The alternate reality where we never needed Roe

(Peter Nunns/Julie Anne Genter via AP)

In the wake of the Supreme Court’s decision in Dobbs v Jackson Women’s Health, we immediately saw the anticipated protests breaking out, including threats of violence, arson, and all the rest. Freeways in California were almost immediately shut down and similar marches were taking place in cities across the country. It seems obvious that one decision by the Supreme Court isn’t going to make this issue simply go away.

As I watched all of this chaos unfold on my television screen last night, I was once again struck by a question that has been nagging at me for many years. In terms of mankind’s response to various medical challenges, particularly in advanced, industrial nations like the United States, what we’ve been able to accomplish in the 20th and 21st centuries has been nothing short of miraculous as compared to earlier eras in human civilization. With enough of a coordinated effort, some diseases like smallpox that exterminated literally millions of people were wiped from the face of the earth. Through a combination of medical advances and social intervention, childhood mortality rates have plunged to levels never imagined possible in the 1800s. The bubonic plague once wiped out nearly half of the population of Europe, yet there hasn’t been a measurable outbreak in any advanced nation in living memory.

And yet, with all of our acquired knowledge and our demonstrated ability to work together as a society to meet and defeat daunting challenges, how is it that we never put an end to unplanned pregnancies? We’re not talking about something mysterious that erupted from a cave full of bats on another continent or escaped from a lab in Wuhan. (Although we’re on the verge of beating that as well.) In case you skipped health class on the day that this was covered, we actually know what causes pregnancy. And unless you are intentionally trying to start a family, we also know ways that are nearly (although not 100%) foolproof to prevent a woman from becoming impregnated if she doesn’t wish to be.

Telling people to simply not have sex is never going to work and the reasons for that date back to the earliest proto-humans who were driven to ensure the continuation of the species. But highly reliable contraceptive medications for women have been available for decades and we are now on the verge of having such birth control pills for men. How is it that we, as a society, have never seriously addressed this question? How do we still have this many unplanned and unwanted pregnancies? Why has this never been addressed in a serious fashion and driven into everyone’s heads?

Who makes up the constituency that would be opposed to ending unwanted pregnancies? Is there a single woman out there who finds herself three weeks late in her cycle, buys one of those home pregnancy tests, and says, ‘Oh good! I was worried I might never get to have an abortion this year. Now I can go have needless surgery and a painful recovery!’ (Yes, I know there are some female protesters who have been posturing and saying that during this chaotic moment, but they don’t mean it.) Is there a single guy out there who looks forward to receiving that phone call from their girlfriend or one-night-stand? Granted, there may be some exceptions if the man has been looking forward to starting a family and sees this as a possible opportunity if his partner is equally willing. But otherwise? ‘Hooray! Now I get to drive her to an abortion clinic. Maybe I can hit the DMV and renew my registration while she’s inside.’ Alternately, how many guys do you think are secretly hoping to wind up with decades of child support payments ahead of them?

How did this never become a priority? Perhaps as a result of thousands and millions of years of not having any choice we socially evolved to accept the idea that unplanned pregnancies are just a thing that happens and we’ll have to “deal with it” when the situation arises. But this is the 21st century. It doesn’t have to be that way. We have options. Surely we are still adaptable enough as a species and a society to alter our communal baseline on such a question, no?

There will always be a certain number of abortions that have to happen. This is particularly true when women are diagnosed with an ectopic pregnancy (or “tubal” pregnancy) where attempting to bring the child to term would not only fail to produce a living baby but would almost certainly kill the mother as well if the situation isn’t addressed. And if you’re someone who is so entrenched on the abortion issue that you would prefer to tell a woman that you expect her to die rather than terminate a pregnancy that will never come to fruition, we probably shouldn’t hang around together because I simply don’t know what to say to you. There are other medical scenarios where the mother’s life can be in danger because she is pregnant. Those cases will always demand abortions as a solution.

But that is thankfully a very rare medical scenario. It’s true that contraception sometimes fails, complicating the alternate reality I’m talking about, but if we addressed the development of bulletproof contraception with the same vigor that was put into developing the COVID vaccines, we could get that number down much, much closer to zero. And if we instilled the same sense of urgency into making such precautions a communal priority as we did with “flattening the curve” during the pandemic, the number of abortions taking place in this country every year would plummet to next to nothing. The small number that were still required for the reasons I described above could be handled as a regrettable but routine outpatient procedure at most any hospital.

If that had already happened, would the case of Roe v Wade have ever even shown up in court? Would Planned Parenthood have come into existence? Would we be on the verge of starting yet another civil war and firebombing medical facilities? It’s not that we wouldn’t find something else to argue about because we’re a herd of cantankerous animals by nature. But all I’m asking is that you imagine for a moment a world where we took this issue seriously from the first moment we had the technological and societal tools to do so. What would that world look like? And is it still too late to try?