NJ has strong abortion law, but not necessarily easy access

LILO H. STAINTON, HEALTH CARE WRITER | MAY 4, 2022 

NJ Spotlight News

May 3, 2022: Demonstrators protest outside the U.S. Supreme Court after the leaking of a draft majority opinion suggests the court is poised to overturn the landmark 1973 Roe v. Wade decision that legalized abortion nationwide.

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Access to abortion remains a “fundamental right” for anyone present in New Jersey, state officials underscored Tuesday, regardless of the U.S. Supreme Court’s intention to overturn the decision known as Roe vs. Wade.

But that doesn’t mean abortion is easy to access in New Jersey or will be in the future. The costs involved can be high — even for insured patients — and abortion providers are scarce, especially in rural areas, health advocates said. And state lawmakers could tweak or reverse these statutory protections in the future.

New Jersey’s law technically enables women from out of state to obtain abortions here, but experts noted that requires those women to have resources, like child care and travel money. If Roe v. Wade is overturned — as a draft Supreme Court opinion leaked late Monday suggests — women and children are at higher risk for sickness and death, they said, and poor and minority women suffer most. New Jersey is already struggling to address significant racial disparities in health outcomes, particularly when it comes to maternal mortality.

“Already in this country there’s limited access in terms of getting reproductive health and contraception or planning for a pregnancy, so the impact of this is just going to significantly marginalize already marginalized people,” said Dr. Glenmarie Matthews, an assistant professor in the department of obstetrics, gynecology and reproductive health at Rutgers Robert Wood Johnson Medical School.

“In every other country where abortion is illegal the morbidity and mortality from abortion complications is significantly higher,” said Matthews, a leader with the New Jersey Black Women Physicians Association. “That’s the health impact of what we’re doing here.”

Rushing to condemn

Gov. Phil Murphy and other Democratic leaders rushed Tuesday to condemn the Supreme Court opinion, drafted in February by conservative Justice Samuel Alito and published by Politico late Monday night, while acknowledging it was not unexpected. A growing number of Republican-led states have sought to limit access to abortion and several legal challenges to the 1973 Roe v. Wade decision have reached the high court, including a Mississippi case on which the controversial opinion is based.

The Supreme Court has not issued a final decision, and may not for weeks, but Matthews and others stressed that if it does opt to overturn Roe v. Wade, abortion won’t disappear. Instead, women will increasingly turn to illegal procedures that are inherently higher risk, health experts said.

“What the court is doing is basically not stopping abortion,” Matthews said, “but they’re stopping the safety of a pretty safe procedure.”

Leslie Kantor, chair of the department of urban-global public health at Rutgers School of Public Health and a maternal health expert, agreed. “We’re not going to get rid of abortion. We’re just going to make it less safe.”

While more than two dozen states have enacted abortion limits of some kind over the past decade, New Jersey has remained a strong pro-choice state where more than 48,000 procedures were provided in 2017, according to the Guttmacher Institute, which tracks reproductive health. Abortions were available at 76 facilities in New Jersey, the institute found, though one in four women lived in a county without an abortion provider.

Some of the barriers

“Even for people who live in New Jersey, it’s hard to access abortion in New Jersey at some times,” Matthews said. “It’s a liberal state, but it’s a big state and you have to travel far just to get an abortion.”

Murphy — who has prioritized abortion access and women’s health during his time as governor — and advocates labelled it a “crisis moment” in the country’s history and urged people contact elected leaders with their opposition. Six in 10 Americans believe abortion should be legal in all or most cases, according to the Pew Research Center.

“We must ensure that every American woman has the freedom that every New Jersey woman has,” Murphy said Tuesday before the start of an unrelated event on flood protection. “If the Court takes this awful step, this decision will have no impact on New Jersey state law or the full right to reproductive freedom under our state law.”

The Reproductive Freedom Act, introduced in late 2020 by former state Sen. Loretta Weinberg (D-Bergen) and others, had Murphy’s support from the start. Lawmakers amended the measure, cutting some provisions designed to reduce cost and other barriers to abortion, but maintained a fundamental guarantee that everyone in New Jersey has the right to access contraception, terminate a pregnancy or carry it to term. Murphy signed the measure in January.

Kantor welcomed these protections, but warned they are not necessarily permanent. “I do think it’s worth everybody noting there is no court protection. This is all up to legislators and governors,” she said. “That means we do need to continue to pay attention to our state elections. None of us should be complacent.”

Cost is an issue

Nicole Rodriguez, research director at New Jersey Policy Perspective, a progressive think tank, agreed the state was “fortunate” to have abortion rights codified in statute, but added, “rights alone are not enough, especially for those for whom health care is too expensive and out of reach.” While the state’s Medicaid plan provides full coverage for abortion services, residents with private health insurance policies may still face stiff out-of-pocket costs, experts note, and uninsured women would need to pay for the procedure themselves. Rodriguez and others urged lawmakers to close these gaps by enacting measures that were cut from early drafts of the Reproductive Freedom Act.

While the abortion protections enacted under Murphy are critical, Kaitlyn Wojtowicz, vice president of public affairs at Planned Parenthood Action Fund of New Jersey, also agreed more work remained to ensure uninsured and undocumented women have access to these services. “Rights without access are meaningless,” she said.

State and national funds are available to assist women with abortion costs, Matthews noted, but accessing them is not easy. Many providers don’t even know they exist, she said, adding, “You really have to be knee-deep in abortion care” to navigate this system.

Alito’s draft opinion, which the court Tuesday confirmed was his work, suggests that the need for abortion has slackened given new options like “morning after” pills, sometimes known as pharmaceutical abortions, and safe havens, or designated sites where parents can safely abandon a newborn. New Jersey was among the first states in the country to embrace safe havens.

Abortion has declined in US

While abortion use has declined nationwide in recent years, Kantor said this argument is both unrealistic and an affront to personal autonomy. Carrying a baby to term and giving birth is a “major physical and emotional experience” that likely keeps many women from choosing a safe haven for their newborn, she said. And many states that restrict abortions are also so-called birth control deserts.

Both Matthews and Kantor stressed the connection between abortion access and maternal health nationwide. “States that already have the most restrictive abortion access also have the worst maternal health outcomes,” Kantor said. “These things tend to be linked to one another.”

One exception may be New Jersey, which still has one of the nation’s highest racial disparities for maternal mortality, with Black women seven times more likely to die from childbirth-related complications than white mothers. “That is not the pattern that you see other places,” Kantor said. “But we know that childbirth is much more risky than abortion, especially in this country where we have poor rates of maternal health.”

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published this page in News and Politics 2022-05-04 02:58:48 -0700