A year ago last week, the US Supreme Court issued a monumental ruling in Dobbs v. Jackson Women’s Health Organization, overturning the constitutional right to abortion and leaving states to limit procedures.
In Georgia, the 2019 state anti-abortion law went into effect the following month. It limits abortions to the sixth week of pregnancy — before many women know they’re pregnant — and allows a few exceptions for rape, incest and maternal health. According to data from a report by the Society of Family Planning, the number of abortion procedures predictably fell from 4,150 in July to 1,850 in August. Since then, however, the numbers have been trending higher, with a post-Roe high of 2,790 in March, the latest month for which data is available.
Kvajelyn Jackson, executive director of the Feminist Women’s Health Center in Atlanta, who is one of the plaintiffs in the lawsuit challenging Georgia’s law, said these statistics apply to the center’s clinic as well. The number of patients seeking terminations of pregnancy skyrocketed in late 2022 and the first half of 2023 as women adjusted to life under the new law, took regular precautionary pregnancy tests or monitored their health more closely.
“It tells me that more patients are acting quickly to get treatment within the timeframe of this six-week restriction,” she said. “So we know that many of our patients come on the very first positive pregnancy test, and we continue to see patients coming in from states around us that have no hospital and no exemptions. If they get pregnant soon enough, they still try to come to Georgia if possible.”
Jackson said the environment is frustrating for doctors, who say the law prevents them from treating patients the way they were taught. “It’s a challenge for our medical staff to adapt to a law that isn’t really rooted in medicine and doesn’t align with best practice,” Jackson said. “I was just explaining that so many of our patients are coming in earlier now. Before the Dobbs decision, we often advised people who were that early in the pregnancy to wait until a few weeks beyond because we can see more clearly where the embryo has been implanted in the uterus.
“While there is good evidence and clear protocols that we use in these early cases, there are other decisions that our physicians would likely make if they were not bound by these restrictive prohibitions.”
Democratic Rep. Michelle Au, an anesthetist from Johns Creek, said frustration also reigns in hospitals, where doctors can be unsure whether the best procedure for a pregnant patient could result in her losing her license. Georgia’s abortion law provides exceptions in medical emergencies, but Au and other medical providers say the wording is too vague for doctors to know which procedures are permissible under which circumstances.
“Doctors in Georgia now work in an environment where we are afraid to do our jobs,” she said. “We operate in an environment where medical judgment and patient care are criminalized and where we are told that poorly written laws written by state legislators without any medical training are replacing centuries of research, science and clinical expertise.”
A divided state
While abortion providers and advocates see the Dobbs anniversary as a celebratory occasion, anti-abortionists in Georgia are celebrating. In an email to supporters ahead of a June 24 rally at the state Capitol, Cole Muzio, president of the influential conservative lobby group Frontline Policy Council, celebrated Georgia’s reduction in abortions but lamented the lack of progress on further restrictions.
“We remain a swing state with a precarious pro-life majority. While many of our members are intent on saving every life, others are more cautious. We also have an electorate across our state that, while aligning itself more closely with the Kemp position on abortion than with the Abrams position on abortion, does not support efforts toward an outright ban,” Muzio wrote.
In a January poll by the Atlanta Journal-Constitution, 49% of respondents said they would like lawmakers to make abortion access easier, compared with 21% who said they wanted it more difficult and 24% who said they that access should remain the same.
Muzio said the group’s top priority will be to push for a law requiring in-person visits to the doctor for women seeking abortions with drugs. A bill to that effect passed the Senate last year before the Dobbs decision, but failed in the House of Representatives.
The U.S. Food and Drug Administration lifted the requirement for personal prescriptions for a drug called mifepristone during the pandemic, and later made the rule permanent. In April, the Supreme Court kept mifepristone available as a legal battle over its approval makes its way through lower courts.
While an upcoming election could prompt Republicans to support tightening abortion restrictions to inspire their conservative base, the party is also aware of the unfriendly national polls, said Rep. Shea Roberts (D-Atlanta).
“I think there are Republicans in rural areas who understand the issue of health care at this point, and medical abortion is not just for abortion, it’s prescribed for miscarriage,” she said. “And so it could potentially prevent their constituents from getting medical care that’s legal in the state, so I honestly don’t know the answer to that.”
Depending on how the state Supreme Court decides on a challenge to the abortion law, lawmakers may have more to do than just refine the current law. A group that includes the Feminist Women’s Health Center is suing over the law. His main argument is that since the law, when passed before Roe v. Wade was unconstitutional, should be considered legally void. That would leave it up to the legislature to draft a new law.
The court heard the arguments in March and a decision is expected sometime before the end of the fall session in November. A decision could come much sooner, said Anthony Michael Kreis, associate professor of law at Georgia State University, but the ruling likely won’t be the end of the story.
“I expect we’ll likely see some development over the next few weeks,” Kreis said. “But I think the more important thing is that whatever happens in the Georgia case right now, we’re going to face either another round of legislation or another round of litigation. So this is really a stopover.”
This is because the court’s decision is about whether or not the law was validly passed, and not about the fundamental question of whether it is consistent with the constitutionally protected right to privacy.
“So if the plaintiffs win, that simply means the General Assembly can go back and try again,” Kreis said. “And if the plaintiffs lose, that means that [they] Go back to the courthouse and leave the Fulton County Court and the judge [Robert] McBurney decides whether or not a fundamental right to privacy under the state constitution has been violated.”
Jackson said abortion advocates are ready to continue the fight, whether in court or in the legislature. “Our work is to continue to mobilize activists across the state who care deeply about this issue, so they can make sure their elected officials understand what they need and want, and that we can push the kind of policies that are needed.” this does. Support the people of Georgia and make sure they have full physical autonomy and full capacity for self-determination,” she said.
“I don’t expect these battles to be difficult and not easy to win, but we believe that reproductive freedom is vital to our liberation and that’s why we won’t give up the fight.”
This article originally appeared in the Georgia Recorder.
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