Forty three years ago on Friday, the U.S. Supreme Court secured the right for American women to have a legal abortion. In a 7-2 vote, the Court ruled that all women could have an abortion at any stage in their pregnancy, but allowed states to regulate the procedure in women's second and third trimesters. In doing so, the crucial work of tireless activists saved countless women in the U.S. from unsafe procedures and emboldened them to lead the lives of their choice.
The legacy of their work is evident today. The majority of Americans currently support abortion — a procedure that is not only one of the safest medical procedures for women in the United States, according to the Guttmacher Institute, but also a relatively common one. The vast majority of women don't regret having had one.
Despite these facts, there are many women in the United States for whom abortion is ultimately inaccessible. Here are the many ways in which this legally protected right has not only been chipped away, but demonized.
State-level attacks on abortion access keep coming.
States have adopted 288 abortion restrictions since 2010, according to the Guttmacher Institute.
Legislators continuously attempt to pass other restrictions to make obtaining an abortion as difficult as possible — especially on the state level, in an attempt to sidestep Roe v. Wade. More than 50 state-level abortion bans were passed in 2015, according to the Guttmacher Institute, including lengthened waiting periods for abortions and abortion bans after 20 weeks of pregnancy, according to the Hill. Other barriers have resulted in "an almost de facto ban on abortion in many states," Jessica González-Rojas, the executive director of the National Latina Institute for Reproductive Health, told Mic.
In addition to these general bills, legislators have specifically attempted to defund organizations that provide abortions. Perhaps most notable are both Senate and state-specific efforts to eliminate Planned Parenthood's funding. Lawmakers weren't the only ones, either: A notorious anti-choice group made false allegations against the organization in a series of sting videos, and local affiliates faced horrifying, violent attacks, too.
If legislators can't overturn Roe v. Wade and make abortion itself illegal in this country, they'll make it impossible to obtain, according to Marcela Howell, founder and executive director of In Our Own Voice: National Black Women's Reproductive Justice Agenda.
State-level restrictions "are designed to keep women from actually accessing the legal right that has been guaranteed to them by the Supreme Court," Howell told Mic. "These laws are not about making women's lives better, they're not about making women's health care safer. They're about keeping women from accessing a legal right and a safe medical procedure."
The Hyde Amendment is still in place.
Since it was passed in 1976, the Hyde Amendment — legislation that withholds federal Medicaid funding for abortion except in cases of rape, incest and life endangerment — essentially makes abortion inaccessible to the 12.5 million predominantly low-income women ages 19 to 64 who have Medicaid coverage, according to Planned Parenthood.
The Hyde Amendment can also cyclically reinforce these women's low-income status. Women who want but are denied abortions are three times more likely to fall into poverty than those who can obtain them, according to one 2012 study. The Guttmacher Institute found that when women who would have had Medicaid-funded abortions are restricted from doing so, about one-fourth give birth.
But pro-choice activists are fighting back. Take the organization All Above All, which mobilizes organizations and individuals to "restore public insurance coverage so that every woman, however much she makes, can get affordable, safe abortion care when she needs it," according to its website. Additionally, the EACH Woman Act was introduced in July and would require insurance plans and programs offered or managed by the government to cover abortion services.
Hillary Clinton also recently told Fusion that she'd attempt to end the Hyde Amendment should she win the presidency, noting "I've been against Hyde for years because I think it deprives low-income women from being able to access the full range of reproductive health services, and I don't think that's fair or appropriate."
Howell agrees, adding, "A woman should not be punished simply because she gets her health care from the government."
The most marginalized women are those with least access to abortion.
Low-income women are uniquely constrained from obtaining abortions. Because many low-income women in the United States are women of color, lack of abortion access negatively "impacts over 12 million black women," Howell said.
"Restrictions on abortion hurt poor women the most, and women of color are particularly impacted," Erin Matson, co-founder and co-director of the organization Reproaction confirmed to Mic. "Wealthy women have always had the means to purchase access to abortion, and they always will."
There's also a relatively hidden economic cost of abortion necessitated by its inaccessibility.
In states with just a handful of abortion clinics especially, women may sacrifice funds to take time off work to obtain the abortion, hire child care if they already have children, obtain transportation and possibly even pay for lodging should the state require a waiting period. Many women are left choosing between the long-term financial commitment of having a child and their short-term ability to pay "rent and put food on the table," as Howell put it.
Some women are taking dangerous measures to avoid giving birth.
In September, 31-year-old Anna Yocca was hospitalized in Tennessee after she attempted to perform her own abortion using a coat hanger in her bathtub six months into her pregnancy. Yocca was charged with first-degree attempted murder in December.
She isn't alone. Purvi Patel is currently serving 20 years in prison after she was convicted of inducing a miscarriage in March. At least 100,000 and as many as 240,000 Texas women may have attempted to self-induce an abortion, according to a 2015 study. It's an act motivated by myriad factors, not least of which often include desperation and economic or geographic barriers to abortion access, and one González-Rojas has seen evidence of in her own work.
"In some cases, women were willing to look under their cabinets and say, 'What can I do to get an abortion? What chemicals can I consume to make this happen because I cannot have a child?'" she said. "If you make abortion illegal or impossible to get, it doesn't mean that women still don't get them," she said, but that the procedures they will get will be "unsafe."
But the movement to protect the right to choose is thriving.
"Here's what I see: a complacency among the generation of young women whose entire lives have been lived after Roe v. Wade was decided," Democratic National Committee Chair Debbie Wasserman Schultz told New York Times Magazine in a recent interview.
But those working on the ground disagree. González-Rojas sees evidence of young people "fighting and lifting up their voices" every day, she said, and Howell echoed that young women are "clearly very active on this issue, speaking out about their own abortion experiences, serving as clinic protection and writing policy makers."
Young women have proven that, if anything, the pushback on their rights has made them more emboldened to fight to protect their rights. In addition to working for organizations like Advocates for Youth, Reproaction and others, several people are creating on-the-ground campaigns. Young adults are also raising awareness and fighting abortion-related stigma on social media. In September, for example, countless women participated in the #ShoutYourAbortion hashtag and plenty more responded to Wasserman Schultz's claim using the hashtag #DearDebbie in early January.
"Walk into any abortion fund, go clinic escorting, go to any rally — it is young people who are largely driving the grassroots movement for abortion access, online and in the streets," said Matson, whose organization launched the #DearDebbie hashtag.
"They're not doing it in the ways our mothers and grandmothers organized, but they are creating their own avenues of activism, and they're telling their own stories in really powerful ways," González-Rojas said of efforts like these. Instead of refusing to acknowledge this activism, she added, we should "celebrate the ways in which our young people are working and organizing because they're the future of our country. We need to support and celebrate rather than critique our young people."
Correction: Jan. 22, 2016
A previous version of this article stated that Purvi Patel was convicted in April. She was convicted in March.