I was appalled at the US Supreme Court’s decision last week to overturn Roe v Wade, thereby ending federal protection of the legal right to abortion for American women. Why should I care so much? I’m not a US citizen or resident, my childbearing years are behind me and I’m fortunate that here in the UK we have well-established legal freedoms ensuring women’s right to choose whether to continue with or terminate a pregnancy. Well, I care for two reasons, one societal, the other personal - more on those shortly. Whether they are facing an unplanned pregnancy or the opposite scenario of trying and failing to get pregnant, whatever their circumstance and whatever their wishes, when it comes to reproductive health women need 4 things to help them decide on the right course of action.

Let's consider first the societal impact of the Supreme Court’s ruling. It hasn’t ‘just’ ripped up the legal right to abortion, it has dramatically unwound years of painfully slow, hard-won progress towards gender equality and equal rights. Women will be forced down paths not of their choosing, denied access to the healthcare they need and criminalised for thinking deeply about whether they are able to bring a baby safely into the world, love it, care for it and provide for it – possibly with minimal support - for the next 18 years and beyond.  And that’s not even taking into account any distressing or traumatic circumstances under which they may have conceived or what the baby’s or mother’s life prospects will be if either are facing serious health issues. Abortions will not cease, they will simply go underground and become unsafe, further jeopardising the mother’s health. Many teenage girls and young women may, as a result of this ruling, stop their education early due to state-enforced motherhood and as a result watch their life choices, job prospects and earnings potential dwindle and never recover. As a a mother and stepmother of two girls, I fear for the futures of all young Americans coming into womanhood.  Travelling out of state to access medical advice and interventions will require sufficient funds and time off work and therefore won’t be available to all; this ruling will disproportionately impact those on low incomes and in precarious employment or unemployment and will deepen social and racial inequalities still further.

Secondly, the personal reasons behind my reaction. As a woman and as a mother who tries hard to instil independence, a sense of agency and resilience in my own young daughter and to teach her to make her own choices in life, it makes me viscerally angry to see this most basic of right – to make our own healthcare decisions, to decide what does and doesn’t happen to our own bodies – taken away from other girls and women. It sends a chilling signal, reminiscent of Margaret Atwood’s The Handmaid’s Tale, that a woman’s role and place in society is first and foremost as a bearer of children; that her own wishes, hopes, ambitions, value and identity come a poor second, if acknowledged at all.

Whilst I count my blessings never to have been in the position of needing to consider a termination, I have needed access to expert advice and medical help for the polar opposite situation: trying to get pregnant. After 3 years of trying for a baby in my mid/late 30’s (not postponed as a ‘lifestyle choice’ in order to focus on my career, simply because I had only just met someone with whom I wanted to bring a baby into this world), we were refused access to NHS fertility treament because my husband has two children from his first marriage. Many investigations, countless injections, one private, failed round of IVF and several thousand pounds later, we were given the diagnosis of ‘unexplained infertility’ and told we’d never have our own child.  But we had still had options and the freedom to make our own decisions and yes, being able to pay for this advice and treatment privately (with all the financial sacrifices that entailed) helped keep some options on the table. We were advised to consider surrogacy or adoption; we were also free to decide, against the experts’ advice, to try one more round of IVF that was ‘bound to fail’ but which, against the odds, miraculously worked. I am eternally grateful for those choices and freedoms, for the support every step of the way from our doctors, families, friends and the few colleagues at work who knew what we were going through.

Going through that experience left me wanting to help others facing difficult journeys to parenthood. So now I speak publicly (FT, £) about my past infertility and try to help break down the taboo at work about this topic. I’m on the Steering Committee of the Workplace Fertility Community that runs free monthly webinars and hosts a Linked In group offering advice, resources and examples for employers. And I work with organisations to help them develop fertility policies and put in place practical, valued support for any employees needing help with their reproductive health.

Trying to conceive and bear a child is clearly a very different situation to trying to decide what to do about an unplanned, unsafe or unwanted pregnancy; I’m not arguing they are one and the same. But whichever situation women – and their partners – find themselves in, they need the same things:

1.    Timely access to unbiased, accurate medical information and advice to help them understand what their options are and what the right choice is for them: whether to proceed or not and what the risks and consequences will be, physically, emotionally, financially.
2.    Non-judgmental support from people around them as they make those decisions and who help them, in time, come to terms with the outcomes and to move forward in life.
3.    Practical, financial and emotional assistance such as being able to attend appointments and take time off work without fear of reprisal, being demoted, seeing their pay or prospects stagnate or losing their job; access to loans, vouchers and other means of funding to cover travel and medical expenses; knowing their employer cares about them as more than just a number.
4.    To be listened to and to be heard. To be asked ‘what is important to you in all of this?’, ‘what do you need right now to get through this?' and ‘how can I/we help you?’. Not to be ignored, told they are wrong or told how they should feel or what they should do.

Sometimes people find themselves facing the hardest decisions imaginable, in life-changing situations they didn’t plan or choose to be in, or they can see the life path ahead that they want to make happen but they can’t do it on their own.  As a society, as employers, as colleagues and as friends, we all have a role to play in helping them to make the choices that are right for them. Not to sit in judgment, label their wishes as ‘wrong’, decide for them, punish them for their decisions or take their freedom away.