Tamara Nuñez was 40 when she learned she was pregnant for the 11th time.
The West Burlington mother of nine had struggled with a myriad of health issues throughout her previous pregnancies, one of which ended in miscarriage, that put her at high risk, and her age would have made the would-be nine-month journey brought on by failed protection even more dangerous.
“I am so high-risk it was not even funny,” she told The Hawk Eye, explaining that her doctor at the time asked her how many more times she was going to play chance with her life.
Nuñez, now 52, said she had to decide whether to end her pregnancy or put her life — and the welfare of her seven younger children still at home — at risk.
Nuñez is among a growing number of women who have chosen to speak publicly about their abortion experiences since the U.S. Supreme Court overturned Roe v. Wade, effectively ending the nationwide right to abortion, clearing the way for states to enact legislation restricting or allowing access to medical procedures and medications to terminate pregnancy.
Planned Parenthood estimates that one in four women will get an abortion before they turn 45, and the reasons behind those often difficult decisions to end their pregnancies are as unique as the women who receive them.
“There are a myriad of issues,” Nuñez said. “You’re not just talking about rape and incest, which is unfortunately a huge issue in this country. They are also talking about a 40-year-old mother of nine who narrowly escaped dying.”
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According to the Pew Research Center, a nonpartisan fact tank that conducts public opinion polling, demographic research, content analysis and other data-driven social science research on issues, attitudes and trends, determining how many abortions take place each year is difficult, but it estimates that number is between 625,000 and 930,000.
That range is calculated using data from the Centers for Disease Control and Prevention and the Guttmacher Institute, a research and policy organization focusing on sexual and reproductive health and rights in the United States.
Using data from states that collect that information, the CDC estimates about 625,000 abortions are conducted annually in the U.S., while the Guttmacher Institute uses data collected via questionnaires issued to abortion providers throughout the country each year to calculate numbers for clinics that do not return the requested information.
According to Pew, Guttmacher estimates the number of abortions is closer to 930,000.
Both the CDC and the Guttmacher Institute agree that abortion numbers have decreased greatly over the past three decades, with the estimates for 1990 putting abortion numbers at between 1.4 million and 1.6 million respectively. Additionally, the per capita rate of abortion dropped from about 29.3 abortions per 1,000 women each year in 1990 to 14.4 abortions per 1,000 women in 2019.
That data accounts only for abortions that were legally obtained through the use of certified clinics, and, according to Pew, there is no way to know how many abortions were obtained using abortion pills that did not come from a clinical setting.
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At the time of her final pregnancy, Nuñez was a single mother.
She had been doing everything she could to keep her family together, working three jobs and relying on a babysitter to watch her children while she worked.
“I knew my chances of dying were astronomical, so I made a very, very, very hard decision,” Nuñez said.
Several years after her abortion, she fully saw the effects of not having family nearby when her seven children were scattered to foster homes, and later adoptive homes, throughout Iowa.
Looking back now, Nuñez said she knows she made the right decision, not only for her, but also for her children. Had she not gotten an abortion, she said, she believes she would not have lived to see her children grow up and come back home after they aged out of the foster care system.
Nuñez now coordinates the peer recovery program at Alcohol and Drug Dependency Services of Southeast Iowa.
In that position, she has worked with women who become pregnant while they are using drugs. She said that sometimes due to the general symptoms caused by drug use, women don’t know they are pregnant until well after the six-week mark.
Some women may still have a period early on in pregnancy, and missed, late or irregular periods are not uncommon and can easily be overlooked.
Nuñez noted that irregularities in menstrual cycles are fairly common for women who use drugs and consequently may not eat properly, thus affecting their cycle. She said under such circumstances, women may not realize they are pregnant until they are 12 weeks along or later.
Iowa currently has a 20-week abortion ban that allows for abortions up until the 19-week and six-day mark, but that window could be made smaller following the Supreme Court’s decision.
In 2019, the Iowa Supreme Court has struck down a law that would have limited abortion access to the first six weeks of pregnancy, but the Iowa Supreme Court in June determined that the Iowa Constitution does not protect a fundamental right to abortion, overturning its own 2018 precedent and clearing legal hurdles for legislation further restricting abortions in the Republican-controlled state future.
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Iowa also has a law requiring those wishing to get an abortion to wait 24 hours between when they are initially seen by a provider and when they can receive the abortion.
According to the Guttmacher Institute, Iowa is among 44 states that have in place some kind of abortion restriction, with most states, including Iowa, having an exception for the life and health of the mother.
When it comes to exceptions outside of just the life of the mother, the bans vary.
Of the seven states that ban abortion completely, only three have any exceptions outside of life of the mother, with Alabama and Missouri offering protection if the mother’s health is at risk, and Mississippi offering exceptions in the case of rape.
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While anti-abortion advocates frame the issue of abortion around morality and religion, Nuñez said that anti-abortion advocates frame the issue of abortion much like they do addiction, with arguments based on morality.
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She noted that medical professionals now recognize substance abuse as a mental health disorder and argued that abortion is a personal health care decision.
“What if you just can’t?” she said. “What would I have done with another baby? I had six from my second marriage and my youngest from my first marriage. I had seven children by myself.”
According to the Guttmacher Institute, 15 states offer a general health exception that includes both physical and mental health.
Iowa’s six-week abortion ban would not include a mental health exception.