not impugned. How much more overt and covert discrimination must racialized pregnancy-capable people experience when seeking abortion?

The transnational flow of people across borders to get abortions, particularly at the southern border of the U.S., with the decriminalization of abortion in Mexico , calls for further investigation as to how individuals navigate the clinical, legal, political, and economic landscapes of abortion provision in a supranational context. As we study abortion politics in its local iterations, we also need to take up Lynn Morgan’s call to study the global dimensions of abortion politics and policies through ethnography. She suggests there are “limits to using country studies to understand the global dimensions of abortion. These limitations are especially pertinent…as movements for and against reproductive rights have become globalised.” It will also become increasingly important to “study up” to understand how abortion restrictions impact healthcare provision and workflows, and how people resist these stipulations at the local level. Equally important will be studying how abortion restrictions impact queer and trans people, who already have difficulty accessing appropriate reproductive medical care.

Despite the important ethnographic work cited above, what Andaya and Mishtal pointed out in their 2017 statement in MAQ still holds true: aside from Faye Ginsburg’s now-classic Contested Lives, few major ethnographic works on abortion politics in the U.S. have been read widely outside the anthropology of reproduction circles. In contrast, scholarship outside of anthropology is receiving more popular attention as people are seeking out research to inform the next phase of the fight for abortion rights in the U.S. Anthropologists are left off of lists of suggested reading, but we have a unique perspective to offer. We need to clearly communicate and advocate for what our methodological and analytical approaches contribute to understandings of reproduction to those in other disciplines as well as those outside the academy altogether.

Anthropology helps us to unpack our own assumptions about what constitutes autonomy, justice, and reproductive choice. As Singer discusses, interrogating the moral worlds surrounding provision of first-trimester abortion services in Mexico City helped her refine her own perspectives on particular (neo)liberal notions of the self and reproductive justice, filtered through a U.S.-based lens. Put another way, anthropology helps us both provincialize and critically analyze what we take for granted, and what the stakes are for women and pregnancy-capable people in the aftermath of Dobbs.

What gives us hope

The Dobbs decision is a major setback, and we join many in feelings of despair and frustration at government inaction in the face of such a blow. However, there is also cause for hope.

We know that abortion activists around the world have made enormous gains in recent years, often in unlikely places. Last year, for example, mass mobilizations in Argentina known as the “Green Tide” built on the momentum of decades of Argentinian abortion activism to finally get abortion legalized nationally up to 14 weeks gestation. Other Latin American countries, such as Mexico and Colombia, have decriminalized abortion nationally, and individual Mexican states have legalized abortion up to 12 weeks, thanks to the persistent efforts of activists there.

Hope also lies in the promises of telemedicine and abortion pills, in both legal and illegal—and clinician-supported as well as self-managed—settings. Extensive research data from social scientists and public health scholars show that abortion pills can be used safely and effectively to self-manage abortions at home. Increased use of abortion pills and the activist strategies that amplified them were central to changing the narrative about abortion in the Republic of Ireland, which overturned a 35–year constitutional ban in 2018. Healthcare providers are already offering telemedicine abortion care across the U.S. where permissible. Additionally, activists are spreading information about safe self-managed abortion care outside of the medical system for those who may lack access to traditional biomedicine or wish to avoid it due to experience of healthcare stigmatization. New and expanding organizations like ReproCare are creating local peer models of care, inspired by full-spectrum doula work and the accompaniment support model developed originally by activists in Latin America. While none of this obviates the need to ensure accessible and safe abortion care in clinics, we are inspired by the expansion of medication abortion options. As Brenna McCaffrey wrote recently in Sapiens, we must continue to urge advocates for legal abortion to embrace the broader political possibilities enabled by the use of abortion medications.

The SCOTUS decision obscures the fact that most Americans support legal abortion options, which indicates that the Roe’s overturning is, in fact, not what the people want, but a tragic byproduct of a conservative SCOTUS majority. That most people in this country support abortion was plainly illustrated by the recent victory in conservative-majority Kansas, where voters soundly defeated a proposed amendment that would have stripped existing abortion rights protections in the state constitution. This, too, is cause for hope.

Finally, anthropological research can and does make a positive impact on abortion politics. Interdisciplinary research combining anthropology and epidemiology has been critical in the French government’s expansion of the gestational age limits for abortion care. This and other wins show that anthropology has an important role to play in ongoing research to support abortion access globally.

What anthropologists can do

What can anthropology more broadly contribute to the struggle to restore abortion rights and promote reproductive justice for all people? How can anthropologists ally themselves with those already fighting “on the ground,” even if they do not study reproduction? We offer a few suggestions:

1) Answer Nancy Scheper-Hughes’  call for a militant anthropology, considering the ethical and political stakes of solidarity not just as a means of academic inquiry, but as an ethical mode of being, whether we’re scholars, teachers, practitioners, or a combination of these.

2) Build your knowledge by engaging directly with critical feminist works on reproductive politics and the ways it intersects with structural racism, neoliberal economic and social policy, and racial capitalism.

3) If you are a medical anthropologist, you might attend to the consequences of foreclosed reproductive autonomy on various issues of health, illness, and healing, particularly among marginalized people. For example, you could aim to understand how pregnancy impacts how individuals living with chronic medical conditions understand risk and shortened life expectancy.

4) Actively interrogate the logics undergirding antiabortion sentiments and policies and consider how antiabortion policies coincide with other movements within the U.S. (such as utilizing constitutional originalism as a means to undermine trans health or “same-sex” marriage). Unpacking each of these aspects forces us to ask: what work are antiabortion legal frameworks doing outside of the juridico-legal system—specifically, how are they spurring other political, legal, racialized, social, and moral actions at a local and national level? How are they allowing for a willed misinterpretation of particular epistemological frameworks, such as those derived from epidemiology (such as the concept that abortion restriction has been associated with an increase in maternal morbidity and mortality) and pharmacology (such as the conflation of emergency contraception with abortifacents)?

What else we can do now

How can we, as anthropologists and concerned people, contribute to the struggle to restore abortion rights and help ensure that people have access to the abortion care they need in the meantime? Even if your research and teaching do not address abortion, there are many things you can do. We recommend:

• Donating to local abortion funds, especially in states with heavy abortion restrictions. You can find your local abortion fund at https://abortionfunds.org/. Setting up a recurring monthly donation, even a small amount, can make a big difference for people who need abortions right now.
• Amplifying the work of anthropologists who research abortion politics. Doctors, lawyers, historians, and political scientists are speaking to the public through op-eds, letters to the editor, and other avenues, explaining how we got here, what is happening now, and what will happen next. Let’s share the important research we have highlighted above, and support future anthropological research on questions of reproductive politics.
• Writing letters-to-the-editor and op-eds for local and national newspapers. This is an important way of engaging because what we find in our research does not typically reach the general public, therefore for our work to have relevance outside of academia it is crucial for anthropologists to engage through everyday media. The Op-Ed Project offers a useful guide here: https://www.theopedproject.org/resources#gettingstarted.
• Volunteering your time to abortion providers. If you live in a state that protects abortion rights, consider becoming a patient greeter or clinic escort at an independent abortion clinic or Planned Parenthood near you. You may also consider becoming a full-spectrum doula to support pregnant people during a range of reproductive experiences such as birth, miscarriage, and abortion (What Exactly is a Full-Spectrum Doula?) Reach out to your local activist groups  and find out how you can help.
• Reading up and staying informed. Do your best to keep up with local and national abortion news. This will help you to have informed conversations with others about the need for safe, legal abortion for all who need it.
• Supporting students and faculty who research and/or teach on reproductive politics, as well as students and faculty who may need to access abortion. Prepare to defend colleagues whose teaching materials may be attacked by anti-abortion students, colleagues, and administration. Advocate for the creation or continued funding of research centers directly engaging with abortion and other reproductive justice issues. Advocate for your university’s health services center and/or health insurance to cover emergency contraceptives and abortion medications.
• Intellectually and materially supporting students and colleagues working on these important issues. If you teach, you can generate intellectual interest in abortion area of knowledge and research by encouraging students to read across anthropology, public health, gender studies, and other fields. If you are involved in a research-granting institution or organization, fund anthropological research on abortion. Funding for research on abortion has been difficult to obtain, especially through government sources like the National Science Foundation and National Institutes of Health, and it will likely only become harder, so private funders should step up to bolster support for abortion research in anthropology.

Politically engaged research, like activism, is often a long game. The anti-abortion movement played it for nearly fifty years, and constitutional protection for abortion will not be restored overnight. As anthropologists, we need to commit to supporting research on abortion politics long after the initial news frenzy dies down. We also need to treat the loss of abortion access in the U.S. as the crisis it is and engage in the direct actions that will make an immediate, material impact on those suffering the most under these current conditions.

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[1] Clark 2022; Redd et al. 2021; Vilda et al. 2021.

[2] e.g., Arey et al. 2022; Harris 2022; Hackney 2022; Wendland 2022.