The annulment of Roe v. Wade adds challenges for women in rural Arizona

Experts fear that the recent U.S. Supreme Court decision that overturned Roe v. Wade, the landmark 1973 case that legalized abortion nationwide, only increases the difficulties already faced by rural communities in southern Arizona in accessing reproductive health care.

“We’re going to see more unwanted pregnancies,” said Elise Lopez, associate director of the relationship violence program at the University of Arizona, of the impact of the ruling in rural areas.

The June 24 Court’s decision in a Mississippi case, overturning Roe, now allows States to establish their own abortion laws. Thirteen states, not counting Arizona, had a “trigger” lawwhich is designed to take effect automatically upon cancellation by Roe.

Lara Ruggles, an organizer for a national women’s rights group with a branch in Tucson, said she felt “abject terror” after Roe’s overthrow.

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“I know quite intimately what it’s like to be very broke and to exist on very little income and to have no insurance beyond the state Medicaid and to have long lists of waiting or not having easy access to the kinds of care I needed,” said Ruggles, director of marketing and development for YWCA Southern Arizona.

She noted that she had privileges that others don’t: a family she could rely on for help, living in a city with resources, and being white.

“Being truly aware of how the privileges I had made things easier for me, and yet how difficult they still were made me want to do whatever I can to defend everyone in my life. a place where they don’t have that support systems.”

Lopez said some challenges to accessing health care in rural areas include traveling to appointments, missing work for those appointments, coordinating child care, accessing contraceptives and education on contraceptive use and insurance costs.

With the latest abortion bill signed by Gov. Doug Ducey in March banning abortions after 15 weeks unless a woman’s life is in danger, access to safe abortions may be more difficult. for people living in rural areas, she said.

She said that in rural areas where people have to travel long distances for treatment, they will need to carefully assess how close they are to dying from lack of care and how long it takes to get to the hospital. nearest medical facility for treatment. Rural areas often have limited options for public transportation.

“When does she decide she’s close enough to death that if she goes to the hospital to get an abortion, she actually gets that care,” Lopez said.

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A potential solution to abortion are abortion pills, Lopez said, noting that challenges could arise if restrictions on abortion pills are put in place.

“I hope telemedicine can help people get access to abortion pills so they can have safe abortions at home. I think this is going to be really transformative for our rural communities,” he said. she declared.

Old law could add more challenges

A 1901 Arizona anti-abortion law could further restrict abortion. The law, ARS13-3603, prohibits all abortions and punishes anyone who helps a woman to have an abortion with two to five years in prison. He stays uncertainty whether this law or a more recent law will prevail.

Lopez said a big concern, especially for people in rural areas, is the wording of the 1901 law punishing those who help someone access an abortion. Would an Uber driver, friend or family member who transports someone to have an abortion be punished?

This could deter people from helping each other access surgical abortions, she said.

“The fear of jail…to access that medical care would terrorize people,” Lopez said.

Residents of rural communities in southern Arizona struggled to access basic health care even before Roe’s overthrow.

A community health worker noted that rural residents often lack the important connection between patient and doctor, an effect that occurs due to the constant turnover of visiting doctors.

The health worker recalled a time when his father suffered a stroke in a rural community near the border. However, because the area lacked medical equipment, a nurse had to hand-pump oxygen into his father’s mask for hours until he could be airlifted to Tucson.

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Shaq McCoy, one of the co-founders of Arizonans for Reproductive Freedom, said organizations and service providers in Arizona are looking at how to help people access abortion services outside the state.

McCoy said the closest areas to Arizona with such services would be The centera city in southern California, as well as places in Mexico and New Mexico. She noted that organizations across the country are raising funds to help women pay for abortions. One such organization is Abortion Fund of Arizona.

This month, Arizonans for Reproductive Freedom worked to collect signatures to add a constitutional amendment protecting reproductive rights to Arizona ballots in November.

According to a press release issued on Thursday, the group failed and collected 175,000 signatures instead of the required 356,000 put protections for reproductive health care on the ballot.

Now they look to the 2024 elections.

“Arizonans for Reproductive Freedom will continue to harness the movement’s passion to ensure the measure qualifies for the 2024 ballot,” the group said in the statement.

Barriers to access to contraception in rural areas

Abortion rights activists demonstrate outside the Arizona State Capitol in Phoenix following the Supreme Court's decision to overturn Roe v. Wade on June 24, 2022.

Difficulties in accessing contraception and education on the effective use of contraceptives also impact people in rural areas.

Lopez pointed out that access to contraceptives, especially longer-acting contraceptives like intrauterine devices, often abbreviated as IUDs, is difficult in areas where there are fewer providers of obstetrician-gynecologists or specialist clinics. reproductive health.

Lopez said physical access is not the only issue, but also economic access. In low-income families, women often have to choose between paying for medications, such as birth control pills, or paying their monthly expenses.

For birth control pills to work, they must be taken every day, and often at the same time each day. Lopez said for people with less access and economic means, it can be a challenge.

According to data from the USDA Economic Research Servicethe poverty rate in rural Arizona is 21.9%, compared to 12.4% in urban areas of the state.

“For a lot of people, especially if you have less access to birth control pills, perfect use goes out the window,” she said. “It’s things like popping pills. It’s things like do I have to pay for my birth control this week? Do I have to pay for my food this week? Where do I pay for my electricity this week? Lopez said.

According to National Institute of Healthmany unwanted pregnancies are the result of improper use of contraceptives.

Women’s rights and pro-choice groups fear Roe’s reversal will pave the way for other restrictions like access to contraception and overturn other precedents.

State data shows that 55.9% of women who had abortions in 2020 have already given birth, a statistic it says contradicts the argument of anti-abortion advocates that abortion is used as birth control. .

Ruggles stressed that the worry would affect him personally if contraceptives were to be banned.

Ruggles, who has an IUD, said she was concerned about how the wording of the ruling to overturn Roe v. Wade could open up future attacks on IUDs and similar contraceptives, making it more difficult for a fertilized egg to implant in the uterus.

“The main reason I have an IUD is because I have intense, severe pain every month during my period,” she said, adding that unlike her IUD, the painkillers did nothing to help. his excruciating pain. She recalled during her teenage years how often she feared she would vomit or pass out from the pain.

Ruggles also noted how the reversal of Roe v. Wade will have more negative impact on communities with intersecting barriers.

As previously reported by The Arizona RepublicRoe v. Wade could lead to an increase in maternal deaths that will disproportionately affect black and Latina women, who already have higher maternal death rates.

Lopez noted that abortion rates tend to be higher in areas where there are higher rates of unintended pregnancies, which are generally higher in communities of color and in areas of socioeconomic status. inferior.

According to data from the Arizona Department of HealthLatinos had the highest number of abortions in 2020 at 40% compared to 35% among whites, 12% blacks, 2% Asians, and 4% Asians and Pacific Islanders.

“I think we’ve been in a situation for years, all the time Roe has been resisting, where abortion care and reproductive health care is much more accessible to women who can afford to travel and can afford to pay. pay for it,” Ruggles said. “It’s a racial justice issue that we haven’t addressed.”

Coverage of southern Arizona on azcentral.com and in the Arizona Republic is funded by the nonprofit Report for America in collaboration with The Republic.

Contact the reporter at sarah.lapidus@gannett.com.

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