Great article by Sophie Novack in The Washington Post 5/15/22

Kathaleen Pittman, director of Hope Medical Group for Women in Shreveport, La., is relishing what feels like a moment of quiet, despite the drilling outside her office. On this Friday afternoon in mid-March, workers are replacing some of the abortion clinic’s phones, leaving hers briefly disconnected. Since Texas implemented a near-total ban on abortions last fall, the lines have been flooded with calls. “Our phones are literally worn out,” Pittman says.

Before Texas’s ban, she tells me, patients could call Hope Medical and get an appointment the same week for the state-mandated first consultation, and often come back the next day for the procedure. Now, it’s typically a two-week wait just for a call back to schedule a first visit, and a couple more weeks before patients can have an abortion. Pittman showed me a red clipboard with the waiting list of people who have called in the past 10 days. The stack of pages with names; phone numbers; how far along they are in pregnancy, if known; age and parents’ contact information, if they are a minor, is an inch thick.

This spring, I drove to clinics in Louisiana and Arkansas, tracing paths that many of the thousands of Texans who have left the state for an abortion in recent months have traveled and speaking to patients about the obstacles they have faced along the way. The abortion clinic in Shreveport, a 5½-hour drive, is the closest to my home in Central Texas that still offers abortions past about six weeks, which is before most people even know they’re pregnant. Little Rock — home to the two abortion clinics in Arkansas — is an eight-hour drive one way. Both states require two in-person visits, 24 and 72 hours apart, respectively, which means many patients must make the journey twice.

The stories that follow are snapshots from this moment. Texas women shared them with me in interviews inside the clinic during first consultation visits in Shreveport, in a car on the way to the clinic for a procedure in Little Rock, over the phone after finally having an abortion following weeks or months of waiting.

They’re also a glimpse into what will likely be a far more common and widespread reality very soon. If a similar version of the draft opinion leaked in early May holds, and the Supreme Court overturns Roe v. Wade as expected, access to legal abortion would disappear in much of the Midwest and across the South, from Texas to the eastern edge of the United States. About half of states would likely ban abortion in the ruling’s wake; Texas, Louisiana, Arkansas and 10 other states, have “trigger” laws that would ban the procedure almost immediately. As a result, more patients would end up traveling farther and waiting longer. These stories explore what that means — for mental health, for family, for work, for daily life in innumerous, interconnected ways. These are patients’ experiences, in their own words. Some women requested partial anonymity to protect their privacy. In the case of the woman who requested full anonymity, her OB/GYN, Crystal Berry-Roberts, who does not perform elective abortions but treated the woman after her procedure, confirmed her story.

Interviews have been edited and condensed.

I found out I was pregnant when I was about five weeks, and it was around six weeks when I started calling and calling. By the time I got [scheduled], they told me I was too far [along] to get the appointment in Texas at all. I got put on a waiting list here [at Hope Medical Group in Shreveport]. It took longer than two weeks. I had to wait and look for the area code to call me. You can’t miss this call.

I’m 12½ or 13 weeks. The GPS told me I was going to run into a crash, and I was going to get here late. I start panicking, trying to call while I’m driving to the clinic. You feel like all your decisions are just based on this law that put you in this time crunch. It’s painful because it’s already a hard choice. Knowing the baby is growing, being forced to keep pushing it along, and going through all these obstacles — it’s a little traumatizing.

I have five kids. My youngest is 4. Since I had her, I’ve been going through a custody case. I’m just trying to not make any more decisions, especially something financially, that’s going to hurt them.

I had an abortion about three years ago. But it was different because I didn’t have to be forced to get attached to the baby. I was able to make a decision and have it done. It wasn’t like being backed into a corner, feeling nervous and scared every day.

It’s affected my time with my kids. I can’t explain it to them, but they know something is going on. At times I think they’re scared that I’m sick or something. I keep making up all these excuses why I don’t have the energy or don’t eat with them, because I feel so nauseous. Going through the longer process and being depressed at times, ’cause you got to think about it for longer and longer — just trying to hide all of that from everybody who I care about, so they don’t take on those feelings. Especially my kids.

I found out that I was pregnant in the beginning of February. I knew [an abortion] was going to be expensive, that I was going to have to jump through all these hoops and hurdles. I was worried, you know: Am I going to get in trouble because of this abortion law? Am I going to get sued?

I was on a wait list [at Hope Medical Group] for like two weeks, and they finally set my appointment for March 4th. We drove four hours, booked a hotel. Friday morning, I had my consultation appointment. Then they tell me that I have to come back for the surgery. So we had to drive four hours back home, wait till the next Saturday to drive all the way back. It was a little hectic and stressful.

Thankfully, I’d just gotten my tax returns, so we were able to take care of everything financially. It was at least $1,000. If we hadn’t gotten our taxes, or if this was a later time in the year, we may not have even been able to do this. I don’t have health insurance. I couldn’t go to a real OB/GYN. Our Planned Parenthood is actually shut down. [My hometown] has one of those [crisis pregnancy centers] where you walk in and they try to tell you that abortion is bad, you know, God made this choice for you, and all that stuff. But they were able to give me an ultrasound and tell me how far along I was before we went all the way to Louisiana.

I was waking up every morning throwing up, couldn’t really eat, just dealing with all this stuff, while trying to take care of my [3-year-old son]. I dreaded every day, just waiting for that phone call [to get off the wait list]. It was awful. Like, please call me, please call me. Because the longer I wait, every day that goes by, I lose another day of my chance of getting an abortion.

To read more click here

By Sharanya Sekaram, Sri Lanka, June 5, 2019, Women’s Media Center

Watching the incredibly restrictive abortion bans unfold from Sri Lanka has been eye-opening. The United States’ bans propose even more intense punishment than those that currently exist in Sri Lanka. For example, Alabama’s bill would make performing an abortion at any stage of pregnancy a felony punishable by up to 99 years in prison. In Sri Lanka, the punishment for all abortion procedures that are “not caused in good faith for the purpose of saving the life of the woman,” is up to seven years and/or a fine.

Undoubtedly, American women will still attempt to access abortion even if Roe v. Wade is ultimately overturned. This reality begs the question: If women are going to seek an abortion no matter the legal status of abortion in the country they live in, who will illegal abortion hurt the most? The answer can be found in examining how significant a role class plays in a woman’s decision to have an abortion.

Class impacts every decision a woman makes about her body from the second she finds out she’s pregnant. Imagine that you are a 35-year old mother of two living as one of the urban poor in low-cost housing. You are struggling to make ends meet. It’s very likely that you work in the in the informal economy, and therefore lack access to paid maternity leave and/or flexible work hours. Having another child would mean that you would potentially need to stay home for months without an income to care for a newborn. This is not an option for many women whose families cannot survive without their additional income and for whom childcare is not an affordable option. Of course, this decision may also be further complicated later in a woman’s pregnancy if it is found the child will be born with significant fetal abnormalities or disabilities and therefore require sustained full-time care which the families cannot afford to give.

This difficulty is compounded in if abortion is illegal. Women with a substantial income can afford to travel to places where abortion is legal and thus infinitely safer. Some can even find providers in their own communities who will perform the procedure for a substantial fee. Impoverished women don’t have these options, and so are forced to seek abortions outside clinics, which may lead to complications, or to resort to dangerous home remedies that can include everything from papaya leaves to bicycle spokes.

Evidence shows that a woman’s socioeconomic success is intrinsically tied to their reproductive lives – even privileged women see their career trajectories tied to their child-bearing. Studies show that forcing women to carry an unwanted pregnancy to term quadruples their odds of living below the poverty line, and laws that restrict abortion access have proven to deteriorate economic outcomes for women. This is to say nothing of the negative impact on the health, opportunities, and emotional well-being of the children born into these situations.

Are we having the right conversation about abortion? Are we placing the realities of women and their children at the forefront of our conversations, or are concerns over a debatable and relatively abstract sense of morality more important than their lives?

Presented by the Bixby Center for Global Reproductive Health, the University of California San Francisco (UCSF) and Advancing New Standards in Reproductive Health (ANSIRH).

It is estimated that more than 4,000 women are denied wanted abortions due to facilities gestational limits every year. As more states pass gestational limit laws, thousands more will be affected.

The Turnaway Study was the first study to rigorously examine the effects of receiving versus being denied a wanted abortion on women and their children. Nearly 1,000 women seeking abortion from 30 facilities around the country participated. Researchers conducted interviews over five years and compared the trajectories of the women who received a wanted abortion to those who were turned away because they were past the facility’s gestational age limit. As legislators pass more and more laws to restrict access to abortion care, it’s important to document what happens to women who are unable to obtain an abortion.

RESULTS

Abortion does not harm women. It does not increase women’s risk of having suicidal thoughts, or the chance of developing PTSD, depression, anxiety, low self-esteem, or lower life satisfaction. Abortion does not increase women’s use of alcohol, tobacco or drugs. 95% of women said abortion was the right decision for them. Women who received a wanted abortion were more likely to have a positive outlook on the future and achieve aspirational life plans within one year.

BEING DENIED AN ABORTION REDUCES WOMEN AND CHILDREN’S FINALCIAL SECURITY AND SAFETY.

Women denied an abortion had almost four times greater odds of a household income below the federal poverty level and three times greater odds of being unemployed. There was an increased likelihood that women didn’t have enough money to pay for basic family necessities like food, housing and transportation if they were denied an abortion. Women unable to terminate unwanted pregnancies were more likely to stay in contact with violent partners, putting them and their children at greater risk than if they had received the abortion. Continuing an unwanted pregnancy and giving birth is associated with more serious health problems than abortion.

WHEN WOMEN HAVE CONTROL OVER THE TIMING OF PREGNANCIES, CHILDREN BENEFIT

Existing children of women denied abortions were more than three times more likely to live in households below the federal poverty level and they were less likely to achieve developmental milestones than the existing children of women who received abortions. Nine percent of children born because an abortion was denied met the threshold for poor maternal bonding, compared to three percent of children born subsequently to women who received an abortion.

OUT-OF-POCKET COSTS

Out-of-pocket costs for women whose insurance or Medicaid did not cover abortion were $575. For more than half, out-of-pocket costs were equivalent to more than one-third of their monthly personal income. It cost closer to two-thirds of their monthly personal income for those receiving abortions after 20 weeks.

For more information about the Turnaway Study and detailed references, visit http://bit.ly/TurnawayStudy.