At some point in time ...

… women’s health care will be a macro economic issue.…
In July, Priyam graduated from the Contra Costa Family Medicine Residency Program in Northern California, entering a reproductive landscape that is rapidly constricting across the US. She’s part of a generation of emerging doctors that have fought an uphill battle to get abortion training as part of their medical education — one whose skills may be even more rare and in demand after the Supreme Court’s decision to reverse federal-level abortion rights.

Now, reproductive-rights advocates and health-care providers are urgently seeking to expand the number of doctors that can provide abortion care in places where the practice remains legal. California, which is positioning itself as a haven for abortion seekers, stands to be one of the few areas where access to training may expand.

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According to several sources, lack of access to abortion mostly affects the young, poor and minorities. Women who already have children (many if not most abortion seekers already have at least one child) often can’t find affordable child care while they travel to an abortion provider. Many women workers can’t get time off from their jobs.

The same sources said that women who sought abortions but were turned away had worse financial outcomes over time than a comparable set of women who sought and obtained abortions. This was a longitudinal study which covered years. The women who were turned away were slightly over the legal time limit for their pregnancies. The worse financial outcomes included lost education, job loss and lower incomes, not to mention the added cost of raising a child.

The most advantaged women have always been able to afford to travel to get abortions. In 1974, I worked in a hospital which provided legal abortions in NYC. Women came from all over the country. Obviously, they had to be able to afford to travel, pay for the procedure and stay at least one night in a hotel.

The Macro impact of loss of abortion access will be growing poverty of mothers and children. This will be most extreme in states which provide few support services for the poor.



I think those impacts will be seen quickly, in the next year or two. In the long term, I think it will be even worse. I can imagine a serious shortage of OB/GYNs in the most restrictive abortion laws. The consequences will work their way up the socio-economic ladder.…
A sexual assault survivor chooses sterilization so that if she is ever attacked again, she won’t be forced to give birth to a rapist’s baby. An obstetrician delays inducing a miscarriage until a woman with severe pregnancy complications seems “sick enough.” A lupus patient must stop taking medication that controls her illness because it can also cause miscarriages.

Abortion restrictions in a number of states and the Supreme Court’s decision to overturn Roe v. Wade are having profound repercussions in reproductive medicine as well as in other areas of medical care.

“For physicians and patients alike, this is a frightening and fraught time, with new, unprecedented concerns about data privacy, access to contraception, and even when to begin lifesaving care,” said Dr. Jack Resneck, president of the American Medical Association.


Dr. Jessian Munoz, an OB-GYN in San Antonio, Texas, who treats high-risk pregnancies, said medical decisions used to be clear cut.

“It was like, the mom’s life is in danger, we must evacuate the uterus by whatever means that may be,” he said. “Whether it’s surgical or medical — that’s the treatment.”

Now, he said, doctors whose patients develop pregnancy complications are struggling to determine whether a woman is “sick enough” to justify an abortion.

I can imagine OB/GYN doctors and nurse practitioners opting to not establish practices in states with highly restrictive reproductive freedoms. It will simply be too dangerous for them both legally and due to the threats of physical violence.


According to several sources, lack of access to abortion mostly affects the young, poor and minorities.

This NYT article points out something I didn’t know:

Democrats Navigate Nuanced Views on Abortion Among Black Voters…
Black women have the highest abortion rate at 23.8 per 1,000 women, compared with 6.6 per 1,000 white women, according to 2019 data from the Centers for Disease Control and Prevention


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From the CDC website

Maternal Mortality per 100,000 births*
Non-Hispanic White 19.1
Hispanic 18.2
Non-Hispanic Black 55.3

Infant Mortality per 100,000 births in first year of life**
Non-Hispanic White 4.5
Hispanic 5
Non-Hispanic Black 10.6

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The most advantaged women have always been able to afford to travel to get abortions… The Macro impact of loss of abortion access will be growing poverty of mothers and children. This will be most extreme in states which provide few support services for the poor.


Your analysis is compelling. I am greatly disturbed by the impact it will have on those least able to travel for abortion services. The High Court’s literalist application of federalism principles will inevitably cause poor pregnant individuals to be trapped in unfriendly states.

Until such time as a legislative alternative can be crafted, the only practical solution is for the major charitable trusts, corporations, humanitarian organizations, Planned Parenthood, billionaires, and open-minded churches to organize coordinated transport networks.

A century and a half ago, the Underground Railroad provided precisely the same kind of protective relocation services to slaves escaping from The Confederacy to the Northern States.…

It’s hardly a mystery that many of the very same states from which slaves sought northern refuge are the states from which poor abortion-seekers must escape.

Given recent unfavorable migration patterns, reverse migration of freedom-loving individuals from “Red States” to “Blue States” might be a welcome opportunity for northern states and California to stem the ongoing tide by motivating people and companies to move back from “Red” to “Blue” states.…

Major companies (especially technology firms) with progressive leaders are very concerned about ESG principles, which investment giants like CALPERS and Blackrock have embraced.

Environmental, social, and governance (ESG) criteria are a set of standards for a company’s behavior used by socially conscious investors to screen potential investments.…

In a separate post, I intend to point out how the current “literalist” Supreme Court (especially in the West Virginia v. EPA ruling) may actually have done Blue states a favor by inviting progressive state leaders to further distinguish themselves from the more socially conservative Red states. Legislation at the state level is an often-overlooked tool for progressive thinkers.

Even a literalist approach to the Declaration of Independence and Constitution (in light of The Federalist Papers) leads the Supreme Court to recognize that our founding documents protect and encourage all manner of transportation and commerce between and among the several United States.

The power of the Commerce Clause is key to ensuring that the diversity of the states engenders lively interaction and economic exchange, including goods, people, and ideas. No state can prevent the free movement of people and goods from one corner of the Union to the other. The Supreme Court acknowledges this in its most recent cases.…

Our representative democracy (a Constitutional Republic by definition) provides almost limitless opportunity for diverse individuals to realize their potential, to obtain protection, and to achieve influence by grassroots efforts or by personal interaction with their state and local leaders.

The recent line of cases from the current Supreme Court encourages people within the United States to do the same thing that waves of migrants are currently doing as they move from Central and South America toward the border between Mexico and the United States. We US citizens, along with those who have not yet achieved citizen status, have the ultimate power over our own bodies, our lives, and our destinies - and that is the power of motility.

The greatest strength of individuals for self-actualization is the opportunity to “vote with our feet.”…

If Dobbs v. Jackson motivates people to seek out others who can help them realize their dreams, then that court case may ultimately produce something more beneficial than anguish, suffering, and fear. By bringing together those who are compassionate and those who need compassion, some good may come of this yet.


The Macro impact of loss of abortion access will be growing poverty of mothers and children.

And most ‘pro-lifers’ will not pitch in to help alleviate this problem. It’s mostly emotion and religion behind their benighted views. I don’t expect the ‘follow through’ from the anti abortion crowd on ameliorating the negative consequences.

It is really sad. Families were able to cope with the inflation of the 80’s primarily because women went to work for a paycheck in unprecedented numbers. Now we will see women drop out of the workforce–whether to a small degree or a large one remains to be seen.

It is not just women and children who will become poorer.

It is sad for our nation. This sort of fanaticism and struggle to disempower a group of people never ends well. This distrust of women and girls, who are always the most peaceful and least threatening part of the population, is a sign of cultural disintegration.

I really, truly, think women should get out of those insane states as quickly as they are able. And men who care about women and families should get out, too.


Legislation at the state level is an often-overlooked tool for progressive thinkers.

Wondering off into macro

The latest supreme court decisions, if handled properly, would focus all kinds of energy into state governments. These have become a cesspool of corruption. This is across political spectrums.

Conflict here and locally, while unpleasant, is necessary for good governance.


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Were I female, I would consider only same sex relationships.

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Were I female, I would consider only same sex relationships.

You still could as a male. :slight_smile:


One theory from the field of evolutionary social science says that some are threatened by other people’s sexual freedoms. “Sexually restricted” people oppose abortion, birth control, marriage equality, and recreational drugs. Why? Because these are perceived to increase casual sex and so are seen as a threat to long-term relationships. Most people get married, and strive to protect that relationship. Maybe some research on why marriages fail and some education would help.

— links —
What really drives anti-abortion beliefs? Research suggests it’s a matter of sexual strategies, Published: July 19, 2022
“it is a mystery why people in Pensacola care so strongly about what goes on in the bedrooms of Philadelphia… The solution to this puzzle – and one answer to what is driving anti-abortion attitudes – lies in a conflict of sexual strategies: People vary in how opposed they are to casual sex. More “sexually restricted” people tend to shun casual sex and instead invest heavily in long-term relationships and parenting children. In contrast, more “sexually unrestricted” people tend to pursue a series of different sexual partners and are often slower to settle down. These sexual strategies conflict in ways that affect evolutionary fitness. The crux of this argument is that, for sexually restricted people, other people’s sexual freedoms represent threats… No one would argue this is a conscious phenomenon. Rather, people’s strategic interests shape their attitudes in nonconscious but self-benefiting ways – a common finding in political science and evolutionary social science alike.”…

Never Married on the Rise, April 22, 2021
About 10% never married age 55 years and older.…

Living Arrangements Over the Decades, November 29, 2021
15% live alone, 58% live with partner, 11% are children.…