Nadine Dirks is an intersectional feminist, writer, and advocate for sexual reproductive health and rights (SRHR). In this opinion piece, she shares her views on unsafe abortions as a public health issue.

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Researchers have referred to unsafe abortions as a “preventable pandemic” — one that affects the health and lives of women, transgender people, and non-binary individuals alike.

It is a global health and human rights issue that is not treated with the seriousness that it deserves. Through a reproductive justice lens, there are many intersecting issues that have caused this “pandemic.”

One of the reasons that people seek unsafe abortions to begin with is the stigma associated with family planning. We see this stigma and discrimination playing out in federal government cuts and pledges to defund organizations such as Planned Parenthood, which works to ensure women’s health and right to autonomy.

When world leaders stigmatize organizations that allow for equal access to family planning, citizens cannot expect to see positive changes in societal attitudes and behavior.

Even where contraceptive services do exist, women may not be able to access them safely and avoid pregnancy. For example, they may be faced with pro-life protesters lobbying outside organizations, hurling insults and referring to people as “baby killers” for providing or accessing the healthcare that they know is right for them — be it condoms, contraception, or a safe abortion.

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Alongside abortions, organizations such as Planned Parenthood also provide many other services. These include:

  • HIV testing and treatment, including preexposure prophylaxis
  • LGBTQIA+ services, such as hormone therapy
  • cancer screenings
  • additional services for men’s health, such as infertility screenings or erectile dysfunction treatments
  • sexually transmitted infection (STI) testing, treatment, and prevention

By defunding organizations such as Planned Parenthood, we have to face the fact that we are putting members of our community at risk of health complications, and that extends beyond allowing women to choose and access the services they need.

Abortions remain one of the most stigmatized medical procedures worldwide — yet according to the Guttmacher Institute, “nearly 1 in 4 women in the United States will have an abortion by age 45.”

Statistics also indicate higher rates of abortion among Black women and Hispanic women. Why is that? It is likely due to a lack of adequate contraceptive care given to women of color and a lack of disposable income to fork out on contraceptive methods, compared with white women.

Also, due to discrimination and racism in the medical field, healthcare professionals often overlook and ignore the medical needs of women of color — sometimes going as far as assuming that Black people have higher pain thresholds than white people.

Abortion and access to other contraception methods is a political, human rights, and reproductive justice issue, underpinned by a lack of comprehensive sexual education in schools.

A report from the Centers for Disease Control and Prevention (CDC), for instance, found that in most states, “fewer than half of high schools and just 1 in 5 middle schools teach all the essential sex education topics recommended by the CDC.”

So, with only 4% of the recommended topics being taught in Arizona, for example, it is not surprising that people are wildly uninformed and lack the necessary tools and education to even ask for what they need in terms of contraception.

And even if a person knows that they want contraception, how are they expected to assert themselves and speak from a place of autonomy when their sexual and reproductive health education has either been stigmatized or avoided altogether? People can hardly be expected to access different methods of contraception safely if they are not first made aware of which options are available to them.

This lack of education and conservative outlook on sexual education furthers the culture of stigma. In such a culture, reports have shown that people feel that they cannot have conversations or ask questions because they fear being ostracized by their communities, either on religious or conservative grounds or due to prejudice, patriarchal views, or a lack of education on matters of sexual health.

As some researchers point out, “Abortion stigma is usually considered a ‘concealable’ stigma: It is unknown to others unless disclosed,” and it is characterized by secrecy.

Furthermore, studies show that “community members disapprove of abortion and that a woman’s age or marital status could exacerbate judgment,” with younger or unmarried women bearing the brunt of these attitudes.

Sadly, a lack of information does not reduce the incidence of unprotected sex or rates of abortion. It does, however, mean that the abortions that people are accessing are more likely to be unsafe or unregulated.

An ample body of existing data suggests that, on a global level, restrictive abortion laws and a lack of education about contraceptive methods are associated with a higher rate of unsafe abortions.

For instance, physicians from Brigham and Women’s Hospital in Boston, MA, warn that in the absence of education about contraception and the availability of legal and safe abortion, “desperate women, facing the financial burdens and social stigma of unintended pregnancy and believing they have no other option, will continue to risk their lives by undergoing unsafe abortions.”

Furthermore, a lack of education could mean that people miss key details in spotting an unsafe abortion versus a safe one. Some may even intentionally lean toward unsafe options because it may seem more “concealed” than going to a clinic during the day in the middle of the city center.

Unsafe abortions come with many potential health hazards, including infections, infertility, hemorrhages, and even death. They are also often performed in facilities that are not adequately equipped, or the procedure may be carried out by someone who lacks the necessary skillset. The tools or methods they use may also be outdated, unhygienic, or traumatic. Another concern is that these unsafe procedures may also be unnecessarily invasive due to the provider not being trained to safely administer healthcare.

Specifically, the World Health Organization (WHO) list “uterine perforation (caused when the uterus is pierced by a sharp object)” and “damage to the genital tract and internal organs” as some of the well-documented complications of unsafe abortions.

Issues of reproductive justice have deep, complex roots. On the surface, it may seem as though we have rights and are free to make our own choices, but many of us are still unable to access services due to our gender, race, sexual identity, or class. What good is a Constitution if some people can access services while others cannot?

Seemingly, in recent years, women’s SRHR have become even more controversial in the U.S.

In an attempt to control a person’s right to choose an abortion, limitations have been implemented that “restrict the allocation of other federal and state funds, such as funds for STI testing and treatment and sex education” in 12 states, according to the Guttmacher Institute. This causes further issues in addition to unintended pregnancies, limiting people’s access to STI testing and treatments.

With the looming possibility of Roe v. Wade being overturned, cis women, transwomen, and nonbinary folk alike are left fighting once again for the autonomy of their own bodies.

Attempting to control what people do with their bodies entirely erases the SRHR and reproductive justice work being done worldwide. It undermines not only human rights but also the 21 million American women who are likely in need of publicly supported contraceptive services and supplies, according to the Guttmacher Institute.

These intersecting issues of education, stigma, discrimination, healthcare, and reproductive justice are all at play in the upcoming U.S. election. With SRHR being under threat, it is now more important than ever for people in the U.S. to play their part in supporting human rights by casting their vote.

To check your voter registration status, click here to visit the website of VoteAmerica, a nonprofit, nonpartisan organization dedicated to increasing voter turnout. They can also help you register to vote, vote by mail, request an absentee ballot, or find your polling place.