UNDUE BURDEN: Life and Death Decisions in Post-Roe America – Preview of Part 2
Shefali Luthra spotlights the issue that will destroy Donald Trump
Re-cap: Roe promised a world in which women were equal.
It shattered. Now, the United States represents the rare country to be going backward, to be enacting more restrictions while other nations are largely expanding legal abortion access; the near-total bans being enforced in many states are among some of the most restrictive in the world.
How and why this happened – and its impact on people’s lives – is the madness measured by Shefali Luthra, an expert on health policy whose writing has won journalism awards.
Note: For those interested in delving deeper, there is a full preview available of the first chapter of this book.
Part 2
In reality, this “haven” state was just too far away for most people to get to.
In California, medication abortions are allowed to be dispensed entirely through telemedicine. As long as someone had an in-state mailing address, they could have the pills sent directly to them, bypassing any hour-long clinic visit. Still, that required having an in - state mailing address — whether it was a mail forwarding address, a post office box, a hotel, or a friend or relative’s home. The fear of criminalization was potent in Gupta’s San Diego clinic. The patients she saw seemed so scared of what would happen when they returned home if someone found out where they had been.
For example, in a high-profile case post-Dobbs, the State of Nebraska prosecuted a mother and daughter, using the daughter’s Facebook messages as evidence, because the daughter got an abortion after twenty weeks, even though the abortion was performed before Roe even fell. Both mother and daughter pled guilty, facing prison time as a result.
Because California law allowed pills to be mailed without an in-person visit, some hoped that this could be the answer: abortion medications were easy to dispense, safe to take at home, and highly effective up until the second trimester.
In anticipation, some California doctors got certified in states like Texas, despite having no intention of moving there, so that, when the time came, they’d be able to send patients the medications needed to end their pregnancy. But they were relying on an untested legal theory.
Only one state — Massachusetts — immediately passed a law that explicitly protected doctors who sent abortion pills to people in other states, even if abortion there had been outlawed. But even in Massachusetts, few doctors were actually taking advantage of it.
In the longer term, doctors worried that the rise in abortion bans across the country would give far fewer young physicians a chance to properly study providing abortion care. The concern was great enough that after Dobbs fewer medical students applied to residencies in states with abortion bans, with the drop especially noticeable among those pursuing ob-gyn careers.
After Dobbs the numbers applying for funding support only kept growing. In one Colorado clinic there were ten to thirty people calling each day for help, desperate not only for money to pay for the procedure but also for anything that could alleviate the hefty cost of traveling to Boulder or Denver. In the last four months of 2021, the clinic spent $ 5,000 just helping people travel to Colorado for abortions; that year, the fund gave out $ 206,511 in total, serving 1,154 people.
After Dobbs, the numbers grew exponentially. In all of 2022, the clinic spent almost $ 700,000 to help people get abortions, with most of that money supporting people who traveled to Colorado in the months after Roe had fallen.
Because the need to travel farther for care was pushing people later into their pregnancies, abortions themselves had grown more expensive.
One day, a group of patients’ flights back home were canceled because of weather conditions. The clinic’s team sent food vouchers so that the patients’ children — waiting back in their home states for their moms to return — would have dinner taken care of. They helped make sure every patient had someone at home taking care of their kids.
Whenever abortion bans appeared in the news, funds like Carlson’s would experience what managers knowingly described as “rage giving” — a sudden influx in donations from people across the country, newly eager to help people access abortions.
As people became acclimated to a post-Roe reality, the level of donations to abortion funds began to fall significantly.
Colorado became only the sixteenth state in the country (not including Washington DC) with clear statutory abortion protections.
About one in four abortions in Colorado was for someone from out of state.
The burden was unequal: Black women were significantly more likely to die from illegal attempted abortions than White women, and wealth dictated who was able to travel to another state or country to access abortion.
With clinics facing heightened demand for abortion, doctors found themselves limiting how often they could provide other kinds of medical care.
There was danger involved. Dr. Hern, for one, opened his clinic almost immediately after the Roe ruling, eager to help reverse the trends he’d studied; soon after he launched his practice, the death threats began. To this day, he lives hyperaware of the risks he faces, of the same man who stalks him every Tuesday morning and the protesters who camp outside his clinic at all hours of the day. George Tiller, whom Hern considered a colleague, was murdered only one state away.
In Colorado Springs, less than two hours from his clinic, an anti-abortion extremist instigated a mass shooting at the Planned Parenthood affiliate, killing three people and injuring eight more.
In the wake of the 2022 elections, Republican state lawmakers instituted a bevy of proposed bills to raise the threshold for voter-initiated measures, requiring 60 or, in some cases, 66 percent approval for voters to amend the constitution.
And this was in states where the voters themselves opposed the wholesale abortion bans favored by state leadership. Those efforts didn’t always work — in Idaho and Ohio, conservatives failed in their efforts to raise the threshold for voters to enshrine abortion protections. But it showed how willing state-level Republicans were to change the rules of their elections if doing so would help in their fight against abortion rights…
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