Key Words: Supreme Court overturning of Roe v. Wade ‘will create an Orwellian dystopia,’ predicts New England Journal of Medicine

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‘Without federal protection, recent state laws curtailing or eliminating the right to abortion care will deny Americans’ reproductive autonomy and create an Orwellian dystopia.’


— New England Journal of Medicine

That’s the grim vision of America’s future offered Friday by the prestigious New England Journal of Medicine in a blistering editorial published following the Supreme Court’s decision to strike down Roe v. Wade.

The journal’s editors condemned the decision and stated that it will disproportionately impact poorer women and persons of color, “who are least able to overcome the impediments placed in their paths.

“These changes,” they wrote, “will inevitably exacerbate our already vast disparities in wealth and health.”

The decision will not significantly reduce the number of abortions conducted, as experience from other countries with restrictions on abortion have shown. Instead, it will reduce the number of “safe procedures,” the journal editors wrote, italicizing the word safe for emphasis.

“Millions of persons in states lacking protections for abortion care are also likely to be denied access to medication-induced abortions,” they wrote. “It may be difficult for many Americans in 2022 to fully appreciate how complicated, stressful, and expensive, if even attainable, their most private and intimate decisions will become, now that Roe has been struck down.”

The road to Friday’s decision was long and painful and based on a misleading notion, the authors continued. The “fig-leaf justification” behind the abortion restrictions recently introduced in states including Oklahoma and Texas, according to the journal editors, is that induced abortion is dangerous and requires tighter regulations to protect that health of women who have one.

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“Facts belie this disingenuous rhetoric,” the authors wrote. “The latest available U.S. data from the Centers for Disease Control and Prevention and the National Center for Health Statistics are that maternal mortality due to legal induced abortion is 0.41 per 100,000 procedures, as compared with the overall maternal mortality rate of 23.8 per 100,000 live births.”

A recent New York Times article highlighted the far greater risks women faced before Roe vs. Wade was adopted in 1973, the authors wrote. “They described humiliating circumstances, unsafe procedures literally performed in back alleys, and the deep shame and stigma they endured,” they wrote.

An abortion-rights activist is comforted as she reacts emotionally to Friday’s news of the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization.


Anna Moneymaker/Getty Images

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Among the complications suffered were injury to the reproductive tract that needed surgery, infections that caused infertility, organ failure and death. “We now seem destined to relearn those lessons at the expense of human lives,” read the editorial.

The decision also has implications for certain contraceptive devices, it continued. “Use of postcoital contraception, either hormonal contraception or placement of an intrauterine device, could be equated with abortion and prosecuted; some jurisdictions (e.g., Mississippi) are already considering such actions,” the journal editors wrote.

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It may also have implications for in vitro fertilization, which did not exist before the passage of Roe. The IVF process typically involves many embryos, not all of which are used, with some generally frozen for potential future use.

“While ‘adoption’ programs exist to allow persons to donate their unused embryos to others who would like to implant them, many people are uncomfortable with this option, and unused embryos are often destroyed,” it said. “If these embryos are declared human lives by the stroke of a governor’s pen, their destruction may be outlawed.”

By abolishing longstanding legal protections, “the U.S. Supreme Court’s reversal of Roe v. Wade serves American families poorly, putting their health, safety, finances, and futures at risk,” the journal editorial concluded.