Reproductive Health at the Reference Desk

The leak of the U.S. Supreme Court’s draft decision on abortion rights has sent people scrambling to understand the current state of abortion care in the United States. As tensions are at an all-time high, librarians have an opportunity to dispel some myths about abortion care and abortion access. Here is some background to help you answer patron questions that may arise.

Barbara Alvarez head shotThe leak of the U.S. Supreme Court’s draft decision on abortion rights has sent people scrambling to understand the current state of abortion care in the United States. As tensions are at an all-time high, librarians have an opportunity to dispel some myths about abortion care and abortion access. Below is some background to help you answer patron questions that may arise.

What is this Supreme Court case about?

The court case at the center of this leaked draft is Dobbs v. Jackson Women’s Health Organization. In 2018, Mississippi legislators passed a law that prohibits all abortions after 15 weeks of gestation, except in rare instances. Jackson Women’s Health Organization, the only abortion clinic in Mississippi, and one of its doctors sued the state. Both the U.S. District Court for the Southern District of Mississippi and the 5th Circuit Court of Appeals struck down the law as unconstitutional. The State appealed to the U.S. Supreme Court, which agreed to review it. This is unprecedented, as the U.S. Supreme Court has long upheld the 1973 Roe v. Wade ruling that states cannot ban abortion before viability. As the Kaiser Family Foundation explains, there is no universal consensus to viability, but it is generally considered to be around 24 weeks of gestation.

Is abortion legal?

As of this writing, abortion is still legal in all U.S. states and territories. The draft decision that was leaked is just that—a draft. This is not an official decision, and abortion is still legal throughout the United States. The U.S. Supreme Court is slated to officially make its decision about the future of Roe v. Wade in June.

Is abortion accessible?

However, while the 1973 U.S. Supreme Court decision Roe v. Wade guaranteed a constitutional right to an abortion, it did not guarantee the accessibility of abortion. Accessibility of abortion depends on the state where you live. You can access a comprehensive list of abortion laws by state at The Guttmacher Institute.

Is abortion safe?

Abortion is an extremely safe procedure. Major complications happen in less than a quarter of one percent of cases. That is a lower complication rate than wisdom tooth removals and tonsillectomies. The United Nations (UN) Human Rights Committee says that abortion is a human right. Furthermore, the American College of Obstetricians and Gynecologists, American Medical Association, American Society for Reproductive Medicine, World Health Organization, Amnesty International, and the American Civil Liberties Union have asked the Court to protect abortion care. Research by leading medical associations and human and civil rights groups, including the Bixby Center for Global Reproductive Health, University of San Francisco, has found that abortion restrictions are not based on medical evidence and jeopardize safe reproductive care. You can read more abortion facts at the American College of Obstetricians and Gynecologists.

Who gets abortions?

An analysis by researchers at the Guttmacher Institute found that nearly one in four women in the United States will have an abortion by age 45. This number does not include trans and nonbinary people who also receive abortions. Contrary to popular stereotypes, research has consistently shown that most people who obtain an abortion have a religious affiliation. Simply put, abortion is a common medical procedure that people of all walks of life may receive.

What’s the deal with abortion pills?

Medication abortion, commonly referred to as abortion pills, is a pregnancy termination procedure that involves two different drugs, Mifepristone and Misoprostol. It was first approved by the U.S. Food and Drug Administration (FDA) in 2000, and accounts for almost half of abortions. Research has found that abortion pills are heavily regulated despite their safety. In fact, researchers at the Bixby Center state that they are safer than many common drugs like Tylenol and Viagra. And while the FDA recently allowed for abortion pills by mail, legislation tracking from the Guttmacher Institute has found that 19 states require the clinician providing the abortion pills be physically present. This means that telemedicine and pharmacy pickup options are inaccessible to millions of people.

Plan C Pills provides detailed information about how people can obtain abortion pills depending on where they live.

What about abortion reversal pills?

You may see digital or billboard signage with information about pills that are claimed to halt the abortion process. The American College of Obstetricians and Gynecologists has said that abortion reversal pills are not supported by science and any claims of effectiveness are unproven and unethical. In fact, a 2020 study on abortion reversal pills ended early because of safety concerns.

The only organizations that promote abortion reversal pills are Crisis Pregnancy Centers (CPCs). An article by Amy G. Bryant, MD, MSCR and Jonas J. Swartz, MD, MPH in the AMA Journal of Ethics described CPCs as unethical because they operate under the guise of a medical clinic, while in reality they “are exempt from regulatory, licensure, and credentialing oversight that apply to health care facilities” and use disinformation to dissuade people from making their own reproductive health care choices, including abortion.

Where can someone find abortion care?

A Google search for abortion care is likely to bring up Crisis Pregnancy Centers. Therefore, it is recommended to search in a database like the National Abortion Federations’ Clinic Finder for independent clinics and Planned Parenthood (note: look for clinics that list “Abortion Services”). Abortion costs may start at $600, depending on the state. Abortion funds help individuals cover the cost of an abortion and may also help with transportation and other fees.

Some states require teens to have parental consent or obtain judicial authorization for an abortion. The Repro Legal Helpline provides information about that, as well as on self-managed abortions.

Providing the information

Because of stigma, fear, and library anxiety, it is unlikely that a patron will come to the reference desk and explicitly ask for information about abortion. Instead, they may ask for information about health care or pregnancy options. Patrons may simply try to find the information on their own. As such, it is crucial to keep your collection current. You can also include signage with call numbers about other sensitive topics, including pregnancy and sexuality. These can be placed throughout the library and in the stacks. Resource guides that can be placed in the stacks and/or uploaded to your website can be another avenue for sharing information. Lastly, consider how you can partner with health care professionals in your community.

Librarians face questions on a variety of topics and it is our duty to create library environments that are welcoming, nonjudgmental, and encouraging. Above all, reference services should hinge on access to information. Reproductive health care should be no different.

Barbara Alvarez is a PhD student in Information Science at University of Wisconsin–Madison with a focus on reproductive health. She has worked on research teams with the University of Wisconsin-Madison’s Collaborative for Reproductive Equity. Barbara is working on a book with ALA Editions about Sexual and Reproductive Health Information Services. She is a 2022 Library Journal Mover & Shaker.

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