Op-Ed: North Carolina’s New Abortion Legislation Would Hurt the Wellbeing of Women, Children, and Families

A group of eight UNC doctors, professors, and researchers highlight the dangerous impact of North Carolina Republicans’ new 12-week abortion ban. “The legislation imposes an array of medically unnecessary hurdles … that make it harder and more expensive for women to get early abortions,” the group writes.

North Carolina Republicans steamrolled the “Care for Women, Child, and Families Act” through the General Assembly last week. The 46-page bill was released late Tuesday; by Thursday evening it had passed both chambers. 

As researchers with extensive experience related to women’s, children’s, and family wellbeing, we are deeply concerned that this bill does exactly the opposite of what its title suggests. Women, children, and families are not properly cared for when substantial obstacles to abortion—both before and after 12 weeks—multiply. The additional hodgepodge provisions in the bill offer little help to the women who will be forced to give birth, or to their children or families.  

The bill prohibits most abortions after 12 weeks of pregnancy; currently 93% of abortions are performed before that time. But the legislation imposes an array of medically unnecessary hurdles –including three in-person office visits for medication abortions, and in-person counseling 72 hours before all abortions – that make it harder and more expensive for women to get early abortions. Poor and rural women, and those with inflexible jobs or limited childcare, already have difficulty getting to clinics before 12 weeks. These restrictions make it even harder.

Those who stumble on these hurdles will face considerable medical risks. Giving birth is 14 times more deadly than abortion. And NC Black women are three times more likely to die than white women. Our maternal mortality rates outstrip other developed nations twice over. And for every US maternal death, 75 to 100 more women will suffer a life-threatening complication during pregnancy or childbirth. 

Being forced to give birth drastically limits women’s life chances. A study comparing women denied abortions with those who received them found those turned away were less likely to finish school and proceed with their career; more likely to be unable to pay for basic necessities; four times more likely to live in poverty; and three times more likely to face unemployment. 

Being turned away also reduces the wellbeing of women’s existing children. Six in 10 women seeking abortion are already mothers; half have two or more children. These women report seeking abortion to be better parents to the kids they have. Children of turnaways are three times more likely to live in poverty—a circumstance disastrous to their wellbeing—and far less likely to achieve developmental milestones.

To be sure, the bill raises Medicaid subsidy rates, which may somewhat improve access to healthcare during pregnancy. But the causes of our maternal mortality crisis go far beyond access and are often linked to preexisting medical conditions. This bill won’t solve these problems, particularly given that its vague exception for medical emergencies may lead frightened physicians to hesitate, as they have in other states, before performing life-saving abortions. 

Following birth, the legislation provides scant assistance to mothers and families. Provisions easing the ability of mothers to give up their children for adoption will aid few women. Nine in 10 people turned away from abortion keep their children, but not because of logistical obstacles to adoption. The great majority of women contemplating abortion simply don’t see adoption as a viable option if they are forced to bear a child.

Furthermore, the bill’s hallmark provision of 8-weeks parental leave applies only to full-time state employees—a glancingly small percentage of women seeking abortions. The bill’s authors could have—but didn’t—provide paid parental leave to all workers, which 13 states and the District of Columbia have implemented, and which would truly help new mothers.

Meanwhile, the childcare provisions simply increase childcare subsidy rates, not the number of families served. But 30,000 NC children 0-5 are on the waitlists for subsidies. Only 1 in 5 NC children eligible for such subsidies under federal standards receive them. And the average annual cost of infant childcare is $9,650— almost half of the yearly median income for a single NC mother.

In sum, this bill will harshly limit abortions while paying only lip service to helping the thousands of women it forces to give birth, risking their lives and health, and causing long-term damage to their children and families. Such a bill takes North Carolina backwards. North Carolina can and should do better for its women, children, and families.

Written by:

Maxine Eichner, Professor, UNC School of Law

Amy Bryant, MD, MSCR

Mimi Chapman, Professor, UNC School of Social Work

Sian Curtis, Professor, UNC School of Public Health

Rebecca Kreitzer, Associate Professor, UNC, Department of Public Policy

Jessica Morse, MD, MPH

Alison M. Stuebe, MD, MSc

Jennifer Tang, MD, MSCR, FACOG