The Struggle for Access to Abortion in a Coronavirus Pandemic

The Struggle for Access to Abortion in a Coronavirus Pandemic

April 21, 2020, Update: Yesterday, in a 2-1 opinion, the 5th U.S. Circuit Court of Appeals announced that Texas officials may legally restrict access to medical abortions during a coronavirus pandemic. The decision came less than a week after the court first ruled that Texas "has not made a strong enough argument to ban medical abortion," according to Politico (opens in new tab). On April 14, the court relaxed the temporary ban, saying that medical abortion is not a "procedure" and does not prevent hospitals from treating patients with COVID-19. Monday's ruling vacated that ruling, and the issue will be taken to a higher court in the coming weeks.

ORIGINAL STORY, April 8, 2020: Heather* is a 30-year-old single mother living in Texas. She has just been laid off from her full-time job as a result of Covid-19. With no health insurance and no source of income, she has no idea how she will continue to pay her bills and support her two sons.

She is also 6 weeks pregnant and unable to get the abortion she wants and needs.

"For me, pregnancy has the potential to be high risk," Heather tells Marie Claire. 'I have a prolapsed uterus, cervix, and bladder. I won't be able to work full time, and I may be bedridden for most of the pregnancy. Besides, I don't want to have children now." Beyond all logical reasons for continuing the pregnancy, I just don't want to get pregnant."

Despite her best efforts, Heather is unable to obtain abortion care where she lives: on March 23, the state's governor deemed the procedure medically unnecessary, citing the need to preserve personal protective equipment and hospital beds during a coronavirus pandemic (opens in new tab) (opens in new tab) A lawsuit filed on March 25 by Planned Parenthood and the Center for Reproductive Rights (opens in new tab) resulted in a temporary suspension allowing abortion services to continue. However, just 24 hours after the ban was lifted, it was reinstated by the Fifth Circuit Court of Appeals.

"I was a nervous wreck," Heather continues. In addition to "severe anxiety, hormonal imbalances from the pregnancy, and constant fear of the looming pandemic, I was overwhelmed by the back-and-forth of lawsuits. My appointments were canceled twice and rescheduled a few days later. I go from extreme highs to extreme lows. It has made me physically ill and unable to give my sons the parenting they deserve during this crisis."

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Texas is not alone in its efforts (open in new tab) to block women's right to choose. So far, Republican governors and deputy attorney generals in Ohio, Mississippi, Iowa, Alabama, Kentucky, and Oklahoma have also called for an end to abortion services.

Meanwhile, Republicans are attempting to include anti-abortion language in coronavirus relief legislation, the recently passed Covid-19 emergency spending bill expands the Hyde Amendment, and anti-abortion groups are calling on the Department of Health and Human Services to exercise its authority to ban abortion outright.

"Anti-abortion policymakers have a long history of trying to attach draconian abortion restrictions to federal law," says Megan Donovan, senior policy manager at the Guttmacher Institute. 'And that threat remains as they move to a new Covid-19 response. Members of Congress and this administration will try to use these moments to negotiate and sort of coerce anti-abortion policies in order to score political points, rather than focusing on alleviating the public health crisis."

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Some legislators argue that banning abortion would free up medical professionals and medical equipment, but Dr. Dan Grossman, director of Advancing New Standards in Reproductive Health, an abortion research group at the University of California, proved on Twitter that this is not the case. Studies have also shown that people who are denied the abortion they want are more likely to experience pregnancy complications. Such people are also more likely to experience depression and other mental health problems. They are also more likely to fall into poverty. And the children they already bear are more likely to suffer long-term.

And with nearly 10 million Americans now filing for unemployment as a result of the coronavirus, these consequences are likely to be exacerbated by a pandemic that is making it increasingly difficult for people to support their families.

"We know that in times like these, people will not stop getting pregnant," Dr. Ghazaleh Moayedi, board member of Physicians for Reproductive Health and an OB/GYN and abortion care provider in Texas, tells Marie Claire . "As a result of this pandemic, we will probably see more pregnancies than we would normally expect during the summer months. So our services will continue to be needed."

She continues, "Everything that this entire country is experiencing right now. It's what abortion-seekers go through every day: How do I pay for this treatment? How am I going to make money? How am I going to take time off work, how am I going to raise my child? That's what people who are seeking abortion care are going through every single year." [Of course, barriers to access to abortion are not new, and the anti-choice movement has worked tirelessly since the passage of Roe v. Wade to limit access to these health services, especially for blacks, the poor, youth, people living in rural areas, and people in the LGBTQ community This has continued. Even before the pandemic, 89% of the nation's counties had no abortion providers, and one-third of abortion patients had to travel an average of 25 miles back and forth to receive care.

So how can states and the federal government reduce the burden on both patients and abortion providers and remove unnecessary barriers to abortion access? One is to utilize telemedicine and telehealth services, as the federal government has already encouraged lay physicians to do, and to lift the 18 state bans on the use of telemedicine for medical abortions. This would make it possible to have abortion pills mailed to you, allowing you to have a safe and legal abortion from the comfort of your own home. States could also eliminate mandatory waiting periods. This waiting period would require multiple visits by those seeking abortions, further increasing the risk of contracting the new coronavirus. Medicaid and Medicare policies could be adjusted to cover abortion costs, and states could prohibit anti-abortion protesters from gathering outside clinics. (Despite warnings by public health officials to stay indoors, protesters continue to demonstrate outside abortion clinics, shouting obscenities and spreading lies that they were infected with Covid-19 inside the clinics.)

The state's abortion policy has been criticized for not covering abortion costs.

Donovan adds that the state could also allow more medical professionals to provide abortions, not just certified OB/GYNs. She notes that physician assistants, nurse practitioners, and certified nurse midwives could "help make abortion care available at all times, including during a crisis like this one."

While the fate of Texas abortion access in this pandemic unfolds in court (opens in new tab), Heather continues to try to access the care she needs. She explains, "All Wednesday I was calling women's health clinics and Planned Parenthoods in New Mexico, Colorado, Kansas, Illinois, and Missouri." 'It's about nine hours to New Mexico, which is on the Texas border. On these road trips, we spend more money, try to devise ways to keep the children safe, try to find someone to drive with us, and risk exposure to coronavirus by making multiple unnecessary stops to use the restroom or fill up the gas tank."

Still, she intends to leave as soon as she can, despite the additional risks.

"My life is important. My sons' lives are also important. Forced birth is not freedom. It is un-American. It is dystopian, destructive, and unconstitutional."

Anyone seeking an abortion in Texas should continue to contact their local clinic. Additional resources include: Clinic Access Support Network, The Yellowhammer Fund, The Lillith Fund, Fund Texas Choice, West. Fund Texas Choice, West Fund, Naral Pro-Choice Texas, National Network of Abortion Funds, La Frontera Fund, Jane's Fund, and the National Network of Abortion Funds. Frontera Fund, Jane's Due Process, etc.

*Heather's last name is being withheld to protect her identity and safety.

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