On June 24, 2022, the US Supreme Court overturned Roe v. Wade, the 1973 Supreme Court decision that asserted the constitutional right to abortion. At Autoimmune Wellness we continue to strongly oppose the decision of the Court and firmly stand with the majority of Americans who know that abortion care is healthcare.
We take this position because limiting access to safe, affordable healthcare is an unacceptable threat to the prerequisites of wellness for the autoimmune community we serve, including the basic human right of bodily autonomy. Additionally, decades of research has demonstrated that abortion bans most severely impact people in marginalized groups who already struggle to access healthcare, especially those with low incomes and those in the BIPOC community. Our commitment to the work of social and health equity for all does not end at food and nutrition. Fostering an anti-oppressive wellness environment must address all prerequisites to health and wellness.
Why Does Access To Abortion Care Matter To Those With Autoimmune Disease?
According to the AARDA approximately 80% of all patients diagnosed with autoimmune disease are women. Thus the right to control one’s reproductive decisions is especially crucial for the autoimmune community, since we know that the hormonal changes of pregnancy and the postpartum period leave us uniquely vulnerable to developing new or worsening autoimmune conditions.
A 2020 report in the journal Cureus outlines how pregnancy impacts body changes, like metabolic rate, lipid levels, and weight variation, that can continue for a year or more postpartum and trigger autoimmune responses. Pregnancy also impacts the levels of hormones, like estriol (a form of estrogen), progesterone, and prolactin. These hormonal changes can potentially trigger or flare autoimmune conditions, during or after pregnancy. The report also outlines evidence that the maternal immune system is suppressed to protect the fetus, but a suppressed immune system is a possible trigger for the development of autoimmune disease.
While most autoimmune diseases are manageable, they are not curable and some are life-threatening. All autoimmune diseases change one’s quality of life. An individual’s right to decide if the risk that pregnancy presents in terms of new or worsening autoimmune disease is critical in light of these facts.
What Are The Repercussions of Abortion Bans On Autoimmune Healthcare?
The knock-on effects of the Court ruling for autoimmune healthcare are very concerning. For example:
- Considering how hormonal changes can impact autoimmune disease, many women in the autoimmune community choose non-hormonal birth control methods, like the copper IUD. However, in a post-Roe era access to this form of birth control may be limited, forcing women to choose other methods, including hormonally based methods, that can worsen autoimmune disease. Additionally, although rare, there is an increased risk of ectopic pregnancy when IUDs fail to prevent pregnancy. Ectopic pregnancy is life-threatening and requires abortion care to treat it, which is now illegal for millions of birthing people.
- Endometriosis, a suspected autoimmune disease, impacts 1 in 10 women of reproductive age. According to Dr. Melissa McHale, an expert endometriosis surgeon, the direct and indirect impact of abortion bans on endometriosis healthcare will be significant. One of the greatest impacts will be on care for miscarriage, which is a 76% higher risk in endometriosis patients. Dr. McHale states, “In many cases patients will not be able to access the care that they need before experiencing the life-threatening medical complications of pregnancy loss: bleeding, pain, and infection, which can cause scarring of the uterus and tubes and which spreads systemically (sepsis). For those experiencing the pain and trauma of pregnancy loss, these added complications will be devastating and marginalizing – further compounding the ways in which our medical system fails those with endometriosis.” In other words, not having access to proper healthcare will not only be potentially life-threatening for those with endometriosis, but not getting the proper care will also lead to damage of the reproductive organs, worsening their already difficult infertility struggles.
- Access to a first line therapy for rheumatoid arthritis, psoriasis, psoriatic arthritis, lupus, juvenile idiopathic arthritis (JIA), and inflammatory bowel disease, all autoimmune diseases, is also being limited due to the abortion ban. According to the Arthritis Foundation, methotrexate is a well established treatment, with a long track record for safety and effectiveness. However, since methotrexate can be used after a miscarriage to help clear tissue from the uterus or to end an ectopic pregnancy some states are allowing doctors or pharmacists to refuse access to the medication. Methotrexate is also not pregnancy-safe and can cause severe birth-defects, which means some patients who become pregnant while taking it may decide to seek abortion care. The reversal of Roe makes this healthcare decision much more restricted in some states, if not criminal.
What Are The Repercussions of Abortion Bans on Marginalized Groups In The Autoimmune Community?
The knock-on effects of the Court ruling for marginalized groups within the autoimmune community are also very concerning. These groups will experience compounded risks, in addition to limitations the bans represent for their autoimmune healthcare access. For example:
- Black women die of pregnancy-related causes at nearly three times the rate of white women. A University of Colorado study in 2021 found that a total abortion ban could further increase pregnancy-related deaths by up to 33% for Black women.
- The risk of rape or sexual assault is 2.5 times higher for Native American women compared to the rest of the US and they are two times more likely to die from pregnancy-related complications than white women. Yet in many states, there will not be be any exemptions for abortions in cases of rape.
- The Economic Policy Institute succinctly summarizes how abortion bans harm those of lower incomes: “Those who are denied an abortion are more likely to be in poverty and experience financial distress for years afterward, with higher rates of evictions and bankruptcies. This decision will cause immediate economic pain in 26 states where abortion bans are most likely and where people already face lower wages, less worker power, and limited access to health care. Abortion rights are economic rights, and this decision means the loss of economic security, independence, and mobility for abortion seekers. Low- and middle-income people, especially Black and Brown women, will bear the brunt of the impact.”
Resources To Take Action
We encourage the Autoimmune Wellness community, especially calling-in those with the most privilege in our community (high-income, white women), to take action that will help ensure the health and wellness of us all. We are confident in our fellow autoimmune warriors to use the grit and resilience they’ve already developed as a result of their autoimmune journeys to work for robust healthcare access and protection. Following are some useful resources:
- IMPORTANT! Start by getting guidance on practicing digital privacy
- Up to date information on rights and abortion access by state
- Access to abortion pills by mail
- Volunteer or support local abortion funds
- Support those doing the legal work of protecting abortion access
- Denied access to methotrexate: The Advocacy Team at the Crohn’s & Colitis Foundation will help. Email them at [email protected].
- Learn about groups operating in “trigger ban” states to support
- Find local protests
Support Autoimmune Wellness
Our tagline at Autoimmune Wellness is “Seeking Health and Building Community.” Pursuing robust individual health while creating strong community networks is how those with autoimmune disease can achieve wellness. We have taken the lead repeatedly over the last few years on issues often seen as “political” or “controversial” that directly impact the health of the autoimmune community. That leadership has not come without risk. We have no plans to stop, but your support certainly makes it easier for us to continue. Please share this article and help us create those strong community networks that will protect the individual health of us all.