Surgical technician Carissa and recovery room staff member Elise walk a Texas patient to the recovery room after her abortion at the Women’s Trust Clinic in Oklahoma City, U.S., Dec. 6, 2021.
Evelyn Hockstein | Reuters
The Tulsa Women’s Clinic, one of four abortion providers in Oklahoma, may have to close completely as early as this summer if the Supreme Court overturns Roe v. Wade as expected later this year.
A draft high court opinion leaked last week showed the Tory majority is ready to overturn the historic decision of 1973 who legalized abortion nationwide. If the court follows through on the draft opinion, it would cause a schism between states where abortion remains legal and those where it is banned, leaving millions of women with little or no access to abortion.
Oklahoma is one of 26 states that plan to ban all abortions if Roe is overturned, according to the Guttmacher Institute, a nonprofit that supports abortion rights.
Oklahoma Governor Kevin Stitt signed legislation in April that makes abortion a crime punishable by 10 years in prison or a fine of $100,000. The law makes an exception for medical emergencies where the mother’s life is in danger, but not for cases of rape or incest. The abortion ban goes into effect in August, after the Supreme Court’s current term ends and a ruling on Roe would likely have been handed down.
“That would mean no abortion, therefore no clinic,” said Andrea Gallegos, executive administrator of the Tulsa Women’s Clinic. “We would not be able to continue to provide the service we provide,” Gallegos said.
Dr. Georges Benjamin, executive director of the American Public Health Association, said overturning Roe would further cement inequities in America’s health care system, primarily punishing low-income women, including minority communities who already struggle to access to quality health care. People with financial means who live in states where abortion faces a total ban will be able to travel to other states where the procedure remains legal, Benjamin said.
“Wealthy women won’t have that as a significant barrier. Low-income women will,” he said.
Some women who need an abortion are already forced to cross state lines even with Roe in place. When Texas passed a last year’s law banning most abortions, patients began fleeing to clinics in neighboring Oklahoma for treatment. The Tulsa Women’s Clinic saw its patients nearly triple as its sister facility in San Antonio, Alamo Women’s Reproductive Services, began referring patients there, according to Gallegos.
“We became a haven for Texas patients who had to flee the state for treatment,” Gallegos said.
Oklahoma, however, is no longer a safe haven. The governor signed a law last week apply the same restrictions as Texas. Abortions are now illegal after a heartbeat is detected in the embryo is detected on an ultrasound, which occurs as early as the sixth week of pregnancy. The law, called the Oklahoma Heartbeat Act, makes no exceptions for rape or incest. It allows abortions only in medical emergencies, for example if the mother’s life is in danger.
“Many women find out they are pregnant around the same time, so the window for accessing an abortion has narrowed significantly,” Gallegos said.
The law prohibits most abortions in Oklahoma. In 2019, 56.4% of abortions in the state were performed after the sixth week of pregnancy, when a heartbeat is normally detected, while 43.6% were performed at or before the sixth week, according to the Centers for Disease Control and Prevention.
The law allows individuals to sue virtually anyone who performs or “aids and abets” an abortion within six years of the procedure. The defendant would face $10,000 in damages for each abortion performed. Patients wishing to abort cannot be prosecuted.
“It doesn’t make sense now for Texas women to go to Oklahoma,” Gallegos said. Since the law was passed, the Tulsa Women’s Clinic has been unable to perform abortions on about half of patients requesting the procedure because they did not arrive until heart activity was detected in the embryo. , said Gallegos.
Some women who are turned away in Oklahoma will likely cross state lines to get abortions at nearby clinics Arkansas and Kansas, where the laws are not as restrictive. However, if the Supreme Court overturns Roe, Arkansas also plans to ban abortion. That would leave just four clinics in Kansas, where the state Supreme Court ruled in favor of abortion rights in 2019, to serve millions of people in the region.
In this scenario, wait times at clinics in Kansas would increase dramatically due to the influx of patients from neighboring states, which would further limit access, according to Zack Gingrich-Gaylord, spokesperson for Women’s Trust, which has clinics in Wichita, Kansas and Oklahoma City. who offer abortions.
“The clinic system in this region just isn’t robust enough to sustain the loss of so many clinics,” Gingrich-Gaylord said.
Although the Food and Drug Administration now allows women to receive the abortion pill by mail, Oklahoma also prohibits doctors from using telemedicine appointments to prescribe the pill and monitor patients taking it. The pill, mifepristone, is approved for use up to 10 weeks of pregnancy. In 2019, about 54% of early pregnancy abortions were medical abortions with the pill, According to the CDC.
Dozens of the nation’s leading medical groups, in briefs filed in the Supreme Court last year, argued that abortion is a safe and essential part of health care. They included the American Public Health Association, American Medical Association, American College of Obstetricians and Gynecologists, and many others.
Benjamin from the public health group said knocking down Roe creates a “tremendous health risk for women”.
“When the procedure is not performed under proper direction in a sterile and appropriate setting, there is a risk of septic infection and death,” he said. “There is a risk of sterility. There is a risk of bleeding to death.”
Obstetricians and gynecologists fear that proper medical training on how to perform safe abortions could fall apart if Roe is knocked down. According to a study published last week in Obstetrics and Gynecology, a peer-reviewed medical journal, the percentage of residents who receive abortion training could drop from 92% by 2020 to 56% if abortion bans by the state come into force. The authors said training is important not only for abortion care, but for other medical skills such as miscarriage management.
Dr. Jen Villavicencio of the American College of Obstetricians and Gynecologists called the Supreme Court’s proposed decision an unprecedented attack on women’s health care that will create fear, confusion and more generally prevent patient access to pregnancy care. As many women now face the reality of having to travel to get an abortion, Villavicencio said the group is working to create an expanded network of doctors to help patients access care wherever they live.
“It is critical that we expand access in states where it is unrestricted in order to assist those traveling from where it is,” she told CNBC in an emailed statement. .
In the Northeast, Governor Kathy Hochul has vowed that New York, which legalized abortion three years before Roe v. Wade, will provide a safe haven for anyone in need.
“It is a fundamental right under attack”, Hochul said on Thursday. “Come to New York. It’s the birthplace of the women’s rights movement.”