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U.S. Supreme Court Decision On Abortion Pill Access Matches Louisiana's Restrictions

The Hope Medical Group for Women abortion clinic in Shreveport, Louisiana.
The Hope Medical Group for Women abortion clinic in Shreveport, Louisiana.

With the U.S. Supreme Court’s decision to reinstate an FDA requirement that patients pick up abortion pills in person, the rest of the country joins Louisiana and 17 other states with similar restrictions on abortion care.

Louisiana is among 18 states, including fellow Gulf Coast states Mississippi and Alabama,with laws that require medication abortion to be provided by a physician and for the physician to be present when the patient takes the first pill. This requirement has remained even as healthcare and health insurance providers in the state expand telehealth services.

Kathaleen Pittman, the administrator for Hope Medical Group for Women in Shreveport, one of three abortion clinics in the state, called the Supreme Court decision “upsetting.”

“This is another trap law that targets the most vulnerable in our communities,” Pittman said.

Louisiana requires patients seeking abortions to make two visits to abortion clinics before they can receive abortions. The state also requires medical providers to perform ultrasounds before patients can receive an abortion.

Families that need our services the most are already struggling financially and often do not have transportation, childcare and time off work to make the required two appointments at the clinics during the best of times,” Pittman said. “Requiring two visits during a pandemic is even more cruel.”

Three lower courts had blocked the FDA’s in-person pick-up restriction for the drug, mifepristone, during the COVID-19 pandemic.

Steffani Bangel, executive director of the New Orleans Abortion Fund, said the decision “sends a message on where the Supreme Court stands.”

The New Orleans Abortion Fund helps pay the costs associated with getting an abortion, including the cost of travel.

“In the Deep South, you’re always telling stories about people crossing divides, crossing state lines just to get the care that they need, scraping resources together, and taking off work,” Bangel said. “It’s already so difficult that so many people believe it’s already unavailable to them.”

Data collected during the first four months of the pandemic showed that 15.3 percent of callers seeking the fund’s assistance traveled across state lines to receive abortion services. That’s compared to the 5.5 percent who traveled to different states for abortion care before the pandemic. The fund sent clients to 13 clinics in 11 different cities in eight different states during the first four months of the pandemic, Bangel said.

That includes patients not only traveling from Louisiana to other states to receive abortions but also patients traveling to Louisiana from places like Texas, where abortions were temporarily banned at the beginning of the pandemic.

Medication abortions, which the FDA approved 20 years ago, are used in early pregnancies — up to 10 weeks of gestation.

Bangel said restrictions on waiting room sizes and the number of appointments that clinics can accommodate due to social distancing requirements associated with COVID-19 can be costly for patients seeking abortions. Delaying an appointment for weeks for someone who is less than 10 weeks pregnant can mean the difference between paying for medical abortions and surgical abortions.

According to its website, Hope Medical charges $600 for the abortion pill and between $600 and $876 for surgical abortions, depending on how far along the pregnancy is.

Bangel also said that 22 percent of clients who called the fund were uninsured and 37 percent were on Medicaid. The Hyde Amendment, which prohibits the use of tax dollars to pay for abortions except in cases when the pregnant person’s life is in danger or in cases of incest or rape, blocks Medicaid from paying for abortion services.

Seventy-three percent of the people seeking abortion services from the fund were already parents.

Since the historic 1973 Supreme Court decision on Roe v. Wadeprotecting the right to abortion, Louisiana has introduced 90 pieces of legislation aimed at restricting abortion access and undermining Roe.In November, Louisianans voted in favor of Amendment 1, which adds language to the state constitution that keeps securities or protections of a right to abortion or any mention of state funding of abortions, except for in cases of life endangerment, from ever appearing in the state constitution.

Bangel calls it a “death by a thousand cuts” approach.

“[Lawmakers are] taking an approach that chips away access in a thousand different ways,” Bangel said. “The sum effect is making it logistically complicated and frustrating to get care.”

The Supreme Court decision is the first abortion-related decision since Metairie native Justice

Amy Coney Barrett was sworn in last year, giving the court a conservative majority.

The court has been considering another case on Mississippi’s bid to reinstate a ban on most abortions for pregnancies beyond 15 weeks. Bangel said she is watching that case closely. There is only one clinic offering abortions in Mississippi, in Jackson, and three in Alabama.

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