Last week, Alabama Governor Kay Ivey signed into law a bill that seeks to prohibit abortions at every stage of pregnancy, making Alabama the first state to pass an outright ban on abortion. The bill makes an exception for cases where a mother’s life is at risk but does not extend the same protections to pregnancies that result from rape or incest.
State legislatures have systematically chipped away at abortion rights for years. But the Alabama bill is the most recent in a string of extreme measures enacted by anti-abortion lawmakers who feel emboldened by Brett Kavanaugh’s nomination to the Supreme Court. This year alone, 11 states have passed measures that restrict abortion access–and many more states have introduced legislation–with the ultimate goal of challenging the Supreme Court’s landmark ruling in Roe v. Wade, which established a constitutional right to abortion. Two weeks ago, Georgia joined Kentucky, Mississippi, and Ohio in passing a bill that effectively bans abortions after six weeks into a pregnancy, when doctors can start to detect a fetal heartbeat–and before some women even know they’re pregnant. Missouri lawmakers passed a bill last week that would ban abortions after eight weeks, pending a signature from the governor.
None of these laws are in effect just yet. Most of the anti-abortion measures will be contested in court, a fight that organizations like Planned Parenthood have been preparing for. The ACLU and Planned Parenthood have already sued over the Ohio bill, and Kentucky’s abortion law has been blocked by a federal judge (a ruling that is in turn being appealed by the governor’s administration). “We’re going to court,” says Staci Fox, the president and CEO of Planned Parenthood Southeast, which operates clinics in Alabama, Georgia, and Mississippi. “Governor Kemp, we’ll see you in court, and Governor Ivey, we will see you in court. We’ve never lost a case that we fought in Alabama, so the good news is probably that these laws won’t take effect.”
Abortion funds–which help women in need receive abortion care through financial aid, transportation, and housing–have seen a spike in donations in recent weeks. The National Network of Abortion Funds, which includes 76 local funds across 41 states, raised $500,000 from 18,000 people between Tuesday and Friday last week. That’s $100,000 more than what the organization usually gives away in abortion funding each year.
But that’s little comfort for people seeking abortion care, many of whom are unaware that the bills are not enforceable yet–and may never be. Planned Parenthood Southeast has been deluged with phone calls from panicked patients since the Georgia bill passed. Fox says patients were becoming increasingly anxious over the last few months, particularly after Mississippi passed a “heartbeat bill” in March. “But after [Georgia], the volume went through the roof,” she says. “We literally had to set up an automated phone line in our centralized call center.” Countless patients were asking the same questions: Was abortion now illegal? Would they have to move up their appointments? Could they come in at all?
A priority for the organization right now is reassuring patients and combating misleading headlines and misinformation. For all the women Planned Parenthood Southeast has heard from, there are just as many whose questions are going unasked. After all, misinformation around abortion precedes this spate of anti-abortion measures: Last year, the Guttmacher Institute, a reproductive health research organization, found that countless young women turn to the internet for information on abortion–especially self-managed abortion–and that one-third of them thought abortion was illegal in their state or weren’t sure if it was legal.
And in states like Alabama, where there are just three abortion clinics, and Mississippi, which has just one, access to abortion services is already heavily compromised. Some women may have to drive hours and sleep in a parking lot just to make it to an appointment. Often there’s a required waiting period before you can get an abortion: In Georgia, a window of 24 hours is mandated between the time a woman receives counseling materials and undergoes a procedure.
“I’ve been doing this work for 23 years, and I literally have a knot in my stomach about the women who aren’t calling,” Fox says. “I’m just so worried about these women who feel scared and alone and abandoned by their own state. They want to access abortion and they think it’s illegal.” And as Fox points out, restricting abortion access doesn’t stop abortion; it just makes it less safe. According to the Guttmacher Institute, the abortion rates in countries where it is legal are not significantly different than the rate in countries where it is prohibited or very restricted–about 34 per 1,000 women and 37 per 1,000 women, respectively. In the U.S., nearly a quarter of women will have an abortion before the age of 45, with poor women accounting for half of abortion patients.
That’s why another focus for Planned Parenthood Southeast is reducing the stigma around abortion, which the organization is already tackling on the ground in Mississippi, as well as Georgia and Alabama. “In my opinion, we are where we are when it comes to fighting for women’s autonomy because there’s so much shame and stigma about women’s bodies and how they work,” Fox says. “If we don’t change the culture–if we don’t get rid of the shame and stigma–we’re going to end up right back here every time.”
Opening up the lines of communication means figuring out how people in states like Mississippi and Alabama will be most receptive to a conversation around abortion, which Planned Parenthood is doing through focus groups or by facilitating small events–say, a dinner at someone’s home–where people may feel more comfortable sharing their experiences. Another form of outreach is a door-to-door Healthy Neighborhood Canvass, which helps raise awareness in areas that have a Planned Parenthood health center. “We’re going to where they’re at, where they feel safe and comfortable,” Fox says.
Planning for the worst
The laws that have passed in recent months may not go into effect at all, if they are held up in court, but that only offers temporarily relief for women seeking abortions. The anti-abortion lawmakers driving this legislation are playing the long game, in the hopes that one of these bills might overturn Roe v. Wade, if they can appeal it all the way up to the Supreme Court. Planned Parenthood and other abortion rights organizations may be fighting each of these measures, but they’re also planning for that potential reality. “Contingency plans for these worst possible case scenarios are happening all over this country in a very coordinated way between funds, independent providers, and Planned Parenthood,” Fox says.
That includes looking at which states have codified abortion–New York, for example–and can be relied on to protect abortion rights and provide care in the event that Roe v. Wade is reversed. “About 25 million women could lose access to safe and legal abortion should something happen on the federal level,” Fox says, referencing the 20 states that would ban abortion if it was no longer protected by Roe v. Wade. “This is not a small problem, and this will become a health crisis in this country.” Planned Parenthood Southeast is also working on expanding its telemedicine program, which allows patients to consult with a physician via video conference to undergo a medication abortion.
In a state like Alabama, Planned Parenthood is already fighting a standard of reproductive healthcare that is already imperiled, between an ob-gyn shortage and unusually high incidence of cervical cancer. The state has just three abortion clinics, and half of the counties don’t even have an ob-gyn; making it a crime for doctors to perform abortions could drive doctors away and worsen that disparity. “In Alabama, black women are dying of cervical cancer at rates six times higher than any other state in the country,” Fox says. “It’s 2019. We can prevent it with the vaccine. We can detect it with a pap smear. We can cure it if we catch it early enough.”
But Planned Parenthood’s efforts to provide care are only as effective as the laws that bound them, which means shifting the legislature of states like Georgia, Alabama, and Missouri, where for every woman who voted in favor of their abortion bills, seven men did. The divide was particularly clear in Georgia, which is much less Republican than the rest, where only one Democrat voted in favor of the abortion bill; of the women who supported the bill, all were Republican. Fox doesn’t mince words when asked why these bills are being pushed through despite the will of the voters in the states (According to the 2018 statewide poll, only 31% of Alabamians were in favor of an abortion ban that lacks a rape/incest exception). She says, “I think this is a dying gasp of the white male patriarchy in this country. They are trying to come for the last thing they can when it comes to women’s autonomy.”
“We’re not waiting until 2020,” Fox says. “We are dropping mail into districts to let constituents know how their lawmakers voted–and we will hold them accountable. Our doors are open, and we are providing compassionate and nonjudgmental healthcare. But we are coming for their seats.”
Correction: This post has been updated to reflect that 11 states—not seven, as was previously stated—have now passed 16 bills to restrict abortion access.