In the wake of the overturning of Roe v. Wade, states across the U.S. grappled with the topic of abortion. The U.S. Supreme Court decision resulted in many states enforcing “trigger bans,” previously passed legislation that became enforceable following a ruling.
While some states chose to have unrestricted access to abortion, the Georgia legislature reinforced the Living Infants Fairness and Equality (LIFE) Act that was initially passed in 2019 and stated that “No abortion shall be performed if the unborn child has a detectable human heartbeat,” which is at approximately six weeks of pregnancy.
In the LIFE Act, Georgia defines “abortion” as the “act of using, prescribing, or administering any instrument, substance, device, or other means with the purpose of terminating a pregnancy.” However, the act of removing a dead unborn child caused by miscarriage or terminating an ectopic pregnancy is not considered an abortion. Further exceptions to this law are in the event of a medical emergency or cases of rape. “Medical emergencies” are defined as conditions in which an abortion is necessary to prevent the death of the pregnant woman or the substantial and irreversible physical impairment of a primary bodily function of the pregnant woman.
The LIFE Act also specifies that “No such greater risk shall be deemed to exist if it is based on a diagnosis or claim of a mental or emotional condition of the pregnant woman.” This line in the act outlines a legal restriction stating that doctors cannot use particular mental or emotional conditions to justify an abortion under the law.
Many see this as a narrow perspective regarding healthcare, particularly for women, because it does not consider even extreme mental health conditions as “medical emergencies.” Therefore, if a woman threatened to end her life due to her pregnancy, according to the state of Georgia, this would not be grounds for the woman to receive an abortion. Many criticize the bill for treating people with mental illnesses differently than those with physical ailments, while others deem Claire Bartlett, the executive director of Georgia Life Alliance, praised the bill and stated, “The Life Act was crafted to balance protecting the basic human rights of an unborn child while meeting society where we are culturally.”
“Access to birth control leads to fewer abortions.”
It is important to note that even before the overturning of Roe v. Wade, abortion rates in the United States were falling at what the Centers for Disease Control called a “slow yet steady pace” since a peak in 1981. In 1981, there were 29.3 abortions per 1,000 women aged 15 to 44. In 2019, that rate had fallen to 11.4 abortions. Experts believe that the increase in access to healthcare and other forms of contraception prompted people to be less likely to seek out abortions.
Linda Rosenstock, public health professor of Health Policy and Management at UCLA, said, “Access to birth control leads to fewer abortions.” Nonetheless, lower socioeconomic classes often have less access to contraceptives. To combat this, Georgia strives to provide healthcare access for all, regardless of socioeconomic status. Most notably, in 2023, the Georgia Budget and Policy Institute eliminated the 5-year Medicaid waiting period for pregnant women and children who are lawful permanent residents. Georgia also plans to provide $7.3 billion in state funds to the Departments of Behavioral Health and Developmental Disabilities, Community Health, and Public Health — the three leading agencies focusing on the state’s healthcare.
Regardless, Georgia’s current maternal mortality rate is among the worst in the country, with 33.9 deaths per 100,000 live births, while the national average is 32.9 deaths. Additionally, the maternal mortality rate for African American women is more than double that of white women.
“Georgia’s current maternal mortality rate is among the worst in the country, with 33.9 deaths per 100,000 live births, while the national average is 32.9 deaths.”
Public outrage regarding the deaths of two pregnant African American women — Candi Miller and Amber Nicole Thurman — brought increased scrutiny to the legislation; these losses also underscore the disproportionately high Black maternal mortality rates in Georgia. The two women died in Georgia following the overturning of Roe v. Wade. It was only recently that the details of their deaths came to light following leaked information by Georgia’s Maternal Mortality Review Committee. In November 2024, Georgia officials dismissed all members of the review committee, citing the leak as reasoning.
In November 2022, Miller was a pregnant 41-year-old Georgia resident who had lupus, diabetes, and hypertension. Her doctors had warned her of the medical risks that were associated with her pregnancy: there was a chance her pregnancy would exacerbate her health conditions. Miller did not want her situation to become dire, so she ordered abortion pills online to terminate her pregnancy at home. According to a 2013 review article published by the Contraception journal, the pills have less than a 0.4% risk of severe complications.
Although Miller terminated the pregnancy, she was unable to expel all of the fetal tissue and subsequently died; medical examiners were unable to determine the exact cause of her death. They found both unexpelled fetal tissue and a lethal mix of medications in her system. There has been speculation as to what caused Miller’s death, with pro-choice activists saying Miller’s death was due to Georgia’s legislation and pro-life activists blaming the medications in her system. Regardless of speculation, Miller likely felt unsafe seeking medical attention.
Many physicians warn against such uncertainty and anxiety and encourage patients to seek medical advice when needed. There has been an increase in the purchase of similar abortion pills by women in states with abortion bans. Despite severe complications arising in one-in-1000 women during a surgical abortion, many women may not seek professional help when complications arise.
In the summer of 2022, Thurman, a 28-year old single mother from suburban Atlanta, died in the hospital waiting to receive a dilation and curettage (D&C) procedure. Thurman had also taken abortion pills to terminate her pregnancy, but unlike Miller, she sought out medical help after facing complications. The doctors waited to perform the routine D&C procedure as they were reluctant to act quickly following the passing of Georgia’s LIFE Act, which criminalized the procedure unless in the case of medical emergencies. She went through 20 hours of pain before doctors began to operate, but it was too late, and she passed.
Georgia’s Maternal Mortality Review Committee, a committee that identifies and reviews maternal deaths to recommend interventions for prevention, deemed her death “preventable,” citing that if the D&C treatment had been performed earlier, Thurman likely would have lived. Her story highlights the confusion and fear healthcare providers sometimes face under these laws as they navigate the risk of prosecution with the health needs of patients.
On September 30, 2024, Fulton County Superior Court Judge Robert McBurney ruled in favor of the plaintiffs, Sistersong Women of Color Reproductive Justice Collective, in their civil case against the state of Georgia. The decision effectively struck down key provisions of the LIFE Act, including the six-week abortion ban, and enjoined the state from enforcing it. The ruling returned Georgia to its pre-LIFE Act legal framework for abortion, which allowed abortions up to the point of fetal viability, which is about 22 weeks.
“Although it is still under review, the Supreme Court reinstated the LIFE Act in the meantime, returning Georgia to the six-week ban less than a week after Judge McBurney’s decision”
This ruling received both praise and backlash. Bartlett believes that the judge was “legislating from the bench… outside of his bounds” and his decision was a “well-timed political decision,” hinting at the 2024 presidential election. Because the judge deemed the LIFE Act unconstitutional, Georgia’s Supreme Court was obligated to review the superior court judge’s decision. Although it is still under review, the Supreme Court reinstated the LIFE Act in the meantime, returning Georgia to the six-week ban less than a week after Judge McBurney’s decision.
Governor Brian Kemp has expressed his satisfaction with Georgia’s legislature for finding an abortion approach that keeps women “safe, healthy, and informed,” a concern central to the broader debate. Despite the law’s reinstatement, there is still some uncertainty regarding the future of abortion rights for Georgians, primarily due to the unclear and often-changing legislation, which can leave women hesitant to seek guidance from healthcare providers, unsure about their options, or fearful of accessing necessary care.
