July 6, 2015 — While women's health advocates are watching the Supreme Court for key decisions on reproductive rights, most of the "action is at the state level, and decisions by state legislators ... underscore the threat to women's choices in reproduction and other health issues," The Conversation reports.
According to The Conversation, lawmakers between 2011 and 2013 passed 205 restrictions on women's reproductive rights, accounting for more restrictions than passed over the previous decade. In 2013, 22 states approved 70 laws restricting women's access to reproductive health care. Meanwhile, reproductive rights advocates found that 27 states in 2013 -- up from 13 in 2002 -- were considered "hostile" to abortion rights.
Lawmakers in some states have targeted abortion rights through procedural bans, The Conversation reports. For example, North Dakota enacted a measure (HB 1456) that would ban abortion as early as six weeks and lawmakers in Nebraska passed a 20-week abortion ban (LB 1103). Neither ban included exceptions for the life of the woman or rape. Federal courts have halted both of the measures, and, according to The Conversation, neither law would pass a constitutional challenge.
However, most states instead are targeting abortion rights by imposing restrictions and additional requirements before accessing abortion care. For example, states have imposed laws such as additional record-keeping requirements, hospital admitting privileges requirements, mandatory ultrasounds, patient-transfer agreements and zoning regulations. In addition, several states have imposed mandatory delays that require women to wait up to 72 hours, not counting weekends and holidays, before an abortion.
Additional Restrictions on Reproductive Rights
State lawmakers also have restricted women's health care in areas beyond abortion care, The Conversation reports. Within the last five years, there has been an uptick in the number of states that impose criminal penalties for drug use by pregnant women, aim to restrict access to safe and effective contraceptives, refuse to require employers to include contraceptive coverage in health plans and criminalize natural events -- such as miscarriage.
For example, women in Tennessee can be charged under a 2014 law that equates a pregnant woman's use of drugs to fetal assault and imposes up to a 15-year prison sentence. Further, the law can be used against women who have sought substance use disorder treatment but have been unable to access it.
According to The Conversation, more than 250 women since 2005 have been prosecuted for cases based on "fetal harm." By comparison, between 1973 and 2005, a total of 413 women in 44 states were charged under such laws. If the current rate of prosecution is maintained, nearly 1,000 more women will be charged under such laws over the next two decades, The Conversation reports. Further, such cases could have a "chilling effect" that might deter low-income women, minority women and others from seeking help for substance use disorders.
According to The Conversation, the American College of Obstetricians and Gynecologists, the American Medical Association, the American Academy of Pediatrics and the American Nurses Association all have expressed opposition to laws that further criminalize substance use in pregnant women (The Conversation, 6/30).