Despite the fact that they often have no medical basis, TRAP laws keep doctors from providing care, says ob-gyn Carrie Cwiak, director of Family Planning at Emory University in Atlanta. “There is no medical reason abortion needs to be marginalized,” she says. “It’s a common procedure, it’s a safe procedure to do in office, and it’s restricted because of political reasons, not safety ones.
When she and her husband decided to carry a pregnancy to term in 2016, she made sure to find a provider who offered the whole spectrum of reproductive care—prenatal, delivery, and abortion. “I wanted to know that if I did end up needing to terminate—God forbid—that they would respect my decision and that they'd help me,” says Clements. “If I hadn't found someone like that, to be honest, I don't think I would have trusted them to touch me.
If allowed to go into effect, it would make getting or performing an abortion (with few exceptions) a felony, punishable by prison time. “These regulations and threats of criminalization prevent doctors from providing the health care they want to—and are trained to—provide,” says Carley Zeal, an ob-gyn in Missouri and a fellow with Physicians for Reproductive Health.
So what can women in need of an abortion do to get care? “Patients might not have the option, but if you can, switch [providers],” Cwiak says. “You deserve someone who listens to you and values your choices. ” She recommends calling reputable organizations, such as Planned Parenthood, the National Abortion Federation, or the National Network of Abortion Funds, who can help find abortion clinics local to your area (and provide financial assistance).
In the end, she decided termination was best. “It makes me angry, looking back,” she says. “I would have had a termination at six weeks, if I'd had access. ” Instead, Clements was just one day shy of 14 weeks and visibly pregnant when she had her abortion at a Planned Parenthood—the same one she had driven three hours through a blizzard to access in 2010. “I went through everything again: the six-hour round-trip drive, the hotel rental, the meals out, the days off work,” she says.
Barrett has no regrets about the procedure, completed at 15 weeks, but it's one she still wishes her own doctor could have performed. “I would have never voluntarily gone to a male ob-gyn given the choice," she says. "But to my knowledge he was the only one available for a second-trimester procedure. ” On top of that, she found herself having to navigate an unfamiliar hospital system and to transfer her medical files to the public hospital in the midst of her grief.
That’s part of a deeper issue: Abortion care is often viewed as separate from mainstream medicine, a view that’s been percolating since abortion was legalized in 1973, says Lori Freedman, a researcher studying reproductive health care access at the University of California, San Francisco (UCSF), and author of Willing and Unable: Doctors’ Constraints in Abortion Care.
Her ob-gyn was kind and compassionate but was unable to provide the abortion herself because of her affiliation with a large Catholic hospital in their area. “I think she regretted that she wasn't able to help me through it,” Barrett says.
A 2016 report from the ACLU found that one in six U. S. hospital beds fall under the rule of directives from Catholic hospitals, which “prohibit a range of reproductive health services, including contraception, sterilization, many infertility treatments, and abortion, even when a woman’s life or health is jeopardized by a pregnancy. ” In some states more than 40 percent of hospitals have to abide by these rules.
The “incredible hostility toward abortion in our country,” in particular, Freedman says, matters. “[Ob-gyns] are taking on a lot of professional and personal risk if they decide to provide abortions—most work in a private medical context and are worried about losing business if there are protestors or a community backlash. ” Not to mention the threat of physical violence.
Many practitioners in Missouri have had to refer patients out to specialists for “second opinions” even when the patient is clear they want an abortion, she adds: “These providers fear the consequences of direct referrals to family planning clinics, so the patient instead has another unnecessary consultation instead of getting the health care they are seeking where and when they need it.
For two weeks after her second ob-gyn visit, Clements wavered between aborting the pregnancy and carrying it to term. “You could say that I took the time to decide, but really it was the treatment I got from the local ob-gyns that caused me to doubt my original decision and delay it,” Clements says.
Outside of criminalization, there are gag rules, which prohibit providers who receive federal funding from even discussing abortion with their patients. “The people I serve rely on me to be honest with them and present them with all of their options, and these gag rules prevent me from being an objective provider,” Zeal says.
Many ob-gyns, even in progressive areas, can’t or won’t provide abortions—whether they're pro-choice or not. https://t.co/kkq8K3SU7t— Glamour (@glamourmag) June 6, 2019