“It’s the best estimate that we have so far,” said Sara Redd, an assistant professor at Emory University’s Rollins School of Public Health and the study’s lead author. “When we’ve spoken about this to people on the ground, providing abortion care, they have said that it is reflective of what they’ve been seeing as well.”
It’s important information for those on all sides of the abortion debate, because of what data show to be the perilous state of health resources that await many pregnant Georgians, Redd said.
What the law does
Georgia’s “heartbeat bill” applies to a embryo before it has a heart. According to obstetrics specialists, at about six weeks of gestation, an embryo has a tiny tube that will eventually become part of a heart. That tube starts to flutter at about six weeks, and modern ultrasound machines augment the flutter with a sound that doctors and patients can hear. Scientists call the flutter cardiac activity.
After that activity starts, abortion becomes illegal under Georgia law. Georgia legislators passed the law in 2019 but it didn’t go into effect until the U.S. Supreme Court decision green-lighted it last June by overturning the national law established by Roe v. Wade.
What the new JAMA study found
By looking at 360,972 abortions performed in the decade from 2007 to 2017 — before Georgia’s law was adopted — the researchers were able to project how the law would likely have played out among those patients. They found that an estimated 9% of all patients would likely have been eligible to still go forward under the new law, and the rest, about 29,900 patients per year over those 10 years, would be stymied by the law. The study didn’t estimate how many of those abortions would still have taken place in another state.
The researchers delved deeper into the most recent two years, 2016 and 2017. In those two years, the anticipated percentage overall of abortions eligible to occur was 12%, as a larger portion of abortions happened within the six-week period. The overall percent ineligible would have been 88%.
The percentage of ineligible abortions was higher for teenagers, for Black patients, and for patients with less than a high school diploma. Whereas 83.8% of white patients would have been ineligible for their Georgia abortion, 90.4% of Black patients would have. A full 90.1% of patients under 20 years of age would not have secured an abortion in Georgia, nor would 90.8% of those without a high school diploma.
What it means
The findings suggest that Georgia’s law limiting abortion to early pregnancy would eliminate access to abortion for a huge number of patients in Georgia “across the board,” Redd said, not only Georgia residents but patients from surrounding states who used to come to Georgia for abortions. But the impact disproportionately affects patients who are Black, younger, and in lower socioeconomic status groups, the study said.
For those who want women and their families to have healthy family lives, with or without the pregnancy, the data are a bad sign, Redd said. The same populations more likely to be blocked from abortion here are the same most likely to be unable to get access to other kinds of health care, including the kinds of health care women need all their lives to be healthy and survive pregnancy.
“It’s very intertwined,” Redd said. Those patients blocked from abortions here are “also living in a state where half of counties don’t have an OB-GYN. So this is like the real intersection of where healthcare service delivery issues can really come to to the forefront.
“There’s a lot of literature showing that restrictive settings and these kinds of restrictive abortion policies can actually lead to increases in things like maternal mortality and infant mortality and other types of adverse birth outcomes,” she said.