This article by Executive Director Tara Romano originally appeared in NC Policy Watch.

As we commemorated the 46th anniversary of the historic Supreme Court decision Roe v Wade last yearour thoughts were on what may happen at the U.S. Supreme Court. Two-thousand nineteen was the first full year of a high court firmly stacked with justices ideologically opposed to abortion, two of whom were appointed by a president who sees overturning Roe v. Wade as a key to his re-election.

While last year saw no direct Supreme Court challenges to the precedent set in Roe, that is not the case as we celebrate tomorrow’s 47th anniversary, a time at which the precedents established by Roe and other abortion rights cases are under direct attack, even as public support for safe and legal abortion access remains high.

While the promise of reproductive freedom for all in the Roe decision never fully materialized, it was still an important and critical court ruling, one that reflected what has been happening since humans have been getting pregnant – namely, that some people, for any number of reasons, will seek out the means to end an unwanted pregnancy.

The decision made by the court in 1973 helped assure that this common medical procedure – one that gave women in particular more say over their own bodies and lives – would be safe and legal in every state. With further erosion of abortion access, and even a possible overturning of Roe on the near horizon, however, we have to face what we are really debating in this country: Do people who may need to terminate a pregnancy have a right to safety, dignity and self-determination, or does our society solely value the human ability to reproduce?

Prior to Roe, we had a two-tier system of abortion care, in which people of means were able to access safe, if illegal, abortions, sometimes in the privacy of their own doctor’s office. Those less financially secure might also be able to access safe abortion, but only after scrambling to raise the funds necessary, both for the abortion and for travel to the procedure; while others, usually in desperation, took their chances with underground networks, including obtaining methods to attempt to self-induce their own abortions. Those opposed to safe and legal abortion have used the years since Roe to recreate that two-tier system, as anti-abortion lawmakers have passed unnecessary and medically unsound laws to restrict access to safe procedures, to isolate and target abortion clinics, and to restrict public and private insurance funds from covering much reproductive health care, including abortion and contraception.

With the U.S. Supreme Court set to hear a case on March 4 about the constitutionality of Louisiana’s recent anti-abortion restrictions – restrictions that very similar to those that were struck down just three and a half years ago in Whole Women’s Health v Hellerstadt – many people on either side of the abortion discussion see the possibility that the standard set in Roe may be severely weakened, if not directly overturned. A direct overturn of Roe, something the anti-abortion movement states is key to its ultimate goal of re-criminalizing abortion, would leave it up to the states as to how to regulate the procedure. While some states have protections in place to keep abortion legal should Roe fall, in 2019 an increasing number of states rushed to put statues in place to ban abortion outright, or severely restrict it.

North Carolina, a state that legalized some types of abortion prior to Roe, currently does not have a law stating what would happen should Roe be overturned. Since anti-abortion leadership in North Carolina passed more laws restricting access to abortion between 2011-2016 than it did in the years prior, however, we anticipate there would be a strong effort here to ban abortion should Roe be weakened or overturned. And while we did see success last year in stopping an unnecessary and inflammatory anti-abortion proposal (SB 359), North Carolina still has a number of medically unnecessary restrictions, including a 72 hour waiting period, the requirement to read anti-abortion materials to patients, and restrictions on insurance funding for abortion care.

And on the ground outside of abortion clinics, now clustered in just nine of our 100 counties, an emboldened anti-abortion opposition has escalated their harassment of patients, clinic staff and volunteers. This includes attempts to block patients from their appointments and to force misleading and manipulative propaganda on them, and the filming and tracking of people going into the clinic. We even saw a county declare itself officially “pro-life” in 2019, although what kind of support for families such a designation includes beyond condemning abortions remains much in doubt.

We’ve seen time and again that safe access to abortion is a human issue, rather than a political one, with people of all religious backgrounds and political ideologies making up the one in four women in this country who access abortion. Whether we know it or not, we all love someone who has had an abortion. And as polling has continued to show, the vast majority of Americans, including nearly half of Republican voters, believe abortion should remain legal in this country, no matter their personal feelings. Yet we may still soon be looking at a post-Roe landscape later this year.

A Supreme Court decision will certainly not be the last word on abortion access in this country. Those who support safe and legal abortion can raise our voices and share our stories to push back on the stigma that informs the stereotypes and false narratives on abortion. We can support abortion funds that provide direct services, and increase our citizen advocacy. And we can vote for policymakers who support abortion access. But again, the true discussion of what will happen in a post­-Roe world is not if abortion will end, but what will happen to those who will still seek out abortion, and those who provide it.

Simply put, are we ready to threaten and jail providers who provide safe, competent care, and leave desperate patients on their own, risking incarceration, serious injury and death? That is the honest question we must be asking ourselves.

Join NARAL Pro-Choice NC, Equality NC and NC Policy Watch for a Crucial Conversation on January 28, discussing what the anti-abortion and anti-equality cases before the U.S. Supreme Court this session may mean for abortion access and civil rights in NC and around the country. You can register here

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