Reaction was immediate on June 24, 2022, when the U.S. Supreme Court overturned Roe v. Wade, taking away a recognized individual liberty and striking down a nearly 50-year precedent that established the right to have an abortion.
Pro-choice and anti-abortion groups were chanting outside the court, and in every state across the nation — and even around the world. The court’s decision wasn’t a complete surprise, as a draft opinion leaked in May indicated SCOTUS might overturn Roe.
But the court’s decision does not appear to align with the majority of Americans’ thoughts on reproductive rights. A Gallup poll conducted soon after the leaked opinion found that 58% of Americans were opposed to overturning Roe v. Wade, and only 13% of Americans believe abortion should be illegal in all circumstances.
The Supreme Court’s decision to overturn Roe v. Wade is a “relevant social justice matter for social workers,” said Lee Westgate, who until recently was NASW’s manager of public policy. “Social work professional licensure has only existed in a post-Roe world,” he said. “Additionally, the social work professional Code of Ethics is predicated upon the essential principals of individual autonomy and self-determination.”
Impact Differs
The complete overturning of Roe has ramifications well beyond abortion rights, wrote Mel Wilson, LCSW, MBA, in an opinion piece on Social Work Blog written after the leaked draft opinion. His piece, Overturning Roe v. Wade Will Disproportionately Affect People of Color; Here is what Social Workers Should Know, outlines the dire effects of the court’s decision. The retired NASW senior policy adviser was lead staffer on social justice policies and legislation and related matters for nearly 20 years.
“For millions of Americans — especially people of color who are women, transgender or nonbinary — reversing Roe v. Wade will be a life-altering decree,” Wilson wrote. It would lead to “profound racial and ethnic health disparities” for the “already vulnerable and marginalized Black, Latino and Native American people.”
Overturning Roe v. Wade could mean abortions would be “criminalized in more than half of U.S. states” and lead to a disproportionate number of people of color being arrested and jailed if they have an abortion in a state where it’s illegal, he wrote. And, Wilson continued, it would be the first time in history for the Supreme Court to “take away a constitutional right that has existed for nearly 50 years. We should be appalled that the highest court of the land would be unhesitant about jeopardizing the health and well-being of millions of people.”
Self-Determination
Kristi S. Wood, MSW, APSW, a social work lecturer at the University of Wisconsin-Whitewater and chair of NASW’s National Committee on Women’s Issues, said Roe v. Wade did more than regulate abortion. It changed the way states can regulate abortion, characterizing it under constitutional rights of privacy, she said. The overturning of Roe could produce implications for other privacy rights like contraception and same-sex marriage.
“The heart of this issue is our right to self-determination,” she said. “It’s about privacy rights … the privacy of human beings. Abortion is a human right, a decision that should be made between a woman and her health care provider.”
Social workers are here to support every human being, Wood said, including, for example, children who have experienced incest, a 12-year-old child who has been raped, people with medical issues who would put their own lives at risk, and those who already are parents who would put their family financial situations at risk. There can be family violence safety issues that would put a parent and child at risk, as well as physical and mental health risks as a person experiences trauma, she added.
“Statistics estimate 3 million women experience rape-related pregnancy in their lifetime, and that’s just the ones we know about,” Wood said. “And 15% of all rape survivors are under the age of 12.”
Clinics that provide abortions also offer many essential health services people need and cannot afford, as many don’t have health insurance. Those can include treatment and prevention of sexually transmitted diseases, contraception access, cancer screenings and pap smears. As some states started legislating away rights with abortion restrictions that closed clinics, clients no longer can receive other health services for low or no cost, Wood said.
The social work profession has a mandate to help people with essential rights, and Wood believes social workers should focus on the 13 states with trigger laws—automatic bans that were triggered once Roe was overturned—and pressure those legislatures.
“Our U.S. Congress can put a new law in place that would protect everyone’s rights,” she said. “We have to vote. We have to vote into office people who support human rights and reproductive rights. That’s really the only way we can keep our privacy rights.”
Freedom of Choice
A person’s bodily autonomy is “integral to our ability to make health care decisions for ourselves and our families,” said Jill Messing, PhD, MSW, Arizona State University professor of social work and director of the Office of Gender-Based Violence.
“In order for a woman to achieve equity, we need to be able to make choices about reproduction and our health free from government interference—to make those choices with our doctors and health care providers,” she said.
Messing, a member of NASW’s National Committee on Women’s Issues, said in intimate partner violence, reproductive coercion is a form of gender-based violence, whether it’s forcing a woman to have an abortion she doesn’t want or preventing the procedure if she does.
“It fits within the conceptual framework,” she said.
When talking to others about bodily autonomy, there are important points to consider, Messing said. “It’s about a woman’s body and her own ability to make choices about her health. Lawmakers don’t know every woman’s situation and whether, as an individual, she should decide to have or not have children.”
Social workers focus on identifying issues and making sure people have the education, resources and ability to raise the children they choose to have in a way consistent with evidence-based practices. The question around women’s rights that includes the ability to make informed choices about her reproductive health is a broader issue, Messing said.
“It’s not only about a woman’s right to choose,” she said. “It’s also about our structure in society that’s created, for the most part, by men, and how they treat women’s ability to make choices about their own bodies.”
Since discussing the issue with others can be difficult, Messing believes it’s important to always frame the discussion around choice—that an individual has the right to choose to have or not have a child.
“Don’t take away the rights of another person to make a choice,” she said. “Frame it and come back to the point. Don’t let others frame the argument.”
A person’s financial ability matters, Messing said. Some can’t afford to go to another state or country, so lack of local availability will hurt marginalized people the most.
“This is a question of social justice, and that makes it part of our mandate as social workers,” she said. “It’s important we focus not only on the micro but on the macro part of our professional values. The profession is educated to work across political differences.”
Some decisions have long-term impact, Messing said. “You can see it in Arizona where there are numerous bills restricting transgender rights. People are using their power to take rights away from others.”
As of March 16, 130 anti-trans bills were filed in the Arizona state legislature. On March 30, Arizona Gov. Doug Ducey signed into law three bills limiting transgender rights and abortion access. Legislation restricts doctors from performing abortions after 15 weeks except in a medical emergency impacting the mother’s life and health. Doctors must fill out all forms completely or face fines or loss of licenses to practice.
Chapters Fight Legislation
In June, two NASW chapters were dealing with recent anti-abortion legislation: Ohio and Oklahoma.
In May, NASW and the Abortion Fund of Ohio (formerly Women Have Options) filed a federal complaint challenging an anti-abortion ordinance the city council in Lebanon, Ohio, adopted that bans abortion and penalizes people who try to help others get one.
In a press release before the Roe decision came out, the ACLU Ohio stated “regardless of that outcome, the Lebanon ordinance violates other constitutional protections—including due process and free speech.” The ordinance, among more than 40 nationwide, is the only one penalizing the person seeking abortion services and those who assist as well.
NASW-Ohio Executive Director Danielle Smith, MSW, MA, LSW, CAE, said moves like this call rights into question and “have so many implications for everyone.” Many people thought of Ohio as a purple state, she said, but “it has become increasingly more conservative since Trump, particularly on the state level where it’s more extremist. Seventy percent of people in Ohio generally support abortion (rights).”
Still, the state legislature “has passed bill after bill to nudge up to limiting abortion in the state,” Smith said. And in June, a state bill was being worked on so “when Roe falls, abortion will be illegal in Ohio, no exception — flat out illegal and criminalized for providers.”
The chapter is working with others on ways to arrange out-of-state services, because Smith said she is not confident the governor will protect abortion rights. “To me, it’s very hypocritical of people who claim the values of freedom.”
In a potential consequence for social workers, the city of Lebanon has prohibited “the aiding and abetting of abortions and didn’t define where that would take place,” she said.
“We are taking ACLU Ohio training, and the social workers there are asking really good questions,” Smith said, which could come in handy if a social worker answers a question asked about abortions or options during therapy — because it might be considered a crime.
The “aiding and abetting” tactic is included in existing state laws, like Texas, and in proposed legislation across the country. A primary effect of these vague prohibitions is to instill fear—not just into abortion providers but to anyone who might assist the person seeking an abortion. This casts the net around social workers who are working with pregnant clients to explore their options, those helping with transportation to states permitting abortion, and many others.
Ohio chapter officials are working to get more information out to social workers on “how they will need to thread this needle to help their clients but protect themselves,” Smith said.
The Oklahoma legislature on May 19 passed “a bill that prohibits nearly all abortions starting at fertilization, which would make it the nation’s strictest abortion law,” a New York Times story reported.
Steven W. Pharris, MSW, JD, LCSW, and NASW-Oklahoma executive director, said this session the state legislature passed five bills to restrict reproductive health care, “all five written differently.”
Two deal with medical necessity, rape and incest, and three don’t, he said, “so if you’re a provider, what do you do?”
“The second thing is, we love to put people in jail in Oklahoma, so if a provider provides services around abortion, (officials) can pick the law. Providers don’t know what to do.”
Pharris said the governor has said about abortion, “I will sign any bill that comes across my desk.”
A central component of social work is integrated health care assistance, Pharris said. “We help clients, but also help other specialists provide knowledge and education to others.”
The state had four clinics and now only two remain open, but “they are not taking any appointments, so it’s been devastating,” Pharris said.
After Texas passed its law and Oklahoma expedited its legislation, “for individuals and families seeking consultation, unless you have the means it’s beyond your reach now. You must travel out of state, and it’s really a problem,” he said. It’s a divisive topic statewide with a strong pro-life community that’s very excited, Pharris added, but they don’t have a majority.
“The majority of people believe in choice, and they recognize the impact this will have on Oklahoma,” he said. “We have the highest infant mortality rate in the country. We have a very high child poverty rate and see disparities in health care.” Adding the Roe decision to this will only worsen Oklahoma’s standing as compared with other states, Pharris said.
Businesses fear closings, and some are saying “if you work here, we’ll pay for you to travel” to another state, he said. “Our health care community is confused on what to do since the multiple laws created confusion.”
But social media has been phenomenal and the public outcry has been huge, Pharris said. “Our members have organized themselves and are doing outreach on social media. They’re being very supportive and asking ‘what can we do?’ They’re meeting, protesting, and if they know of a resource or something new, they will share that via social media.”
They’re also working with students, Pharris said, helping them as they organize and “get loud.” And they’re encouraging and educating young professionals, “ensuring they know they do have a voice and it does matter.”
There were large protests in April and May, Pharris said, and some chapter members took part. “Our chapter will participate to the fullest to make sure families and individuals have choices and options,” he said. “We’re strong partners with the ACLU and Planned Parenthood, and we make sure people know they’re not out there all by themselves.”
State Courts Have A Say
A Pew Trusts analysis in a May 27 “Stateline” article — before the Roe ruling — outlines why its title says “State Courts Could Overturn Abortion Bans in Red States.” If the Supreme Court overturns Roe, 26 states with already existing abortion bans likely will take effect.
“The spotlight will shift immediately to state courts, where experts say judges in some conservative states could surprise everyone and uphold the right to abortion,” the article says. In Alabama, Louisiana, Tennessee and West Virginia, state constitutions were amended to say the right to abortion is not protected, it says, and 12 other states have bans “designed to immediately take effect if Roe is overturned.”
But 16 states and the District of Columbia have laws guaranteeing the right to the procedure, the article says. And in “all other states, there will be little reason for abortion-rights advocates not to file lawsuits in state courts. In some unlikely places, including Florida, legal experts say previous court decisions indicate some chance of success.”
Privacy rights could be a consideration. Cornell Law School’s Legal Information Institute states “the Supreme Court first recognized the right to privacy in Griswold v. Connecticut (1965). The Court used the personal protections expressly stated in the First, Third, Fourth, Fifth and Ninth Amendments to find that there is an implied right to privacy in the Constitution.”
And, it says, constitutions in 11 states already have “explicit privacy provisions.”
Resources
NASW Reproductive Rights Page
Overturning Roe v. Wade will disproportionately affect people of color. Here is what social workers should know
Center for Reproductive Rights: Abortion Laws by State
Arizona Governor Doug Ducey signs series of bills limiting abortion access and transgender rights - CBS News
State Courts Could Overturn Abortion Bans in Red States - Pew Charitable Trusts
U.S. Supreme Court has recognized the right to privacy