With a near total abortion ban pending in Utah, many are worried about the future of reproductive rights — a future that holds serious implications for women and other groups.

On Friday, June 24, the United States Supreme Court overturned Roe v. Wade, which had previously allowed abortions in the first two trimesters of pregnancy on a federal level. Now, it is up to individual states to determine their abortion laws.

This ruling holds serious implications for any person who could become pregnant, healthcare providers, people of color and more.

Yasi Shaker, who uses she and they pronouns, is a doctoral student and graduate teacher of the sociology of gender and sexuality at the University of Utah. Shaker has been frustrated by the gendered and exclusive language used to talk about abortions. 

“It is important to understand that people of all genders have abortions,” she said in an email interview.

An Evolving Landscape

Misha Pangasa, a board-certified OB-GYN at the U Hospital, said there is fear among providers about the ambiguity of the law.

“People are asking, what if a patient presents with this thing that I know could be life-threatening, can I take care of them?” she said. “What if a patient presents with this other thing that may be life-threatening in a few days, can I take care of them?”

Pangasa has already heard of some providers who delayed that care because they were scared of losing their license or facing legal consequences for doing what they believed to be medically correct. 

“We didn’t go to medical school to be felons,” she said. 

This uncertainty and fear also rings true for the patients themselves — some are unsure about what their current options are.

“I have to give so much credit to the office managers and nurses and clinical assistants who are answering phones and calling patients and scheduling them right now because, you know, the law has changed like at least five times in the last two weeks,” Pangasa said. 

As a general OB-GYN, Pangasa does pap smears, counsels patients on contraception, cares for pre-menopausal and post-menopausal individuals, delivers babies and performs C-sections. Along with this work, she also provides abortion care. 

Pangasa has worked in other states that have fewer restrictions on abortion care and has found that people seek abortions for similar reasons, regardless of their location. What is different about Utah, though, is the number of hoops a patient must jump through to actually get one. 

“They have to go through an online module that’s essentially approved by the legislature, which contains some non-factual information and certainly presents a significant amount of stigma and shame to those patients,” she said. “Once they do that, they have to have a face-to-face interaction with a health care provider in order to sign a consent after the provider reads a state-mandated script, again, that has some questionably factual information.”

After that, they have to wait an additional 72 hours before they can proceed. Pangasa said the shame and stigma from the community also serve as a barrier for those seeking abortion care.

Abortion Access

Pangasa said access to abortion care is essential for many reasons — a fundamental one being bodily autonomy. 

“If you don’t have the right to take care of your own body, you literally cannot be considered a free person in society,” she said.

Abortion care is also life-saving, Pangasa explained. Carrying a pregnancy to term and undergoing childbirth is more dangerous than having an abortion.

“I was on call on labor and delivery just last weekend, and there were no less than four women whose lives were significantly threatened by their delivery,” she said. “And that’s just a fraction of what we see.”

Pangasa cited the Turnaway Study, explaining there are significant, long-term harms to denying someone an abortion, such as remaining in poverty, being unable to afford housing and being more likely to stay in contact with violent partners.

Shaker said those who will still be able to access abortion despite this legislation are affluent and typically white.

Prior to the ban, BIPOC, transgender people, immigrants and disabled individuals already faced barriers to accessing abortion, they said.

“The ban exacerbates the systemic injustices and makes it even harder for folks to receive care,” Shaker said. “The struggle for reproductive rights and body autonomy for BIPOC folks is constant and is important to decenter whiteness in [these] conversations.”

According to Pangasa, those with fewer resources, who already are disproportionately impacted by pregnancy-related morbidity and mortality and face systemic racism in healthcare, are going to give birth in scenarios they did not want to.

“So in simple terms, that means that the people with the fewest resources are inevitably going to have more pregnancy-related complications, and more of them are going to die from this decision,” she said.

Banning abortion does not stop people from getting abortions — according to Shaker, it just makes safe abortions less accessible. 

Advocating for Justice

As a researcher of environmental, food, racial and reproductive justice, among other areas, Shaker emphasized the sociological synthesis of issues — for example, reproductive justice is connected to both environmental and economic justice. 

“As environmental stressors increase (pollution, etc.) with climate change, maternal and infant mortality increase, with the effect disproportionately affecting communities of color, so not having this body autonomy leads to further killing of Black and Brown women,” they said. 

To contextualize abortion care, Pangasa spoke about the psychological principle of the tension of opposites, where two opposite things can be true at the same time.

“As a physician who provides abortion care, I understand that there’s a potential life there that people want to protect — I understand that,” she said.

On the flip side, she said there is a person with a heartbeat and aspirations and a body that is also impacted by pregnancy. 

“And that is what drives me to do the work that I do because even though it’s complicated and nuanced, I understand that as human beings, decisions are complex and nuanced,” Pangasa said. “Turning our backs on those people is inevitably going to cause more harm in this world.”

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@chronykayleigh