If (when?) Virginia imposes new abortion restrictions, those with the least will suffer the most

Bob Marshall got what he wanted.

For a generation as a Republican member of the House of Delegates from Prince William, Marshall was the foremost anti-abortion voice in Virginia government until he lost his seat in 2017 to Democratic Del. Danica Roem.

Every legislative session during Marshall’s tenure saw a flurry of bills from his pen that would crimp access to abortion in Virginia – some successful, others going too far even for fellow Republicans who ruled the General Assembly at the time.

His real goal – outlawing it – got a lot closer to reality when the U.S. Supreme Court struck down the 1973 Roe v. Wade precedent that kept abortion clinics in Virginia open and Marshall and legislative anti-abortion crusaders at bay.

Now, absent federal court protection, abortion rights are determined state by state, with many – mostly in the Deep South – already severely restricting or even banning the procedure. Virginia is not among them, but that may not last much longer. And if or when that happens, women and families with the least will suffer the most.

As of Thursday, bans were in place in 20 states, and abortion remained legal in 19 states plus the District of Columbia, according to a state-by-state count of abortion laws by The Associated Press. Virginia was listed among 11 states where the issue remains to be determined.

Thirteen of the states that now ban or sharply restrict abortions had “trigger laws” on the books waiting to take effect as soon as the Supreme Court released its Dobbs v. Jackson Women’s Health Organization ruling. In those states, except for a few where court challenges have enjoined the law from taking effect, abortion clinics were forced to close immediately. In some states, the law would make a felon of any doctor who performed an abortion.

The ink hadn’t yet dried on the Dobbs decision before Republican Gov. Glenn Youngkin called for new legislation restricting abortion access in Virginia. Details he has offered publicly are still vague, but he has said he would sign whatever limiting legislation the General Assembly sends him and expressed an interest in cutting off abortions after 15 to 20 weeks of gestation with exceptions for victims of rape and incest and to protect the life of the mother.

That’s not exactly what he’s telling abortion opponents from the other side of his mouth. The Washington Post reported Thursday that in an online forum with the Family Foundation of Virginia, Youngkin called the 15-week cutoff he proffered just a first step to put something palatable before a divided General Assembly, but said he would push for stricter limits as political conditions might allow later. During the forum, the Post reported, he acknowledged that a 15-week ban “won’t be the bill we all want,” adding that he believes “life begins at inception” – a faux pas his spokeswoman later corrected to “conception.”

“It’s what you can do with the folks that you have,” Marshall said in a telephone chat last week, acknowledging the limitations of the current partisan legislative split.

As a candidate, Youngkin tried to keep his antipathy for abortion rights on the down-low, but hidden camera subterfuge by progressive activists posing as abortion foes blew that up. In a covertly recorded conversation, Youngkin said he had to soft-pedal his position on abortion to win independent votes he would need to get elected, but once he’s governor with a Republican legislature, he confided, “then we can go on offense.”

He got part of what he wanted last November with his victory over Democratic former Gov. Terry McAuliffe, an abortion rights supporter, in the governor’s race and a Republican takeover of the House. Democrats still hold 21 of the Senate’s 40 seats, but the swing vote on abortion issues would be Sen. Joe Morrissey, a pro-life Democrat. Assuming any legislation yields a party-line 20-20 vote with Morrissey siding with the GOP, fiercely pro-life Republican Lt. Gov. Winsome Earle-Sears would cast the decisive vote, returning women’s reproductive rights in Virginia closer to what they were before 1973.

That was a time when women living on or below the margins financially had little choice but to carry their pregnancies to term and forfeit opportunities while wealthier women could jet away to locales where abortion was safe and legal and “get it taken care of” discreetly, preserving their social standing and their educational and career options.

It’s what post-Roe America will resemble. Even while Roe was in force, women at or beneath the federal poverty level were disproportionately driven to seek out abortion services, according to a study by the Guttmacher Institute. In 2014, the study found, three-fourths of patients were low-income: 49 percent at or below the federal poverty level and 26 percent at or slightly above it.

Now, with abortions banned, many women and their families on the cusp of penury will likely slip deeper into helplessness and hopelessness. One comprehensive multi-year study conducted at the University of California-San Francisco looked at 1,000 women who sought abortions at 30 clinics in 21 states. The research, which began in 2008 and is known as “The Turnaway Study,” compared outcomes for women who were able to have abortions and women who sought them but were turned away by providers because they were too far along in their pregnancies to qualify.

By tracking those women with semiannual telephone surveys for five years, the study’s researchers found that women who were turned away experienced more detrimental financial, health and family outcomes. Among them: Women denied a wanted abortion who were forced to give birth were four times more likely than women in the survey who received abortions to live below the federal poverty level.

It should be noted that pro-life advocates vigorously dispute the study’s findings and assert that abortion causes far greater harm to women in addition to their seminal argument that the process terminates what would be a human life. In rebuttal, they cite various papers like this one on the alleged ancillary harms, all produced by pro-life organizations.

Even if Virginia doesn’t act to restrict abortion access, bans in neighboring states will make it more difficult to obtain abortions for Virginians. Tennessee and Kentucky have already enacted abortion bans (although a court challenge in Kentucky has stayed enforcement of that state’s law), and some conservative lawmakers in North Carolina want the state to enforce a 20-week ban that’s been on the books since the 1970s but has been stymied by Roe.

As expectant women from those states cross into Virginia, where abortion is still legal, the influx will dramatically increase caseloads for Virginia’s providers, forcing longer waits for appointments for women whose pregnancies are already approaching the point of fetal viability past which elective abortions can no longer be performed.

Virginia is not a hotbed for abortions,according to the Guttmacher Institute, a research and policy nonprofit focused on reproductive health. In 2017, the most recent year for which complete data are available, Virginia’s abortion rate was 10.2 per 1,000 women aged 15 to 44, ranking the commonwealth 25th nationally. The 17,210 abortions performed in Virginia that year accounted for just 2 percent of the more than 862,360 abortions performed nationally. The District of Columbia, New Jersey, New York and Maryland, in that order, had the four highest abortion rates that year.

Tannis Fuller sees firsthand the urgent desperation women in crisis seeking abortions experience. As executive director of the Blue Ridge Abortion Fund, which last year provided more than $600,000 to nearly 1,900 women who needed assistance, it’s her job.

Life will get even tougher for the poor, many of them minorities, if Virginia restricts or ultimately bans abortion, she said.

“Any time someone doesn’t have the financial means to access abortion it can be devastating,” Fuller wrote in an email response to an inquiry from the Mercury. “If the General Assembly makes abortion illegal after 15 or 20 weeks (of) gestation, we will most certainly see patients who need care later in pregnancy needing additional financial support to access care in states where it is still available, most likely Washington, D.C., Maryland, New Jersey, or New York.”

Think of it as trickle-down inequity.

Those with the financial means will once again get inconvenient pregnancies in their proper, comfortable households discreetly dispensed with, just as they did 50 years ago.

The privations and pain, meanwhile, will pool knee-deep for the masses in America’s  socioeconomic basement who can least afford it.

Just as they did 50 years ago.