- January 5, 2023
If you had told my east-coast, twenty-something-year-old self that, in the not too distant future, I’d be making a home and raising a family in Utah, you’d have been met with a confused look—Where? Which square state is that?
However, as so often happens, I was awe-struck by my first visit here. The red (really truly red!) rocks! The way erosion shapes the landscape! A geology nerd at heart, I was intrigued. As an obstetrician specializing in high-risk pregnancy care and providing abortions as part of that care, I was less enamored with the red (really truly red!) politics and the potential for erosion of a different landscape — the landscape of reproductive rights.
Nevertheless, since national precedent in the form of Roe v. Wade and Planned Parenthood of Southeastern Pennsylvania v. Casey generally protected the right to abortion, and thus me from criminal prosecution, we made a home and a life here. I even found some like-minded individuals, and we worked to educate fellow Utahns and do our best to provide and protect the full range of reproductive options.
Any UPEC supporter likely knows that the Supreme Court’s June 20, 2022 Dobbs vs Jackson Women’s Health Organization decision (hereafter referred to as Dobbs) changed the entire landscape of reproductive rights in one fatal moment. This wasn’t your typical erosion by weathering, wind, and the elements. This was cataclysmic shift. All abortion regulation would now occur on a state level.
The subsequent results were head spinning. Allow me to give a brief timeline of the pertinent Utah legal events:
- March 2019: Utah Legislature passes HB 136, limiting unrestricted abortion access to less than 18w
- April 2019: Federal judge issues injunction, halting enforcement of HB136 after challenge by Utah chapters of the American Civil Liberties Union and Planned Parenthood
- March 2020: Utah legislature passes SB174, written as a “trigger law,” and thus only enforceable if and when it becomes constitutional, limiting its ability to be challenged in court. This law bans all abortions after implantation (so, all abortions) with some limited exceptions
- Morning June 24, 2022: Dobbs decision delivered
- Evening June 24, 2022: Trigger law (SB 174, banning all abortions) goes into effect
- June 27, 2022: Judge grants temporary restraining order, after challenge from state abortion rights groups, and enforcement is halted for two weeks. Federal lawsuit over 18w ban is dismissed.
- June 28, 2022: Utah’s HB 136 goes back into effect, banning unrestricted access after 18w
- July 2022: Judge extends injunction of “trigger ban,” 18w ban remains in place
Still with me? You can see how those two weeks caused much confusion and consternation. We medical professionals didn’t know what we could and couldn’t offer patients. Did I need to send the person with the fetal anomaly at 19w out of state or could I help her here? Would I be committing a felony and risking my license and 15 years in prison by providing an abortion already scheduled for weeks? The answers literally changed from one hour to the next. It was a bad time to be an abortion doctor, a woman, or, frankly, an empathetic human in Utah.
Some background information might be helpful here. About half of half of all pregnancies in the US are unintended, with significant disparities by income level. Almost 20% of pregnancies (excluding miscarriages) end in abortion. By age 45, one of every four women has had an abortion. The vast majority of those individuals are already parents.
What happens next in Utah is difficult to predict.
Our neighboring states differ markedly. Despite my personal wishes, there is no realistic chance that we will mimic Colorado and implement full unrestricted access. Instead, I see significant risk that we will mimic Idaho, which has a full ban with no exceptions (yes, you read that right).
Despite the absence of a national “red wave” in the recent election, the Utah Senate and House kept their Republican supermajorities. Furthermore, all four of Utah’s national congressional districts continue to be held by anti-abortion Republicans. The closest senate race in some time was between two candidates who do not support the bodily autonomy of pregnant individuals. Many lawmakers who recently sent a letter to abortion providers in Utah telling us that the injunction on the trigger law doesn’t mean that the law isn’t in effect and that we will be prosecuted retroactively won re-election. (For the record, they are wrong. Your legislators literally don’t understand how laws work.)
I suspect that we have yet to experience the full downstream effects of Dobbs in Utah.
People who need an abortion will need to choose from seeking one out of state, self-managing their abortion, or continuing a pregnancy and giving birth against their will. The first option is impossible for many people depending on resources and circumstances. The second option may be feasible in some scenarios and life-threatening in others. The final option is a fundamental violation of an individual’s human rights — and will lead to a host of pathologies brought on by unwanted babies.
What can regular Utahns do? A few suggestions for those so inclined:
- The anti-abortion forces are strong and vocal in Utah. If we hope to shift public perception, and eventually policy, appropriate countermeasures are necessary. Those of us who value a person’s right to bodily autonomy need to be brave enough to say so — to friends, lawmakers, religious leaders, administration and policy makers, and anyone else who will listen.
- Support local and national abortion funds
- It goes without saying that you need to vote in local and state elections. What might be less clear is that efforts to expand voting access and draw fair boundaries are also impactful.
- Support local and national groups doing legal work to preserve abortion access (e.g., UPEC, ACLU, Planned Parenthood, and SisterSong).
Although Dobbs was a cataclysmic event, the circumstances that led to the damage had been building form some time. Thus, we cannot expect to emerge from the current era overnight. Let us hope that we can do it somewhat faster than a geologic timescale. The lives, well-being, and human rights of millions of individuals depends on it.
By Cara C. Heuser, MD
