Buying abortion pills online can be the most affordable way to get care. Waiting for them can be agony.

Tara* has health insurance. Her health insurance even covers abortion—something of a rarity, considering that 11 states have laws restricting coverage of the procedure in private insurance plans, and 26 states restrict coverage in plans sold under the Affordable Care Act.

But when she found out she was pregnant, she realized she still wouldn’t be able to afford the cost of an in-clinic abortion: Since she hadn’t met her $1,500 deductible, she would have to pay for the entire procedure out of pocket, which would cost several hundred dollars.

“On paper I look like someone who could afford an abortion, which is weird to say. I make money, but I have to pay for rent, car payments, student loans, and health insurance—I don’t have the expendable income to just drop $600,” Tara told VICE.

She thought it over for a week—she could miss a car payment, or pay her rent late, but neither of these options were acceptable to her. Then she remembered she had read about Aid Access, a website run by a doctor based in the Netherlands who prescribes abortion pills for just $90. After one last attempt to scrape together the funds for an in-clinic procedure, she contacted the site.

Buying pills through Aid Access is designed to be simple and straightforward: First, Rebecca Gomperts, the doctor who started the service, has a consultation with U.S. patients over email to make sure they’re eligible to use the method. Then she writes a prescription for the pills, which patients email to a pharmacy she works with in India. Gomperts gives her patients instructions for how to use the medication, and when the pills come in the mail, they can take them at their convenience—but typically only during the first trimester. The U.S. Food and Drug Administration has approved medication abortion for use up to 10 weeks in pregnancy.

Gomperts started Aid Access to help people overcome the many obstacles to abortion care in the U.S., considering it her duty as a doctor to help people access the procedure. But because of the FDA’s restrictions on mifepristone, one of two drugs found in the abortion pill regimen, the service Aid Access provides is considered a violation of federal law, which is why Gomperts has an international—not a U.S.-based—pharmacy ship the pills. That means the drugs must go through U.S. Customs, which can delay them for an unpredictable amount of time: Some people receive their package in just a few days, but others may wait weeks for theirs to arrive. (Customs did not return VICE’s multiple requests for comment about whether it is targeting packages from Aid Access.)

Tara belonged to the latter group: She watched the medication sit in Customs for 16 days, an agonizing period of time during which she was growing more worried about whether she was still going to be able to end her pregnancy using the method she wanted.

“Those were the longest 16 days of my life,” she said.

Aid Access is currently considered the most reputable resource for self-managing an abortion. While there are several sites where people can buy abortion pills online, Aid Access is the most affordable—other websites charge anywhere between $115 to $430—and the only one operated by a licensed physician. On Plan C, a website that ranks online abortion pill retailers in a “report card,” Aid Access is the only site to receive an A.

One online abortion support group is filled with people’s accounts of using Gomperts’ service: Anyone who posts about not being able to access a clinic, be it for reasons of cost or distance, can expect to receive at least one response recommending Aid Access. The experiences detailed in this group are overwhelmingly positive. (VICE is not including the names of the online forums so as not to make them a target for shuttering.)

But while Aid Access may be the best option for people who find themselves needing—or preferring—to end their pregnancies on their own, the restrictions on mifepristone can put them in an impossible situation.

While three women VICE spoke to who used Aid Access were all ultimately successful in self-managing their abortions with pills from the site, some women online have described panicking about the wait time for the pills and going to a clinic after all, even if they still couldn’t afford it. And others—including one of the women in this story—said that they had used the abortion pills past the recommended time frame due to shipping delays.

The women who told VICE about using Aid Access said they don’t have any regrets about choosing the service, but their experiences were still characterized by feelings of stress and anxiety when days of waiting for a package of pills to arrive turned into weeks.

“Those were the longest 16 days of my life.”

This is not a situation of Gomperts’ making; rather it is the result of the many restrictions on medication abortion, which doctors and reproductive health experts say are medically unnecessary.

“You’re in quite the nerve-wracking situation if you don’t find out you’re pregnant until six or seven weeks, and that’s often around the time when someone who isn’t planning for a pregnancy will find out,” said Abigail Aiken, an assistant professor at the University of Texas at Austin, who studies self-managed abortion. “If you have to wait three weeks for pills, you risk bumping up against that [10-week] cut-off point.”

Taking abortion pills past 10 weeks of pregnancy—and especially past 13 weeks—can mean heavier bleeding and raise the chances of an incomplete abortion, requiring patients to seek medical care afterward. Though such cases are rare, these caveats make the wait for abortion pills to arrive in the mail feel like a race against the clock.

“On top of the stress and anxiety of dealing with a pregnancy that’s not wanted, you have the added stress and anxiety of getting the pills,” Aiken said, not just because patients want to end the pregnancy as quickly as they can, but because they want to do it in the safest way possible.

Gomperts warns patients about the potential wait time for the pills: In the first email she sends people who request pills from her, she estimates the package will take seven to 21 days to arrive, and informs them that there is no faster shipping method available. She also urges patients to make their decision about whether they want to move forward with Aid Access as soon as possible, since she only treats patients who are less than nine weeks pregnant.

When Alex, who asked that VICE withhold her last name as a legal precaution, ordered abortion pills through Aid Access, she was about four weeks and five days along. Had the medication arrived in the estimated seven to 21 days, she would have been well within the 10-week window. But instead, her package remained in Customs for a full month; Gomperts ended up writing her a second prescription for the pills, but the first package arrived sooner: Alex took the pills when she was nine weeks and three days pregnant.

“I’d had a medication abortion once before with a clinic, but I was only about five weeks along at that time,” Alex said. “So I was kind of nervous [this time] because even though they say you can take the pills up to 13 weeks, things can get more complicated after the 10th week, and I didn’t want to complicate things.”

If the pills hadn’t come by the 13-week mark, Alex said she would have used the advance on her tax return to pay for an in-clinic procedure, even though she had been saving the money for a birthday gift for her three-year-old son.

“I had promised my son that we would redecorate his bedroom for his birthday,” she said. “It made me upset to think that I wouldn’t be able to do that, but I knew I wouldn’t be able to raise another kid by myself.”

Once patients have decided to end their pregnancy with Aid Access, they’re committed to seeing it through: Their back-up plans—like paying rent late in order to afford an in-clinic abortion—aren’t satisfactory to them because they weren’t satisfactory in the first place.

Even though Tara didn’t receive her pills until the 11-week mark, she was undeterred by the warnings about taking the pills past 10 weeks. She researched medication abortion past 10 weeks, looked up the signs of infection, and read about the experiences of other people who had been in a similar situation. She knew if she had any complications to just tell doctors that she had a miscarriage, to avoid possible criminalization for self-inducing an abortion.

“I was prepared for the worst outcome,” she continued. “I couldn’t have a baby so there wasn’t any other choice—no matter how long Customs made me wait I wasn’t having this baby and I didn’t have $600 to pay the clinic.”

Women like Tara and Alex face a difficult choice: wait an indeterminate amount of time for abortion pills to come in the mail, or find a way to get the pills from a clinic and suffer the financial consequences.

“I couldn’t have a baby so there wasn’t any other choice—no matter how long Customs made me wait I wasn’t having this baby and I didn’t have $600 to pay the clinic.”

There are other possibilities. Some of the sites that appear on Plan C’s report card have much faster ship times because they operate as online pharmacies rather than full-scale telemedicine services like Aid Access that require a consult. And because they sometimes ship from within the U.S.—flouting FDA rules—there’s no Customs checkpoint to hold up the packages. But pills from these pharmacies are more expensive, and don’t offer the comforts that come with having a licensed physician walk you through the process.

“It’s a bit of a trade off,” said Elisa Wells, the founder of Plan C. “Aid Access offers a really good price, physician support and excellent ongoing support in terms of instructions and answering questions. But there is this issue that the pills ship from overseas and they take longer to get to you. It’s not perfect, but people have to decide what’s important to them.”

Paige, who also asked VICE to withhold her last name, decided to make this compromise when contemplating how to end a recent pregnancy. The last time she’d gotten an abortion, she’d had a difficult time getting scheduled at a clinic, and ended up driving out of state for the procedure—when taking travel costs into account, she’d spent a total of $900.

“When it came to this recent pregnancy, I said, ‘Fuck that,’” Paige said. “I was learning more and more about self-managed abortion online and I didn’t to fight with the limitations of clinics again.”

She ordered the pills from one of the online pharmacies reviewed by Plan C for about $250, which she paid according to the instructions of a man who called her.

“It was kind of a sketchy work-around, but I knew it was legit from the Plan C report card, and [the pills] were in my mailbox in four days,” she said. “No waiting for weeks, no waiting for an appointment. Waiting in my experience was the worst part of being pregnant when you don’t want to be. The waiting is torture.”

Giving yourself a medication abortion doesn’t have to include weeks of waiting for a package to arrive in the mail, reproductive health advocates say: If the FDA lifted the restrictions on mifepristone, services like Gomperts’ would be free to operate in the U.S. And indeed some already are, through a clinical trial operating in 10 states, which exempts researchers from the FDA regulations.

“Aid Access really is demonstrating a way forward for safe and effective and convenient access to abortion services for the U.S.,” Wells said. “It’s a model we need to see made available here through regular medical channels so we don’t end up having the delay.”

In the end, neither Tara nor Alex had any complications passing their pregnancy—and they both described feeling happy and immensely relieved not to be pregnant anymore.

“It took a huge weight off of my shoulders,” Tara said. “I felt present for the first time in three weeks.”

Source: https://www.vice.com/en_us/article/884v7b/aid-access-abortion-pills-stuck-in-customs?fbclid=IwAR2uScWtwpyHijEG8jiFFIAfAzSkHhWsGBe8CX9omi7xjR2i6C4cOlNEl5M

States that have seen clinic shutdown laws struck down could reintroduce the measures if Supreme Court conservatives side with Louisiana in June Medical Services v. Russo.

The Court will hear arguments Wednesday in June Medical Services, a case about the constitutionality of Louisiana Act 620, an admitting privileges law identical to the Texas law the Court struck down four years ago in Whole Woman’s Health v. Hellerstedt.
Rena Schild / Shutterstock.com

A U.S. Supreme Court ruling in favor of Louisiana in June Medical Services v. Russo could mean nightmare scenarios for abortion access not just in Louisiana, but in states across the country with Republican-held legislatures.

The Court will hear arguments Wednesday in June Medical Services, a case about the constitutionality of Louisiana Act 620, an admitting privileges law identical to the Texas law the Court struck down four years ago in Whole Woman’s Health v. Hellerstedt.

Even though the Court ruled in Whole Woman’s Health that there was no scientific evidence to support Texas’ claim that laws requiring abortion providers to maintain admitting privileges at a nearby hospital advance and protect the health of pregnant people, Louisiana lawmakers soldiered on. And because the Fifth Circuit went rogue and ignored the extensive lower court findings that the Louisiana law, like the Texas law, provide no medical benefit and that providers in Louisiana were finding it almost impossible to obtain admitting privileges, June Medical Services found itself in the curious position of petitioning the Supreme Court to strike down a law that the Court had already struck down.

Should conservative justices on the Court uphold Louisiana Act 620 by either limiting to Texas the principles set forth in Whole Woman’s Health or reversing Whole Woman’s Health outright—which is what congressional Republicans who filed an amicus brief have asked the Court to do—the repercussions will reverberate across the country. A decision in Louisiana’s favor would reduce what should be a broad ruling that admitting privileges laws are an undue burden—because, as the Court said in 2016, they have no health or safety benefit—to a state-by-state inquiry into whether a particular law in a particular state has any benefit and whether requiring physicians to comply with the law constitutes an undue burden.

And it will give anti-choice lawmakers across the United States the green light to resurrect admitting privileges laws that were either struck down by lower courts or abandoned in the wake of the 2016 Supreme Court decision. A ruling in favor of Louisiana would give anti-choice legislators an opportunity to make the case that in their state, admitting privileges laws provide medical benefits and the burdens on pregnant people are minimal.

But first, Louisiana needs to convince the court that the circumstances in Louisiana are different than those that prompted the Court to strike down Texas’ law four years ago.

In order to skirt the ruling in Whole Woman’s Health, attorneys for Louisiana are arguing that those factual findings are limited to Texas and have no bearing in Louisiana. Just because the Court found that HB 2 burdened abortion rights in Texas, they argue, doesn’t necessarily mean that Act 620 burdens abortion rights in Louisiana.

Sure, the laws are identical and, sure, lawmakers in Louisiana passed Act 620 because they saw how effective HB 2 was in closing clinics in Texas, but what does that matter? The abortion rights landscapes in Texas and Louisiana are different and, according to Louisiana’s attorneys, the impact of HB 2 in Texas says nothing about the impact of Act 620 in Louisiana. (In one respect, Louisiana’s attorneys are right: The abortion rights landscape in Louisiana is worse, given the lower court’s findings that Act 620 would close every clinic in Louisiana but one, leaving only one provider in the entire state.)

A ruling favorable to Louisiana would provide an opening for other states to make the case that admitting privileges laws don’t burden abortion rights in their state. They could argue, for example, that even though the Court found that providers in Texas were finding it nearly impossible to obtain admitting privileges—and therefore demanding that they do so unduly burdens abortion rights—that’s not necessarily the case in every state.

In the wake of Whole Woman’s Health, several states dropped lawsuits defending their admitting privileges laws. But if the Court sides with Louisiana in June Medical Services, it could breathe new life into those laws. In addition, states that have seen their laws struck down by courts could simply enact new laws.

Alabama and Tennessee 

Alabama and Tennessee were both in the process of litigating the constitutionality of their admitting privileges laws (HB 57 and HB 3808) when the Supreme Court issued its ruling in Whole Woman’s Health. Citing that ruling, both states promptly dropped their lawsuits, noting that their state laws were nearly identical to Texas’ and there was therefore no need to continue litigating them.

In court documents filed with the 11th Circuit Court in Planned Parenthood Southeast v. Bentley, attorneys for Alabama noted, “Because Alabama’s law is identical in all relevant respects to the law at issue in Whole Woman’s Health, there is now no good faith argument that the law is constitutional under controlling precedent.”

Tennessee stopped defending its admitting privileges law, in Adams & Boyle, P.C. et al. v. Slatery. Attorneys for Tennessee noted that Whole Woman’s Health had applied the undue burden standard to Texas’ admitting privileges law and found that it constituted an undue burden to access, and that because Tennessee’s law was so similar, it would be a waste of resources to continue litigating it.

Oklahoma 

In 2014, Oklahoma’s Republican-held legislature passed an admitting privileges law that was challenged in Burns v. Cline. The Oklahoma Supreme Court struck down the law, rejecting argument that “the impetus for this legislation was to advance and protect women’s health,” noting that “[a]s in Hellerstedt, we reject defendants’ argument and find that SB 1848 places a substantial obstacle in the path of women seeking a lawful abortion. We further find this legislation causes a significant reduction in abortion providers, creating an onerous burden to women of child-bearing age.”

Mississippi

Mississippi’s admitting privileges law, HB 1390—which was enacted in 2012 and which the Fifth Circuit struck down in Jackson Women’s Health Organization v. Currier—could be resurrected should the Supreme Court decide that a state-by-state inquiry into whether admitting privileges are an undue burden is required.

Unlike in Whole Woman’s Health, where a three-judge panel of the Fifth Circuit upheld the Texas admitting privileges law (before the Supreme Court struck it down), a three-judge panel of the Fifth Circuit struck down Mississippi’s law in part because upholding the law would have shuttered Mississippi’s last remaining abortion clinic, unlike in Texas where a handful of clinics remained in the wake of HB 2’s passage. (Mississippi finally gave up defending the law in 2017. Attorneys for the state told the court that they could not “identify any meaningful distinction between the Texas admitting privileges law struck down in Hellerstedt and the admitting privileges requirement of HB 1390.”)

Here’s where it gets alarming: The judges conceded that if it were permitted to take into account the number of abortion clinics available in neighboring states, their calculus might have changed. However, they were constrained by a 1938 Supreme Court decision, Gaines v. Canada, which held states can’t discriminate in the distribution of state services by relying on the availability of similar services in nearby states. “Gaines simply and plainly holds that a state cannot lean on its sovereign neighbors to provide protection of its citizens’ federal constitutional rights, a principle that obviously has trenchant relevance here,” the court wrote.

But given that Supreme Court conservatives don’t seem to value precedent, should the Court be compelled to revisit Gaines, states like Mississippi will no longer have to ensure that at least one clinic remains in their state if they can rely on neighboring states to provide abortion care that Mississippians can access.

Then the question becomes: How far does a pregnant person have to travel before it is considered an undue burden? If a pregnant person cannot access abortion in a neighboring state, what about forcing them to travel two states over? Three states? What if laws shuttering all clinics in one state don’t pose an undue burden as along as at least one state in the country offers abortion care?

These are questions that could become critical if the Court sides with Louisiana and declares that whether or not admitting privileges laws are an undue burden depends on the circumstances in a given state.

Texas and Wisconsin 

A ruling that the constitutionality of these laws is a state-by-state inquiry that involves examining whether admitting privileges laws actually provide a medical benefit could even give states that have seen their laws struck down another bite at the apple.

Texas, the state at the center of the 2016 decision that Louisiana seeks to undermine, and Wisconsin—which saw its admitting privileges law struck down by the Seventh Circuit in 2013 in a case called Planned Parenthood of Wisconsin v. Hollen—could feasibly introduce new admitting privileges laws and learn from Texas’ mistakes in Whole Woman’s Health. Lawmakers in both states could shore up evidence that these laws promote health and safety and that they don’t pose an undue burden. (One way they could do this is by keeping their mouths shut about how gleeful they are that the laws are closing clinics.)

It’s unclear what circumstances in Texas or Wisconsin could have changed so that the admitting privileges laws no longer unduly burden abortion rights. But Republicans have taken over the courts, and the newly Trumpified federal judiciary may be the only change necessary for states like Texas and Wisconsin to try to pass another admitting privileges law, especially if courts are willing to allow state lawmakers to pass the abortion care buck to a neighboring state.

What is clear is that admitting privileges laws provide no medical benefit. They are a solution looking for a problem.

First, they are predicated on a “country doctor” style of medical care that existed at a time when people lived in small communities and had one general practitioner who handled all of their health-care needs. That kind of care doesn’t exist anymore.

Second, admitting privileges are hard to come by due to the stigma that abortion providers face (in part because of unfounded claims like those Louisiana has made before the Court that abortion providers don’t have their patients’ best interest at heart.) In Whole Woman’s Health, the Supreme Court acknowledged that the admitting privilege requirement would force clinics in Texas to shut down because they would be “unable to find local physicians in those communities with privileges who are willing to provide abortions due to the size of the communities and the hostility that abortion providers face.” Hospitals aren’t keen on granting admitting privileges to abortion providers due to that hostility, and in some cases due to the Catholic directives under which many hospitals operate.

Third, hospitals are profit-driven institutions that rely on hospital admissions to operate. In Whole Woman’s Health, the Court called it an “undisputed general fact” that “hospitals often condition admitting privileges on reaching a certain number of admissions per year.” And because abortion is so safe, abortion providers cannot guarantee a minimum number of hospital admissions.

That’s the great irony. Louisiana lawmakers insist admitting privileges laws are necessary to promote the health and safety of pregnant people. But abortion is so safe that many hospitals won’t grant providers admitting privileges.

It’s like ten thousand spoons when all you need is an abortion.

Source: https://rewire.news/ablc/2020/03/03/the-supreme-court-could-create-a-national-nightmare-for-abortion-access/

LOS ANGELES, CA, UNITED STATES – 2019/05/21: An activist seen holding a placard that says I Don’t … [+] LIGHTROCKET VIA GETTY IMAGES

In some ways, reproductive health and medicine are facing greater threats today than ever before, including a fast-approaching Supreme Court fight that could ultimately deny care to millions of US families. Meanwhile, experts in this field are also making major strides, including landmark research on abortion outcomes over time, which debunks numerous common anti-abortion claims.

In January, researchers at the University of California, San Francisco’s Advancing New Standards in Reproductive Health (ANSIRH) center published the third and final paper based on their groundbreaking Turnaway Study, which tracked the experiences of 1000 women who either received an abortion or were denied one, recorded at one week after the event and then semiannually for five years.

Overall, researchers found that women and their families saw long-term harms when they were denied wanted abortions, including dips in extant children’s developmental progress and women’s income and credit scores. They also concluded that some of the most popular arguments to restrict abortion — suggesting that women will regret their abortions, or that the procedure may be bad for women’s mental health — just don’t line up with the data.

The team’s latest article tackles this point head-on: despite frequent popular rhetoric arguing otherwise, their longitudinal study found that women who received abortions overwhelmingly said that they primarily felt relieved, and continued to feel their decision had been right in the five years that followed.

“We found no evidence of emerging negative emotions or abortion decision regret; both positive and negative emotions declined over the first two years and plateaued thereafter, and decision rightness remained high and steady,” they explained last month in an article for Social Science & Medicine. “At five years postabortion, relief remained the most commonly felt emotion among all women.”

The negative emotions that women did experience seemed to correspond most to perceived levels of decision-difficulty and stigma in their communities, but also petered out over time. “These results add to the scientific evidence that emotions about an abortion are associated with personal and social context, and are not a product of the abortion procedure itself,” researchers wrote.

Dr. Corinne Rocca, the study’s first author and one of the Turnaway Study’s lead researchers, noted in a phone interview that women who were denied abortions reported raised levels of anxiety, but women who received them reported feeling the kind of positive-and-negative emotional mix you’d expect “during any big life event” (such as changing jobs, moving, or ending a relationship).

“Feelings were most mixed during week after, with some sadness, but also happiness and relief; relief was the most common,” Rocca said. “Experiencing negative emotions during a big life event is completely normal; I don’t find that concerning. What I would find concerning would be if that persisted, or if women looked back [months or years later] and felt tremendous guilt,” but that just wasn’t the case. “And a very-high-to-overwhelming proportion said they felt they made the right decision, which held out over five years.”

The data also showed that women’s consistent feeling of ‘decision rightness’ continued “even under difficult circumstances,” Rocca said — for example, if they had chosen to have a late-term abortion, or had self-reported that they live around abortion stigma. “Even they still felt this was the right decision.”

This kind of evidence about women’s emotions and perspectives after abortions hadn’t previously existed, Rocca said — for one thing, because it wouldn’t make sense to compare data on women who had abortions with that of women who experienced miscarriages, or who carried a wanted pregnancy to term.

Now that it is available, Rocca and her colleagues hope lawmakers will start taking this and other scientific evidence into account more often when legislating our reproductive health. In numerous states already, she said, “There have been multiple of these targeted regulation of abortion providers (TRAP) laws — a family of them, really — all centered around the regret claim.”

Sometimes such laws will require patients to wait 72 hours before getting the procedure, or require two separate visits (one for ‘counseling,’ one for the abortion), or have ultrasound-viewing requirements. “They’re all really targeting the idea that women will regret abortion,” Rocca said.

“But data suggest those policies are wrong, and that those policies won’t work,” she continued. “My desire for this research is really that we just base our policies on evidence. These are needless policies, and probably create the outcome that they are claiming to protect people from.” In terms of providing meaningful support to pregnant persons in the moment of their decision-making, Rocca added, “A better idea would be to offer solutions for dealing with stigma.”

Regarding the oft-used argument that abortion is or may be bad for women’s mental health (or that they’ll come to regret it), Rocca commented, “I think in part it’s because people who are against abortion don’t want to be anti-women, and the claim that they want to protect women from this decision has seemed appealing.” It’s far from the only misconception (or misrepresentation) out there, however. And usually the problem isn’t that research hasn’t been done.

“Some of the biggest gaps in people’s knowledge about abortion, and in the public’s knowledge, aren’t things we haven’t answered yet. They’re things that are out there, and firmly established,” Rocca said.

According to Rocca, the biggest knowledge gap has to do with “just how safe abortion is,” she said. “Far safer than a colonoscopy, or many other common procedures that people routinely get.” That includes surgical as well as medication abortions, “despite [the latter] being heavily regulated by the FDA.”

“The second [gap] is how common it is: people think abortions are rare, but one in three or four women have them in their lifetime,” Rocca said. “People may think they don’t know somebody that’s had one, but they’re wrong.”

Source: https://www.forbes.com/sites/janetwburns/2020/02/29/women-overwhelmingly-dont-regret-abortions-research-finds-but-denying-them-costs-a-ton/#5efd2c021604

Even though HB 481 has yet to take effect, Georgia clinics have been inundated with calls from people who worry abortion is illegal or that they’ll be criminalized for obtaining one.

Roxanne Sutocky, the director of community engagement at Atlanta Women’s Center, said the center has used the passage of HB 481 as an opportunity to educate the public on why abortion bans and abortion stigma are harmful and on how to get involved in protecting reproductive rights.
John Ramspott / Flickr

With a stroke of his pen, Georgia’s Republican governor Brian Kemp incited anxiety, confusion, and fear in people who need abortion care in his state when he signed HB 481, a near-total abortion ban, into law in May 2019. The law would prohibit people in the state from accessing an abortion as early as six weeks into pregnancy, before most know they are pregnant.

While HB 481 wasn’t slated to take effect until January 1, 2020, clinics that provide abortion services in Georgia were immediately inundated with phone calls inquiring if abortion was illegal. Despite a temporary injunction halting the ban from taking effect—thanks to a lawsuit to strike down the ban filed by the American Civil Liberties Union, the Center for Reproductive Rights, and Planned Parenthood on behalf of abortion care providers, advocates, and patients—the calls still haven’t stopped.

“When Kemp signed the law last summer, our call center got flooded,” Staci Fox, the president and CEO of Planned Parenthood Southeast (PPSE), told Rewire.News. “We had to set up a separate number in our call center just for information about where the law and the litigation stood so that patients and anyone, really, could stay informed.” (PPSE operates four health centers that provide abortion care in Georgia and is one of the lawsuit plaintiffs.)

Since HB 481, one of Fox’s priorities has been informing people who need an abortion in Georgia that the procedure is still safe, legal, and available up until a pregnant person reaches 20 weeks (later in special cases), mainly through social media and on-the-ground campaigns. She’s far from alone in this mission—many of PPSE’s fellow plaintiffs are undertaking similar efforts to ensure that people receive accurate information.

Kwajelyn Jackson, the executive director of Feminist Women’s Health Center (FWHC), told Rewire.News it was their duty to join the lawsuit as a reproductive justice-centered clinic that serves patients from marginalized communities. FWHC has been receiving the same nervous calls from abortion-seekers as PPSE.

“We made a banner shortly after the bill was signed to put outside of our clinic that said, ‘This clinic stays open,’ just so that people would have a visual representation of reassurance that we’re here, we’re open, we’re accepting appointments, we’re seeing patients every day—that we don’t have any plans on going anywhere,” Jackson said.

Roxanne Sutocky, the director of community engagement at Atlanta Women’s Center (AWC), another plaintiff, said that after an uptick in calls due to HB 481, their advocacy center staff began tracking the concerns of callers. They found that callers asking about Georgia’s ban were from both inside and outside the state and were generally afraid of being criminalized for accessing an abortion—including callers who’d already had one.

Callers also reported being given misinformation by anti-choice pregnancy centers (also known as “crisis pregnancy centers,” or “fake women’s health centers”). These organizations, of which there are 91 in Georgia, intentionally confuse pregnant people, claiming to offer “abortion pre-screenings” that are really ploys to persuade people from terminating their pregnancies.

“In our call tracking, we actually did talk to folks who said they went to crisis pregnancy centers and were told that because the fetus had a heartbeat, they would go to jail if they got an abortion. So crisis pregnancy centers are absolutely manipulating and taking advantage of folks and their level of understanding of the law and where it stands,” Sutocky said.

When people visit AWC’s website, the first thing they see is a banner: ‘’Yes, abortion care is still legal in Georgia.” This message is all over the center’s social media, as well as on posters and in handouts at the clinic. AWC has used the passage of HB 481 as an opportunity to educate the public on why abortion bans and abortion stigma are harmful and on how to get involved in protecting reproductive rights, Sutocky said.

The anti-abortion measure has inadvertently resulted in opportunities for abortion care providers: PPSE has attracted more clinicians to their staff who provide abortion care. Meanwhile, FWHC has partnered with medical schools to introduce residency programs for a new generation of family planning physicians to be trained to provide abortions. Due to an influx of donations following the signing of the law, their clinic has been able to expand their capacity by hiring new nurses, nurse practitioners, and administrators.

Last week, lawyers for American Civil Liberties Union, the Center for Reproductive Rights, and Planned Parenthood filed a motion for summary judgment in their lawsuit, asking the judge to permanently block the abortion ban.

The abortion care providers Rewire.News spoke with believe that they will win—“both in the long-term and in the short-term,” Jackson said. She noted that every pre-viability abortion ban (a ban against abortions before a fetus is developed enough to survive outside the uterus) in the United States has been deemed unconstitutional and struck down. Jackson said she deeply believes in the brilliance of the reproductive health, rights, and justice activists who are fighting the abortion ban, and also in the expertise of the attorneys fighting bans and other anti-choice legislation in Georgia and across the country, sentiments echoed by both Sutocky and Fox.

Still, clinics that provide abortion care in Georgia are working together to develop a contingency plan and are part of a national strategy to assess which states are most at risk of losing access to abortion care and which states have the fewest abortion restrictions in case people aren’t able to get the services they need in their home state.

They’re also focused on both national and statewide elections this year, since Republican state legislators were the architects and champions of the ban.

“Let’s be honest: We would not have this abortion ban if it were not for voter suppression tactics. We would have had a different governor in the governor’s mansion who would have vetoed this bill,” Fox said.

Georgia’s abortion care providers are looking forward to being able to focus on issues beyond the ban, such as the state’s high maternal mortality rate. Fox lamented that PPSE wouldn’t be able to devote its full attention to actual reproductive health crises until Republican lawmakers stop “playing politics with people’s lives.”

“They act and say words like ‘we care about women,’ ‘the safety of women,’ and ‘we’re pro-life,’ but their actions do not reflect that,” Fox said. “They’re wasting tax dollars, and they’re wasting Georgia’s time while they’re not focused on real problems.”

Source: https://rewire.news/article/2020/02/26/how-georgias-blocked-6-week-abortion-ban-is-already-affecting-clinics/

I know from personal experience that it’s already very hard to get an abortion in Louisiana. The Supreme Court could make things even worse.

Protesters march down Bourbon Street in the French Quarter of New Orleans, in 2019, to protest a proposed anti-abortion bill. Emily Kask / Getty Images

Next month the Supreme Court will hear arguments in a case that could leave just one abortion clinic open in the entire state of Louisiana and pave the way for anti-abortion politicians in other states to do the same — effectively abolishing the protections of Roe v. Wade, 47 years after the case was decided.

I had just started working my first job with a decent salary and benefits in 2015 when I discovered I was pregnant. When I told my boyfriend, he apologized and said he needed to focus on his future, and this would mess that up. He offered to send money to compensate me.

I made two decisions after that. First, if I was to go through with this pregnancy, I would do it on my own. Then I thought about my future and what the best choice was for me. That’s when I made my second decision. I decided to get an abortion.

In Louisiana, that’s easier said than done.

First, I wasted three weeks going back and forth, an hour each way, to what I believed was a health center that could help me get an abortion. It turned out to be an anti-abortion crisis pregnancy center — one of more than 2,500 across the country, multiplying while abortion providers are being regulated out of existence. There, I was asked deeply personal questions, made to sit through two ultrasounds, watch a video of complete lies tying abortion to breast cancer and other health risks, and told multiple times that if I just came back for one more appointment, they could schedule my abortion. At one point, someone told me that I wasn’t “the type to get an abortion.”

One in four women in the US has an abortion in their lifetime. There is no type.

The state of Louisiana is trying to paint abortion providers as not having their patients’ best interests at heart. In reality, abortion providers were the only people I found who weren’t manipulative and coercive.

It wasn’t until I went to Planned Parenthood that I finally got the information I needed. I was told where I could get an abortion and what the process would be like. I traveled 250 miles each way to Hope Medical Group in Shreveport, home to one of the three remaining abortion clinics in the state: once for state-mandated counseling, and once for my procedure.

Both times, the doctors and staff at the health center made me feel supported, not judged. I was asked multiple times to confirm that this was what I wanted and that I was not being pressured into ending my pregnancy. They empowered me to make my own decision. Unlike the crisis pregnancy center. Unlike the state government.

In early January, 207 anti-abortion politicians wrote an amicus brief to the Supreme Court regarding the upcoming Louisiana case, arguing that the right to abortion is “unworkable.” The threat has never been more clear.

As a woman in Louisiana, my opinion should carry more weight than these 207 mostly male politicians who are not women in Louisiana (That’s right: None of the brief’s signers are Louisiana women who would be affected by the ruling. And only 13 of them are women.)

What I know from personal experience is that it’s already very hard to get an abortion in Louisiana. The state has put up a series of hoops women must jump through — including state-mandated counseling designed to convince you not to have an abortion, and a waiting period designed to put you in time out and make you travel back and forth to multiple appointments. I jumped through their hoops and more. I don’t wish my experience on anyone.

Like most women, I do not regret my abortion. I was able to keep my livelihood, without worrying about whether having a child would make me an undesirable employee or about how I would make ends meet. Today I am still working in that job, helping low-income residents with housing.

There are 1 million women of reproductive age in Louisiana. Our choices about our bodies and our futures are individual decisions.

Politicians in Washington and in Baton Rouge can write their opinions about abortion in legal briefs, in newspapers, in speeches to their donors. They’re entitled to those opinions. But they are not entitled to use their position to make my decision for me.

Source: https://www.buzzfeednews.com/article/jasminerivers/let-louisiana-women-decide-abortion-supreme-court?fbclid=IwAR2UCakrP6UAtsGnVMcp4Shbtpv5BNmkXfFDjyCqesAT5tMsgU_GWIn3B6U

The ordinances labeled some abortion advocacy groups as “criminal organizations.”

Over the last eight months, seven towns across east Texas have declared themselves “sanctuary cities for the unborn,” which effectively banned abortion and organizations that advocate for the right to the procedure.

Now, those towns are being sued for their new rules.

On Tuesday, the national ACLU and ACLU of Texas announced a lawsuit against the seven Texas towns on behalf of the abortion rights advocacy groups Lilith Fund and Texas Equal Access Fund. Under the ordinances, both of those groups were labeled “criminal organizations,” according to the lawsuit, which was filed in U.S. district court.

As “criminal organizations,” they were forbidden from operating within the towns’ limits, which banned them from offering services, renting or buying property, or “establishing a physical presence of any sort,” the lawsuit alleges. Getting or performing an abortion was also deemed illegal, as was helping anyone get an abortion, though that restriction wouldn’t actually take effect unless Roe v. Wade, the 1973 Supreme Court decision legalized abortion nationwide, is overturned.

The ordinances also declare abortion to be an “act of murder with malice aforethought.” Under Texas law, that’s not true: Abortion remains legal; it’s legal in all 50 states.

“Abortion is legal and constitutionally protected in these cities — officials there just do not want their residents to know it,” the ACLU lawsuit alleges.

The lawsuit accuses these seven Texas cities of unconstitutionally limiting the Lilith Fund and Texas Equal Access Fund’s rights to free speech and free association and discriminating against their pro-abortion rights viewpoints. (Neither the Lilith Fund nor the Texas Equal Access Fund actually perform abortions.)

“A major part of our work is to make sure every Texan knows their rights and can find legitimate, fact-based information about getting an abortion — regardless of income or zip code,” said Amanda Beatriz Williams, executive director of Lilith Fund, said in a statement. “These would-be abortion bans are deliberately designed to confuse people about their rights and push safe abortion care further out of reach.”

The ordinances first appeared in Texas in Waskom, a town of about 2,200 people near the Louisiana border. When the all-white, all-male city council voted unanimously to pass the measure last June, Waskom Mayor Jesse Moore acknowledged that the town would probably face an expensive lawsuit over it.

“Y’all save your nickels and pennies,” Moore joked, to laughter from the packed room.

But a local news outlet reported that the townspeople weren’t worried, because “they say God will take care of them.”

Source: https://www.vice.com/en_ca/article/4agq8n/aclu-sues-texas-town-abortion-sanctuaries-cities-for-unborn?fbclid=IwAR2lYkrzPN27wlNdGlB5VQi4AAGyPhnqJN6k4FJ5JoupVn-RYx_MR2zsk8k

Activists outside the Supreme Court in January voiced their support for abortion rights nationwide

If you received a diagnosis of a horrific pregnancy problem, would you want access to an abortion? Or would you want your options to be limited to stillbirth, miscarriage, or a suffering child, who would most likely die within a year?

At a press conference at the Capitol last week, proponents of Initiative 120, a campaign to place an initiative to ban abortion after 22 weeks on Colorado’s November ballot, argued that women in these circumstances are better off having miscarriages or stillbirths, or delivering a baby that will soon die, than having an abortion late in pregnancy.

“Miscarriage is a natural process that happens,” said Lauren Castillo, a spokesperson for the campaign, called Due Date Too Late. “With perinatal hospice, it’s giving them a healing way to really have that journey of a late-term miscarriage, and that’s what we’re advocating for women who may receive a fatal fetal diagnosis where the baby might not live after the birth.”

The initiative takes aim at the Boulder Abortion Clinic, which specializes in serving patients from all over the world who chose to terminate a pregnancy rather than suffer a miscarriage or stillbirth, or deliver a child that would have a low quality of life due to fetal anomalies that often aren’t detected until late into a pregnancy.

Perinatal hospice has become a common messaging tool used by abortion opponents as an answer to what women should do in the event that a wanted pregnancy goes awry.

Several states, including Oklahoma, Mississippi, and Kansas, have laws mandating that doctors provide women with information about perinatal hospice if they’re considering abortion after receiving a lethal fetal diagnosis. Such a law was implemented in Indiana in 2016 under the leadership of then-Gov. Mike Pence, who called it “a comprehensive pro-life measure that affirms the value of all human life.”

Pressed by another reporter on whether Initiative 120 would provide funding for perinatal hospice care, Castillo responded that it would not, but that the campaign is taking a “robust educational approach” to “let people know what resources and support are available in their communities.”

It’s not clear, however, what that educational approach entails. The Due Date Too Late website contains no information about perinatal hospice care, nor any other resources for women with wanted pregnancies who are choosing whether to terminate due to a life-limiting fetal anomaly.

Castillo added that “late-term abortion” can be “very traumatic to the mother psychologically and in a medical way.”

That sentiment was shared by Deacon Geoff Bennet, a spokesperson for Catholic Charities of Denver, who claimed that “abortion causes more trauma on a woman than delivering the baby.”

There isn’t, however, good medical or scientific research to back up the assertion that having an abortion results in adverse mental health outcomes compared to carrying a pregnancy to term.

In fact, a comprehensive study from the American Psychological Association (APA) found no significant correlation between abortion and mental health. The study did, however, reveal that perceptions of stigma, need for secrecy, and low social support for the decision to have an abortion can be a predictor for the very small portion of those who do end up having negative psychological side effects following an abortion. Similarly, a different study found that women are more likely to experience mental health issues if they’re denied access to an abortion than if they’ve received one.

Dr. Tom Perille of Democrats for Life of Colorado acknowledged what he referred to as the “controversy” around links between mental health and abortion, but suggested that research indicates a higher likelihood for adverse mental health outcomes in women who abort wanted pregnancies due to fetal anomalies compared with those who don’t choose to terminate.

Asked to provide that research, Perille pointed to two studies that echo his claim, one from the anti-abortion Catholic University of America and another from the Life Institute, an anti-abortion advocacy organization in Dublin.

These studies are in conflict with the APA’s research, which showed no difference in mental health outcomes between women who choose abortion late in pregnancy after being diagnosed with a fetal abnormality and those who have a miscarriage or stillbirth, or experience the death of a newborn. One study, however, did show a higher occurrence in adverse mental health outcomes for women who deliver a baby with severe abnormalities. Another study from the University of California, San Francisco’s Bixby Center for Global Reproductive Health also found no higher prevalence in mental health problems for women who chose abortion due to a fetal anomaly.

The press conference at Colorado’s Capitol took place before state lawmakers considered two Republican-backed bills that took aim at abortion: one that promotes scare tactics about abortions later in pregnancy, and one that’s identical in concept to the ballot initiative that would ban abortion at 22 weeks.

Lawmakers and other anti-abortion advocates were quick to acknowledge the fact that no anti-abortion legislation would move forward in Colorado’s Democratically-controlled legislature.

“The only way we are going to get a fair hearing is with the public at the ballot box,” said House Minority Leader Patrick Neville (R-Castle Rock).

Proponents have asserted they’re confident they’ll be able to get the 124,632 signatures needed to qualify for the 2020 ballot.

Castillo wouldn’t say how many signatures they’ve collected thus far, but said that they “anticipate having way more” signatures than are needed to reach their goal.

Still, questions remain over whether a split in the pro-life movement could hurt Due Date Too Late’s chances.

For one, Colorado Right to Life, a key player behind multiple failed ballot initiatives that would have banned all abortion in the state by defining life as beginning at conception, opposes a 22-week ban based on its opinion that it doesn’t go far enough.

It isn’t clear, however, how deep the divide among anti-abortion conservatives runs.

Asked whether she knew of other organizations or churches who shared their view, Colorado Right to Life spokesperson Susan Sutherland said, “Sadly, no, I’m not aware of any others in our state who would oppose this flawed measure.”

“Denver Bible Church, led by Bob Enyart, is the only church I know of which completely understands that abortion murder, just as any murder, should be abolished rather than regulated,” she continued.

Proponents of Initiative 120 have until March 4 to turn in signatures.

Source: https://coloradotimesrecorder.com/2020/02/proponents-of-22-week-abortion-ban-recommend-miscarriage-stillbirth-instead-of-abortion/21312/?fbclid=IwAR1dpnbugu8M7wXMvSCLo_ZwHo6quuyfYa6t08la5YVBN1v4SUiOsgFoeuI

When I provide patient-centered counseling to people seeking abortion care, I have to undo the damage from biased counseling mandated by the state.

Even though having an abortion is 14 times safer than giving birth, some abortion providers have to inform patients about risks of death, infertility, and even breast cancer—talking points deployed by the powerful anti-choice movement in Texas and nationwide.
Shutterstock

I’m a counselor at an abortion clinic in Texas, where patients have to navigate roadblocks to care every day, including forced counseling against abortion.

Over the past year, I’ve counseled hundreds of people. Although I do provide some state-mandated counseling 24 hours before the procedure, most patients visit me separately on the day of their abortion. It isn’t unusual for people to enter my counseling room with their guard up, viewing it as yet another barrier imposed by the state before they can continue with their health-care decision. In reality, clinics that offer abortion counseling do so in order to provide patient-centered care that considers people’s unique experiences. But patients were confused so often that, eventually, I changed the way I began every interaction.

Before providing patients with an overview of what to expect from our counseling sessions, I now let them know that I won’t question their decisions. Recently, I told a patient who seemed uncomfortable after I introduced myself that I don’t need her to convince me that her reasons for having an abortion are good enough. While I wanted to make sure it was her decision to be there, I reminded her that she’s in control of what she shares with me. “Oh, thank God,” she told me, explaining that she had dreaded meeting with me because of what she expected counseling to be like. We talked about her life, her reasons for being there, and her goals for afterward. We developed a rapport. As she walked out, she thanked me for being “so nice” and not at all what she had expected.

Thirty-four states require that patients receive state-mandated counseling before an abortion can be performed, according to the Guttmacher Institute. Twenty-seven of those states also have mandatory waiting periods, forcing people to wait 24 to 72 hours after counseling before receiving the health care they have sought.

Typically, state-mandated counseling includes providing resources on alternatives to abortion (like adoption and continuing the pregnancy), inaccurate information and terminology about fetal development (such as the presence of a “heartbeat,” the ability for a fetus to feel pain, and language like “baby”), and the medical risks of abortion and of continuing the pregnancy.

Even though having an abortion is 14 times safer than giving birth, some abortion providers have to inform patients about risks of death, infertility, and even breast cancer—talking points deployed by the powerful anti-choice movement in Texas and nationwide.

Because of the “Texas Woman’s Right to Know Act,” we have to tell patients all of those things before their 24-hour waiting period can begin. We have to give them printed materials with that information, too. A separate booklet we’re forced to provide includes a list of anti-choice pregnancy clinics that offer free sonograms but don’t discuss abortion care. The idea behind state-mandated counseling is that people need “ample” time to make a decision based on the dubious information doled out by the state.

Here’s the thing: No other medical procedure requires this kind of biased counseling, which until 1992 the U.S. Supreme Court had found unconstitutional. The patients I speak to are capable of making informed decisions without state interference.

Part of my job includes providing these state-mandated materials and reciting a script about alternatives to abortion—a script that includes how the patient’s partner in the pregnancy is responsible for child support regardless of whether they’ve offered to pay for the abortion. It’s frustrating for me as a provider, and as someone who’s had an abortion, because we deserve to be trusted to make family planning decisions. Much like the patients I speak to, I knew I had the options of continuing the pregnancy and of adoption, but I showed up to an abortion clinic for a reason.

Forced counseling and waiting periods devised by lawmakers who oppose abortion rights disproportionately affect low-income families and people in rural areas without an abortion clinic nearby. Patients in Texas who live more than 100 miles from the nearest abortion provider may receive the counseling over the telephone; otherwise, they must make two trips on separate days. That means missing work and losing income, securing transportation and child care multiple times, and sometimes not paying rent or utilities because of all the costs added to abortion care by these onerous regulations.

The anti-choice counseling creates confusion for patients who receive separate counseling on the day of their abortion, which generally includes reviewing consent forms, checking for understanding, assessing for coercion, describing the abortion process, answering patient questions, and providing a space to discuss emotions and thoughts surrounding their decision without shame or judgment.

Some patients fear they won’t be able to have children later on if they want them. When I ask if that’s because of the information we had to provide them earlier, the answer is almost always yes. It’s times like these I’m reminded why patient-centered counseling is so valuable, even though not all clinics are able to offer it. Texas policymakers wants patients to fear they won’t be able to have children later, and it’s a privilege to be able to talk them through those fears. I always let patients know that although the state makes us tell them it’s a risk, the American Congress of Obstetrics and Gynecology says abortions without complications (that’s the overwhelming majority of abortions, since complications are very rare) do not affect fertility—a comforting fact for many.

Dr. Jessica Rubino, an abortion provider in Texas, said that while she complies with the law by providing state-mandated counseling, she also makes room in each visit to offer patients actual facts.

“It has the effect of exhausting me and confusing my patients. When you go to the doctor, you expect your physician to give you expert, sound medical advice. That’s why you go,” she told me. Dr. Rubino said this should be “exactly the same” when accessing abortion. “If I don’t lie, it’s illegal. If I don’t tell them the truth, I’m a bad doctor and committing malpractice—also illegal. It’s a lose-lose [situation]. Which is exactly what the Republicans who pass these draconian laws want. They don’t want patients to have the correct information.”

Even though most people who have abortions are confident in their decision by the time they come to the clinic, state-mandated counseling is grounded in the myth that people feel conflicted. Research shows most abortion patients aren’t conflicted—and that even experiences accompanied by complicated emotions don’t result in regret.

But it’s no surprise that after going through various political hoops to receive abortion care, some people find more counseling overwhelming. Abortion providers deserve the ability to provide patients with accurate, evidence-based care, and people who have abortions deserve to be trusted to make these decisions in the first place.

Source: https://rewire.news/article/2020/02/19/if-i-dont-lie-its-illegal-how-forced-counseling-affects-abortion-patients/