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  • Title: The laws that affect abortion in the United States and their impact on women's health.
    Author: Harrison LK, Naylor KL.
    Journal: Nurse Pract; 1991 Dec; 16(12):53-9. PubMed ID: 1798604.
    Abstract:
    Abortion has been a hotly contested political issue since the mid 1960s, when states began liberalizing their abortion laws. Recent Supreme Court rulings, such as Rust vs. Sullivan, the retirement of two liberal Supreme Court justices and the battle over Louisiana's abortion legislation have created new fervor on both fronts of the battle. All health care providers who care for women need to be cognizant of the current abortion laws and the factors that influence the abortion decision. These factors include the different levels of health risk and financial implications posed by continued pregnancy or abortion. Historically, numerous court cases have influenced women's health care, and reviews of several significant cases are provided. The Webster vs. Reproductive Health Services decision was the first case that directly challenged the Roe vs. Wade decision. The Webster decision enables states to have greater authority in writing their own abortion laws. Individual state laws can vary greatly, so it is vitally important for providers to know and understand the laws of their state. Changing abortion laws means changing medical practices. Roe v. Wade (1973) established and absolute constitutional protection against state regulation in 1st trimester abortions, increasing abortion safety by allowing professionals working in sterile environments to perform abortions. In Planned Parenthood of Central Missouri v. Danforth (1976) the Supreme Court invalidated a spousal/parental consent requirement. In Harris v. McRae (1980) the Court upheld the Hyde Amendment prohibiting the use of Medicaid funds for abortions. In City of Akron v. Akron Center for Reproductive Health Inc. (1983) the Court held as unconstitutional the requirement of hospitalization for all 2nd and 3rd trimester abortions, that unmarried minors under 15 obtain parental consent, that physicians give detailed lectures on fetal status, and that women wait 24 hours before an abortion. In Thornburgh v. American College of Obstetricians and Gynecologists (1986) the Court held as unconstitutional mandatory statements about alternatives to abortion, and particularized medical risks. Webster v. Reproductive Health Service (1989) upheld a state's right to protect life beginning at conception, withhold use of public employees, facilities, and funds for counseling a woman about, or performing, a nontherapeutic abortion, to encourage birth over abortion. Subsequent cases established a state's right to require parental notification for minor's abortion when a judicial hearing exists as an alternative. Rust v. Sullivan (1991) upheld regulations prohibiting medical staff from talking about abortion with family planning patients when the facility receives funding under Title X of the Public Health Service Act, and requires objective physical and financial separation of facilities from programs that offer abortion information. These regulations have been denounced by medical groups for compromising ethics. While the Senate passed a bill allowing such talk about abortion, President Bush promises a veto. Abortion is still legal in every state, but each state has its own laws.
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