Colorado could become a safe haven for women around the country if new legislation in the House makes it to the governor for a legal signature. House Bill 1279 will ensure every individual has the fundamental right to choose or refuse contraception; every individual who becomes pregnant has a fundamental right to choose to continue a pregnancy and give birth or to have an abortion; and a fertilized egg, embryo or fetus does not have independent rights under the laws of Colorado.
The Reproductive Health Equity Act was introduced March 3, 2022 as other states like Texas make it nearly impossible for women to get an abortion, even in the event of rape and incest. Since the Texas law took effect September 2021 banning abortions the moment a heartbeat can be detected or about six weeks into a pregnancy, medical professionals say women from that state have been coming to Colorado to seek a full range of options.
On March 9, 2022, Kate Coleman-Minahan, PhD, RN, FNP-BC testified before the Colorado House Health and Insurance Committee about the health consequences of banning abortion.
Thank you for joining us for this Hot Topic, Dr. Coleman-Minahan. Can you please tell us about your testimony to legislators about how abortion can protect and support maternal health?
You’re welcome. I told lawmakers the ability to choose if and when to parent is essential to the health and well-being of individuals, families and communities. We can't have liberty, dignity or autonomy over our lives if we cannot prevent a pregnancy and are forced to continue one. So, as the U.S. Supreme Court is deciding, whether they think abortion is constitutionally protected under both the liberty and dignity clauses in the constitution, it's important that people really consider the impact on somebody's life of being forced to continue a pregnancy.
There are health consequences of banning abortion. People denied abortion and forced to give birth have worse short-term mental health and worse physical health than people who obtain a wanted abortion. And research by Amanda Stevenson at the University of Colorado Boulder found that completely banning abortion in the United States would increase pregnancy-related deaths by 21%. When Dr. Stevenson and I looked at severe maternal morbidity, which is life-threatening events related to delivery, we found those conditions would increase by 20%, resulting in hundreds of women dying or suffering because they were denied healthcare and forced to continue a pregnancy.
That’s because abortion is substantially safer, and less risky than carrying a pregnancy to term and delivering. I think a lot of people don't know that. A lot of people think abortion as something that's kind of scary or something that's not super healthy. But actually, it is much safer than carrying a pregnancy to term and delivering.
Today in the United States, we have a maternal health crisis, we have much higher rates of maternal morbidity and mortality than many other high-income countries. The disparities are glaring, Black women are three times more likely to die than white women from pregnancy-related causes because of structural racism. So, eliminating the access, or the ability of people to get abortion is going to increase maternal morbidity and mortality, it's going to widen the disparities that we see by race and ethnicity. This law in Colorado would protect and support maternal health, both from the maternal morbidity and mortality standpoint.
Why do you think legislation is needed in Colorado to protect women’s choices and to deny a fetus special rights?
We don't have any current protections for the right to choose or refuse contraception or the right to continue a pregnancy or have an abortion. Right now, in the United States, people have access to those services based on Supreme Court cases, most notably 1973 Roe v. Wade decision, which forbids the government from banning abortions prior to viability; viability is generally the gestational age in which a fetus could potentially live outside of a uterus. The right to contraception is also based on Supreme Court cases making the right to this healthcare vulnerable to changes in the court.
It is important for Colorado to have something in the law that will protect these rights. Almost half of states have a law in place that will immediately make abortion care illegal if Roe v. Wade is overturned. Colorado does not have one of those laws, but also doesn't have anything to protect it. So, this law will protect the rights of all people to choose or refuse contraception to continue a pregnancy and give birth or have an abortion.
How are restrictive laws in other states impacting Colorado?
My colleagues at the Texas Policy Evaluation Project recently reported that between September and December 2021, over 5,500 Texans were forced to obtain abortion care in other states, including Colorado. Forty-five percent went to Oklahoma, a state that will immediately eliminate access to abortion if Roe v. Wade is overturned, which means even more people will seek healthcare in states like Colorado. It's also really important to note that people need the resources and the means to travel out of state. Only people with the most resources are going to be able to do that.
How would a ban in Colorado impact healthcare workers here?
About Our Expert
Kate Coleman-Minahan, PhD, RN, FNP-BC is an assistant professor at the University of Colorado College of Nursing. She also leads an academic-community partnership funded by the Society of Family Planning to explore young people’s access to and experiences with medication abortion in Colorado, Illinois, California and Texas that have different abortion policy landscapes. She is also studying reproductive aspirations among immigrant young adults and is a collaborator on a project investigating fertility and contraception among Mexican-origin women in the U.S. and in Mexico.
Dr. Coleman-Minahan provides sexual and reproductive healthcare to young people at the Adolescent Family Planning Clinic at Children’s Hospital Colorado.
On March 9, 2022 Coleman-Minahan testified on behalf of herself, before Colorado lawmakers about HB22-1279, the Reproductive Health Equity Act concerning the codification of a person’s fundamental right to make reproductive healthcare decisions from government interference.
As nurses, we have an ethical responsibility to support patient autonomy. That means the right of patients to make their own healthcare decisions and their own decisions about their bodies, whether or not we agree with their decision, and contraception and abortion are essential forms of health care. More than nine out of 10 women will ever use a method of contraception and one in four will have an abortion in their lifetime. So, eliminating access to either contraception or abortion interferes with our ability as nurses and health care providers to provide evidence-based and ethical care.
The National Academy of Science, Engineering and Medicine reported in 2018 that abortion is safe, effective and necessary health care, and that state and federal restrictions reduce the quality of health care for people. That is the safety, effectiveness, patient centeredness, timeliness, and efficiency and equity of care. Our professional organizations, including the American Nurses Association, American Medical Association, oppose restricting and eliminating access to abortion care.
Thank you for your insights, Dr. Coleman-Minahan. The prime sponsors of Colorado’s Reproductive Health Equity Act are Representatives Meg Froelich and Daneya Esgar and Senator Julie Gonzales. On March 9, 2022, the legislation passed out of committee and went to the house for consideration.