Abortion A Basic Health Care Right

Running head: ABORTION A BASIC HEALTH CARE RIGHT 1

Abortion a Basic Health Care Right

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ABORTION A BASIC HEALTH CARE RIGHT 2

Abstract

Abortion has been a topic of debate in American politics and culture long before U.S. Supreme

Court declared abortion as a fundamental right on January 22, 1973. This debate is still ongoing

between pro-choice that supports legalized abortion and pro-life that supports anti-abortion. Even

though abortion is legal, 43 states still have restrictions on abortion based on gestational age with

exception to save life or physical health of the women (Guttmacher Institute. 2017). According

to Center for Disease Control and Prevention 664,435 legal abortions were reported from 49

reporting areas in 2013 (Jatlaoui, 2016). The purpose of this paper is to support my stance on

women’s choice for abortion as a basic health care right.

ABORTION A BASIC HEALTH CARE RIGHT 3

Abortion a Basic Health Care Right

Evolution.

Topic of abortion would surely date back to the beginning of civilization with debates on

abortion as taking life, which would go against the religious belief, and women having abortion

for personal reasons such as health and economy. From religious and social point abortion is

frowned upon, subjecting the act with shame and fear. Women give birth to rape pregnancy as it

is believed that to take a child’s life as a response to the crimes of her father is, in the Catholic

understanding, not an option similarly abortion for medical condition or life-saving treatment is

also not an option and viewed as deliberate killing (Stephens, Jordens, Kerridge, & Ankeny

2010). At the same time women are made to suffer with choices made by the government or the

community. In 1791 Philadelphia newspaper reported that Sarah Pewell a domestic servant of

William Birth died after taking powder for abortion given by William. (Philadelphi, 1791 as

cited in Frasca, 2016).

Griswold v. Connecticut was the first case where Supreme Court declared that a state law

which prohibited the use and distribution of contraceptives was unconstitutional. Abortion was

made legal in United States by Supreme Court when it handed down the landmark Roe v. Wade

decision on January 22, 1973. The ruling supported women’s right of freedom and privacy to

make personal medical decision, which meant women could chose to have abortion or not

without government interference. But at the same time court announced a trimester approach

where government could prohibit abortion at the stage subsequent to viability, which ment

during the third trimester state can deny abortion unless it is necessary to save the life or health

of the mother (Chemerinsky, & Goodwin, 2017).

ABORTION A BASIC HEALTH CARE RIGHT 4

Position on this issue

Since abortion was made legal it has gained attention of policy makers nationwide, from

both pro-choice and pro-life supporters. President Trump and vice President Pence have made it

very clear that they are against abortion. President Trump on January 23, 2017 signed an

executive order to reinstate the Mexico City Policy, which blocked the funding for international

NGOs that offered abortion services and related information for family planning (Collins, E.

2016). In a letter to pro-life leaders, he expressed his view of nomination pro-life justice to the

U.S Supreme Court, signing into law the Pain-Capable Unborn Child Protection Act, defund

planned parenthood as long as they continue to perform abortion and make Hyde Amendment

permeant law to protect taxpayers from having to pay for abortions (personal communication,

September,2016).

Mike Pence voted for S3- Partial-Birth Abortion Ban Act of 2003, which amends the

Federal criminal code to prohibit any physician or other individual from knowingly performing a

partial-birth abortion, except when necessary to save life of a mother whose life is endangered by

a physical disorder, illness or injury (CRS. 2003). He also voted in the senate supporting anti-

planned parenthood bill that would support state to withhold federal funds from planned

parenthood and healthcare providers that perform abortion (Gaudiano, 2017). Representative

Duncan Hunter and Tom Price who is the U.S. Secretary of Health and Human Service have

sponsored H.R.618-Right to Life Act and H.R.552-Right to Life Act that defines “human being

and human person to encompass all stages of life including but not limited to fertilization or

conning” (CSR. 2005, 2007). Other than individuals there are groups like The Pro-Life Caucus,

National Right to Life, National Pro-Life Women’s Caucus that support and fight against

abortion laws.

ABORTION A BASIC HEALTH CARE RIGHT 5

At the same time, we have organizations like National Abortion Federation, Planned

Parenthood, NARAL and Emily’s List that support women’s freedom and abortion. With recent

win on Whole Woman’s Health v. Hellerstedt, court ruled out against two provisions of a Texas

TRAP (Targeted Regulation of Abortion Providers) that imposed restrictions on delivery of

abortion services and on women seeking abortion (Claxton, 2017).

Senators like Susan Collins, Lisa Murkowski, Shelley Moore Capito and house

representative Charlie Dent, Rodney Feelinghuysen, Lyn Jenkins and Greg Walden are few from

republican party that supports pro-choice. They represent groups like Republican Majority for

Choice and Republican for choice. Advocates like Janet Robert who is the president of

Democrats for life of America have helped in introducing Pregnant Women Support Act which

was sponsored by representative Davis Lincoln. This help to provide support and options for

women facing unplanned or crisis pregnancies (CRS, 2009).

Nursing involvement

Nurses like any other member of the society is influenced by the topic of abortion, but

with years of education and working in the field of providing health care I believe we are open to

the concept of patient making personal choice. Situation may be about abortion, or patient

choosing to sign out against medical advice, or health care proxy choosing to have everything

done for a 100 year old family member, we are taught to provide accurate knowledge that would

help them make the right decision and to be empathetic. And if situation does arise where

personal belief conflict with work, we are instructed to escalate the issue to our leaders. With

advancement in abortion procedures, nurses have started to give medication such as cytotech that

would chemically induce abortion (Bugalho, Bique, Almeida, & Faundes, 1993). Since this

brings the nurse away from bedside care and involve in actual process of abortion act it can

ABORTION A BASIC HEALTH CARE RIGHT 6

conflict with personal beliefs, leading to a conscientious objection (Lachman, 2014). Nurses are

also at a prominent position to care and guide patient by educating on topics of abortion care and

preventive measures that can be used for future. Nurses can educate about community resources

such as planned parenthood that provides counseling and education, and city programs that

provide free contraceptives.

Ethical concerns.

The abortion debate on ethical concerns asks whether it is right to abort a child or is it

morally wrong to take a life. Despite the US Supreme Court declaring abortion to be a

fundamental right to a personhood, it remains an ethically contentious subject. The two groups

that have valid arguments on the debate are pro-life and pro-choice. My choice would be the

latter because I believe that it is a fundamental right of a woman to have 100% control over her

own body. Reproductive choice empowers a woman’s independence and determines her future

by giving her the choice to when and whether to have a child. It gives her the ability to

participate equally in the economic and social life in a family, community and country. Pro-life

believes that abortion is a murder, which defies the word of god. They believe life begins at

conception and fetuses feel pain during abortion (Kolb, 1981). As a pro-choice believer

personhood begins after a fetus is born and not at conception. According to a study fetuses can’t

feel pain until the 29th or 30th week of gestation (Lee, Ralston, Drey, Partridge, & Rosen (2005).

Supreme Court Justice Antonin Scalia stated that the right to privacy defended in Roe v. Wade as

“utterly idiotic”.

Pro-life argues that abortion causes psychological damage (Pedersen, W. 2008), but

according a peer-reviewed study the mental health of a woman who denied abortion felt more

regret and anger and less relief and happiness when compared to a woman who received abortion

ABORTION A BASIC HEALTH CARE RIGHT 7

(Rocca, Kimport, Gould, & Foster 2013). Studies also show that women induce abortion through

unsafe measures particularly in restrictive states like Texas where more than 100,000 women in

that state attempt abortion outside clinical settings (Jerman, Jones, & Onda, (2016). According to

the World Health Organization (WHO) in 2008, 21.6 million women experience an unsafe

abortion worldwide with 47,000 maternal deaths from complications of unsafe abortion each

year. By taking away the reproductive choice of a woman it keeps her at a financial advantage

and takes away the freedom of choice. According to Sep. 2005 survey in the peer-reviewed

Perspectives on Sexual and reproductive Health 42% of women having abortion were below the

federal poverty line, 73% could not afford having baby and 38% thought giving birth would

interfere with their education and career goals (Guttmacher Institute, July 2014. Finer, Frohwirth,

Dauphinee, Singh & Moore, 2005). Therefore, I believe a baby should not come into the world

unwanted since it is an important decision that requires a lot of consideration, preparation and

planning.

Options for resolving the issue.

Politicians play a critical role in resolving this issue. By supporting programs like

Planned Parenthood, and by providing free birth control, sex education and emergency

contraceptives we could decrease the abortion rate without taking away the freedom of privacy.

Abortion is an issue that results from lack of planning, lack of education, non-use of

contraceptives and unaffordable contraceptive /birth control services. According to a study

substantial number of women wanted to stop or delay childbearing but didn’t have access to the

contraceptive supplies and services, his was due to the lack of knowledge, fear of side effects and

social and familial disapproval (Bongaarts & Bruce 1995). However, due to education, which

brings awareness, contraceptives are no longer considered unsafe that causes health issues.

ABORTION A BASIC HEALTH CARE RIGHT 8

People are aware that is a safe and an effective measure to avoid unintended pregnancy. Thus,

rising contraceptive use especially in countries like Singapore, Republic of Korea and the United

States resulted in decrement of unintended pregnancy (Wilkie, 1981; Marston & Cleland 2003).

Study showed that in the United States rise in contraceptive use was responsible for 13%

decrement in unintended pregnancy between 2008 and 2011 (Jones & Jerman 2017). There was

also a significant decline of 77% in the adolescent pregnancy for women age 15-17 years

because of improvements in contraceptives, usage of condoms and birth control pills (Santelli,

Lindberg, Finer, & Singh 2007).

Planned Parenthood is an organization that provides care to everyone regardless of their

age, status and ability to pay. The goal of this organization is to provide, promote and defend

access to care to patients around the world. It provides sexual and reproductive health education

to millions of women, men and young adults, provides contraceptives, increase access to

treatment for complications from unsafe abortion, increase access to safe abortion care, provides

counseling and advocate for laws and policies promoting women’s health (Planned parenthood,

2017.). It is a measure to ensure all women, men and young people in the world’s most rural

places to get access to health care they need to take control for their body and future.

Awareness and education is important for women to know that they have options and a

choice but at the same time counseling also plays a significant role to avoid the risk of

psychological damage like depression. Counseling is also a vital part of the service to ensure that

all women are well informed and comfortable so that they take nonjudgmental decisions for their

future. More than half of all U.S. abortion patients in 2014 were in their 20s. Patients aged 20-24

obtained 34% of all abortions. The main reason behind their choice were because of their

concern for or responsibility of parenthood, low-income and inability to afford to raise a child

ABORTION A BASIC HEALTH CARE RIGHT 9

and the belief that having a child at that age would be a burden and would interfere with their

school and work (Jerman, Jones, & Onda, 2016). According to a patient, who visited the Planned

Parenthood county hospital in San Francisco, she expressed how the counselor made sure to talk

with her regarding all the procedures and made her feel that it is normal to be afraid and sad. She

could have been completely bewildered in the mental pain she was going through, but because of

counseling the choice of abortion was less stressful. Similarly, there were others who had such

experience and due to counselling now the feel comfortable using contraceptive measures. They

expected a crowded setting in the hospital but were shocked to see how patients were assisted

with individual care. They learned that not being able to afford private medical care didn’t mean

they cannot afford counseling from the Planned Parenthood organization (House &

Goldsmith,1972). Therefore, I believe Planned Parenthood is necessary since it gives patients the

right to information access, safety, privacy, comfort, dignity and most importantly a freedom of

choice.

preferred Solution

The solution I prefer to resolve the issue of unintended pregnancy is Planned Parenthood

because it makes people aware of using improved contraceptives like condoms, birth pills and

emergency contraceptives – plan b. It is a safe and an effective measure to avoid unintended

pregnancy and childbirth. According a study, since the 1960s in many developing countries there

has been a substantial portion of women who wanted to delay childbirth. The results from the

study indicated that due to unmet needs for contraceptives and lack of information being the

main reason behind expanding family planning. There were 120 million women in developing

countries that were unaware and not taking birth control or contraceptives practices due to lack

of knowledge and information. Women did not use contraceptives not simply because they were

ABORTION A BASIC HEALTH CARE RIGHT 10

not aware of it but because they didn’t use it as a remedy since they feared side effects such as

psychological damage of health and peer pressure of social and familial disapproval. This lead to

a program that provided a service to the community which is to reach the homes or places of

families and influence them to change their cultural and familial factors that was a barrier to a

safe measure to avoid unintended pregnancy. These programs were most successful when it

reached the home environments of women who lived in rural areas or environment beyond the

conventional boundaries where there were poor services to provide information and awareness

about improved contraceptives (Bongaarts, & Bruce, 1995). In Mexico City where oral

contraceptives and several emergency contraceptives are easily accessible, patients believe in

emergency contraceptives and express how it should be even more widely available such as in

schools and vending machines. They believe that the knowledge and information of improved

contraceptives should reach the entire city by the mass media and elsewhere. Moreover, they

promise to reduce the unintended pregnancy and abortion rate by taking part in campaigns that

promotes emergency contraceptives that would provide knowledge, attitudes and practices

regarding the methods of modern contraceptives. They had a cautious support for emergency

contraceptive which was an effective measure to reduce the unintended pregnancy rate of the city

(Langer, Harper, Garcia-Barrios,Schiavon, Heimburger, Elul & Ellertson 1999). According to a

study improved contraceptive use did prove to decline adolescent pregnancy rate in the United

States. The data showed women from 15 to 17 years of age who used improved contraceptive,

which included increasing use of condoms, and birth control pills brought 77% decline in

pregnancy risk (Santelli, Lindberg, Finer & Singh 2007). Unintended pregnancy rate has also

reduced in countries like Bulgaria, Turkey, Tunisia and Switzerland as the prevalence of modern

contraceptives use rose (Marston & Cleland 2003) 40-50% of abortion rate has also declined due

ABORTION A BASIC HEALTH CARE RIGHT 11

to improved contraceptives and nonrestrictive laws for abortion in countries like Denmark,

Finland, Japan and Italy (Henshaw, Singh & Haas 1999).

Studies have proven that there is strong relation between demographic factors and less

effective use of contraceptives. Minority and low-income women are less likely to use

contraceptive than women who has a steady high income due to differences in knowledge and

attitudes toward contraceptives and pregnancy. Minority or low-income women are at more risk

of experiencing unintended pregnancy as well as teen pregnancy than higher income women.

According to a survey 9% of Whites, 12% Hispanics and 15% of Blacks do not use

contraceptives. This is due to lower levels of education, cultural based myths and differences in

familial communication about reproductive health (Dehlendorf, Rodriguez, Levy, Borrero &

Steinauer 2010).

Therefore, I strongly believe that both knowledge of Planned Parenthood and free access

to improved contraceptives could be one of the best ways to resolve the issue of unintended

pregnancy.

ABORTION A BASIC HEALTH CARE RIGHT 12

References

Bongaarts, J., & Bruce, J. (1995). The causes of unmet need for contraception and the social

content of services. Studies in family planning, 57-75.

Bugalho, A., Bique, C., Almeida, L., & Faundes, A. (1993). The effectiveness of intravaginal

misoprostol (Cytotec) in inducing abortion after eleven weeks of pregnancy. Studies in

family planning, 319-323.

Chemerinsky, E., & Goodwin, M. (2017). Abortion: A Woman’s Private Choice. Texas Law

Review, 95(6), 1189-1247.

Collins, E. (2016, September 16). Trump announces 'pro-life coalition,' supports making Hyde

Amendment permanent. Retrieved from

https://www.usatoday.com/story/news/politics/onpolitics/2016/09/16/trump-marjorie-

dannenfelser-anti-abortion-rights/90431388/

Claxton, K. L. (2017). Whole Women's Health v. Hellerstedt. Ohio NUL Rev., 43, 257.

CRS. (2003). S.3 - Partial-Birth Abortion Ban Act of 2003. Retrieved from

https://www.congress.gov/bill/108th-congress/senate-bill/3?q=%7B%22search %22%

3A% 5B%22S+3%22%5D%7D

CRS. (2005). H.R.552 - Right to Life Act. Retrieved from

https://www.congress.gov/bill/109th- congress/house-bill/552

CRS. (2007). H.R.618 - Right to Life Act. Retrieved from

https://www.congress.gov/bill/110th-congress/house-bill/618

CRS. (2009). H.R.2035 - Pregnant Women Support Act

. Retrieved from https://www.congress.gov/bill/111th-congress/house-bill/2035

Dehlendorf, C., Rodriguez, M. I., Levy, K., Borrero, S., & Steinauer, J. (2010). Disparities in

ABORTION A BASIC HEALTH CARE RIGHT 13

Family Planning. American Journal of Obstetrics and Gynecology, 202(3), 214–220.

http://doi.org/10.1016/j.ajog.2009.08.022

Frasca, R. (2016). Abortion in the Early American Press: Secular and Catholic Approaches to the

Pre-Born Child. U.S. Catholic Historian, 34(1), 27-51.

Gudiano, N. (March 30, 2017). With Vice President Pence breaking tie, Senate passes anti-

Planned Parenthood bill. Retrieved from https://www.usatoday.com/story/news

/2017/03/30/vice-president-pence-breaking-tie-senate-moves-against-planned-

parenthood/99820022/

Guttmacher Institute. (2017). An Overview of Abortion Law. Accessed from: http://

https://www.guttmacher.org/state-policy/explore/overview-abortion-laws

Guttmacher Institute. (2014). "Induced Abortion in the United States," Retrieved from

https://www.guttmacher.org/fact-sheet/induced-abortion-united-states

Henshaw, S. K., Singh, S., & Haas, T. (1999). Recent trends in abortion rates worldwide.

International family planning perspectives, 44-48.

House, E. A., & Goldsmith, S. (1972). Planned parenthood services for the young teenager.

Family Planning Perspectives, 4(2), 27-31.

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