Why I’m letting go of Roe

Roe was the floor of our rights and I’d caution advocates not to grow nostalgic for those times at the expense of fighting for what could be.

(Photo by Astrid Riecken/Getty Images).

By Signe Espinoza

Today is the 51st anniversary of the Roe v Wade decision, but this day is no longer a celebration of our rights and bodily autonomy. However, I have decided to no longer be wistful about the world under Roe. I have decided to let go of Roe and work toward a more free future for sexual and reproductive health care.

Roe was the floor of our rights and I’d caution advocates not to grow nostalgic for those times at the expense of fighting for what could be. Yes, Roe prohibited outright bans on abortion – but there were more abortion clinics in Pennsylvania before Roe was decided and in the 51 years since, Pennsylvanians face a crisis of access.

There are fewer than 20 clinics providing abortion care right now in the Commonwealth, and most of them are in urban and densely populated suburban areas. Patients in rural areas, particularly the northern tier of the state, face long drives and logistical hurdles to comply with the counseling and 24 hour waiting period required by the Abortion Control Act. Eighty-five percent of counties in this state do not have an abortion provider; 48% of the state lives in a county without one, but 1 in 4 women will have an abortion before they are 40 years old.

These problems existed under Roe and they will continue to exist if we do not continue to fight. The Supreme Court made very clear in Dobbs that there will be no federal protection for abortion; states are on their own. Pennsylvania is on its own.

As discouraging as the federal stance is, we are encouraged by the legislative action that reproductive health care advocates have taken.

Introduced in the Pennsylvania House right now are bills that would reduce the onerous requirements of abortion providers – requirements that align them with ambulatory surgical facilities when a vast percentage of abortion care is the simple prescription of oral medication; a requirement of insurance companies to fully cover contraceptive care and extend prescription supply so that patients have easy, affordable access to birth control; and to allow highly trained and qualified advanced practice clinicians like midwives and nurse practitioners to provide abortion care – Pennsylvania currently only permits physicians to administer this care, while many other states permit a wider variety of specialists to practice in this field – the intention of that policy is to limit access to care. The House has passed a bill that would shield providers and patients from prosecution by other states that outlaw abortion.

Awaiting a decision in our state’s Supreme Court is a case that could end the discriminatory Medicaid ban on abortion care. As it currently stands, state law prohibits women living in poverty from using their public health insurance plan on this essential care, practically putting abortion out of reach since this policy was codified in 1982, nearly 10 years after the Roe decision. This has a very disproportionate impact on Black, indigenous folks and people of color. Abortion may be legal, but if you can’t access it or afford it, you may live under a de facto ban.

I have mourned Roe but I will no longer be discouraged by its loss. That case provided us with the bare minimum of our rights and we deserve better; we deserve more. I envision a future for Pennsylvania where every person has access to abortion care, can afford it, and feels no shame or stigma in seeking it. Roe never provided those things, and so it’s time to set the old precedent aside and build a better, more inclusive future for sexual and reproductive health care. I hope you’ll join that fight.

Signe Espinoza, MPH, is executive director of Planned Parenthood Pennsylvania Advocates

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