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How realistic are the post-Roe abortion workarounds that are filling social media?

A demonstrator in Berlin in 2020 holds up a placard reading "Against Abortion?! Have a Vasectomy" during a protest against Poland's near-total ban on abortion.
Tobias Schwarz
/
AFP via Getty Images
A demonstrator in Berlin in 2020 holds up a placard reading "Against Abortion?! Have a Vasectomy" during a protest against Poland's near-total ban on abortion.

With abortion now being heavily restricted in many U.S. states following the fall of Roe v. Wade, social media has been filled with complicated and, in some cases, baseless workarounds that experts say should be intensely scrutinized before one considers pursing them.

Mandatory vasectomies, building clinics that offer abortion services on Native American reservations and placing children for adoption or foster care are among the most popular choices for post-Roe abortion workarounds, but experts say that these suggestions aren't realistic.

Here's what those researchers have to say about why these post-Roe workarounds are not as realistic as they may seem.

Mandatory vasectomies

When news hit that abortions were going to be nearly totally banned in several states, it was reported across the U.S. that calls for vasectomy appointments were increasing.

While many men were quoted saying they were doing it for their significant other or because they had no interest in having kids, Twitter was filled with suggestions, both serious and not, that men should be forced to get vasectomies.

"I understand that they are trying to show how restrictive abortion [bans] are on the body and how unfair it is and how it is an attack on women, but I do find that they are quite tone-deaf when it comes to the very real history of eugenics and of forced sterilization of men," Georgia Grainger, a PhD student at the University of Strathclyde in Scotland, who is studying the history of vasectomies, told NPR over the phone.

In a thread that garnered over 17,000 retweets, Grainger explained why the idea of mandatory sterilization is harmful to men, especially men of color and men with disabilities.

Eugenics in the 20th century was a form of sexism and racism in the United States, a report from the University of Michigan explains.

The report says that the first sterilization law came in 1907 from Indiana, and other states passed similar legislation almost immediately after. Currently, those laws still exist in 31 states.

Grainger said that there are ways to talk about unjust restrictions on bodily autonomy without suggesting further restrictions on other people's bodies.

"It's so long as it's voluntary," Grainger said, "and by choice, then any contraception is good, any reproductive choices are good in my book. But it's when it becomes not about choice, I think there's a real issue."

Building clinics that provide abortions on Native American reservations

The sovereign status of Native American reservations has brought up the idea of building clinics that provide abortions on reservations.

The tribal sovereignty that the U.S. has granted to Native Americans gives Native tribes the right to govern themselves and allows them to regulate their own affairs in-house, meaning they are exempt from laws like the bans on abortions that have taken effect post-Roe.

One suggestion that has circulated on social media is to start building clinics on reservations because they are sovereign nations where decisions from state governments do not apply.

However, Aila Hoss, an associate professor at IUPUI's McKinney School of Law in Indianapolis, said that building clinics on reservations is much more complicated than it might seem.

"First off, legally, it's not as simple as, 'Oh, tribes are sovereign nations,' even though it should be," Hoss told NPR over the phone.

She said that the difference between criminal and civil laws, who is providing the services, and funding and tribal membership are among many of the reasons that providing abortions for outsiders is difficult for tribal nations.

Hoss said that practitioners on reservations typically work under a federally funded system called the I/T/U. The I/T/U is made up of three parts: the Indian Health Service (IHS), which is the federal government directly helping with clinics and other health services for Native Americans; tribal health services, which are IHS-funded health services directly handled by the tribes; and Urban Indian Health Programs, also funded by the IHS but handled by nonprofit organizations.

Medical practitioners within the I/T/U system cannot administer abortions on tribal land, except under certain situations, because of the Hyde Amendment. This 1976 law prohibits the federal funding of abortion, except in cases of rape, incest or the pregnant patient's life being in danger. This means that if reservations wanted to go forward with providing abortions for nontribal patients, they would have to use their own resources to bring in a practitioner who was not part of the federally funded system and who would not have some of the legal protections granted to practitioners working within the federal system.

For example, under the federally funded system, practitioners are covered from having to personally take on the financial brunt of a malpractice suit. But Hoss said practitioners not under the federal system wouldn't have this protection in the event of a medical procedure going wrong. She added that in order to build clinics that would provide abortions for nonmembers, tribes would have to want to take on these legal and financial risks.

Aside from the legal issues surrounding this idea, it also ignores ethical and cultural factors.

Hoss said that none of the suggestions for building clinics that provide abortions have come from tribes themselves, but have instead come from non-Native national organizations that don't think of the legal and ethical effects of volunteering tribes to take on the weight of a complicated issue.

Reproductive health care, including abortion, is already difficult for Native American women to access on their own land, Hoss said, so this suggestion of building clinics on reservations now comes only at a time when lack of abortion access is impacting the non-Native population.

According to a study published in 2014 in the American Journal of Public Health, over 80% of Indian Health Service facilities, the primary provider of reproductive health care to Native American women, were not in compliance with IHS and Hyde Amendment regulations because they did not provide abortion services in the event of rape, incest or the life of the pregnant patient being in danger. Only 5% of these facilities performed on-site abortions, and none had Mifeprex, a drug used for medication abortion.

Native Americans also have the highest poverty rate of any racial group in the U.S., which has negatively affected their access to proper health care.

"And so I think the first point is a reflection on why this was not important to you pre-Dobbs. Why are folks making these kinds of broad generalizations without thinking about the legal, the ethical, cultural impacts of this?"

Adoption as an answer

As protests took place across the U.S. on the morning that the Dobbs v. Jackson Women's Health Organization decision overturned Roe, a tweet featuring a couple holding a sign that read "We Will Adopt Your Baby" became a meme.

The couple in the photo, Neydy Casillas and Sebastián Schuff, are lawyers who have spent most of their careers supporting conservative Christian legal fights. Casillas is tied to an anti-LGBTQ law firm, Alliance Defending Freedom, that has been pushing to transform the U.S. into a more "Christian values" nation.

To convince people not to have abortions, many have suggested placing babies for adoption or putting them in the foster care system.

More than 100,000 children were already waiting for adoption in the foster care system in 2020, according to the Kids Count Data Center.

Dana Davidson, co-director of adoption and family support at The Cradle, which helps facilitate adoptions for families nationwide and internationally, told NPR over email that the impact of the overturn of Roe v. Wade and its effect on adoption will vary in different parts of the country.

"What we know to be true is that adoption is complex and is born of loss," Davidson said.

Davidson said that in the agency's experience, clients are not making the decision between abortion and adoption at the same time.

"Adoption is an alternative to parenting, not an alternative to being pregnant," she said.

States like Texas, which has a trigger law that banned abortion once Roe v. Wade was overturned, were among those with the most foster youth as of 2021, according to the project Who Cares: A National Count of Foster Homes and Families.

"I think it's also important to point out that while there has been a lot of conversation online suggesting a Roe v. Wade overturn could be great for prospective parents who want to adopt, The Cradle is not in the business of finding babies for families," Davidson said. "We are in the business of finding families for babies if and when the expectant parents decide that adoption [is] the best option for themselves and their families."

Copyright 2022 NPR. To see more, visit https://www.npr.org.

Corrected: August 19, 2022 at 9:00 PM PDT
An earlier version of this story misspelled Georgia Grainger's surname as Grainer.
Magaly Muñoz