ATLANTA – Almost a year ago, women across the country learned that they no longer had a guaranteed right to an abortion if they wanted to. And in Georgia, it meant it was only a matter of time before access was severely restricted.
The US Supreme Court ruled on June 24, 2022 in Dobbs v. Jackson Women’s Health Organization that there is no constitutional right to abortion, overturning a nearly 50-year-old decision that said the opposite.
Weeks later, a federal appeals court enacted Georgia law banning most abortions once a doctor can detect the fetus’s cardiac activity, usually about six weeks into a pregnancy and before many people know they are pregnant.
States in the South and Midwest have enacted legislation over the past year that either severely restricts access to abortion or bans the procedure entirely.
The effects of the state law were immediate and effective in Georgia. According to the Georgia Department of Health, abortions have fallen by almost half. And abortions after the sixth week of pregnancy are all but over.
Bring the number to zero
Claire Bartlett, chief executive of anti-abortion group Georgia Life Alliance, said she was “delighted” the numbers are falling.
“We’d like to see the number at zero, but we have generations of people who have a different understanding of things,” she said. “Now we want to work on an awareness campaign to go where we are changing hearts and minds. To be honest, that is a bigger challenge.”
In the first seven months of 2022, before Georgia’s law came into force, an average of about 4,000 abortions were performed each month. Since the law came into force in late July 2022, an average of about 2,176 abortions per month have been performed through April, according to DPH data.
It is unclear how many people have been told they cannot have an abortion because their pregnancy is too advanced. It is also not easy to determine how many have left the state to have abortions.
Kwajelyn Jackson, executive director of the Feminist Women’s Health Center, said the clinic tries to conduct thorough interviews during pre-screening phone calls to ensure people don’t make unnecessary travel. However, she says that while numbers dropped immediately after the Dobbs decision, the clinic is now performing between 55 and 60 abortions per week over the three days the procedure is offered, almost as many as before the decision .
On a recent Saturday at the Brookhaven Clinic, just one of the 23 patients arriving for her scheduled abortions was turned away after the ultrasound technician found fetal heart activity. She was six weeks and one day pregnant.
Georgia law permits deferred abortions in cases of rape, incest, when the woman’s life is in danger, or in cases of “medical futility” when a fetus might not survive. As of June 8, 199 abortions have been performed in Georgia since the law went into effect after a doctor detected fetal heart activity.
Limited options
Women who seek an abortion after a doctor diagnoses fetal heart activity face a choice: go to term and give birth to a child they didn’t originally want, or—if they have the financial means—to another Travel to a country where abortion is still legal. Anyone who gives birth to a child must decide whether they want to keep the child or put it up for adoption.
A 21-year-old Georgia woman told the Atlanta Journal-Constitution that when she found out she was pregnant, she sought an abortion but found her pregnancy was too advanced to have one in Georgia. Before her unexpected pregnancy, she said, she was firmly against abortion.
The AJC does not use the woman’s, her husband’s or son’s name to avoid harassment.
The Columbus-area woman then arranged a trip to Illinois, where abortions are legal until viable, around 25 weeks gestation. However, when her family found out she was pregnant, they persuaded her to have the baby.
“I realized how selfish I was in that moment,” she said. “Then I was relieved that I didn’t have to have an abortion. … And I was happier with myself because I knew I wouldn’t do anything that would traumatize me and hurt the people I love.”
A few months after deciding not to have an abortion, she married the child’s father and now has a son who is almost two months old.
Travel for abortions
Those who have the means can travel to another state where access to abortion is less restrictive. However, the nearby places they can travel to have become more limited.
Earlier this year, Florida, North Carolina, and South Carolina passed laws similar to Georgia law. South Carolina’s law is being challenged in court and a judge has put its passage on hold, meaning abortion will remain legal in that state up to 22 weeks of pregnancy while the state Supreme Court reviews the case. Abortion is illegal in Alabama and Tennessee at all stages of pregnancy.
Those who do not have the financial means to seek help can seek help from groups such as Access Reproductive Care-Southeast, a nonprofit organization that provides money to those who need it to get an abortion.
Planned Parenthood Southeast, which serves Alabama and Mississippi and Georgia, waited until it received legal counsel’s approval to let “patient navigators” connect abortion patients to clinics in other states. Alabama’s Attorney General has said that a person who assists someone perform an abortion can be prosecuted under that state’s Conspiracy and Assistance Act, which is why Planned Parenthood doesn’t offer patient navigators there, said Vivienne Kerley-de la Cruz, director for the state of Georgia and campaigns .
Since October 2022, the patient navigators have helped 289 people get abortions, she said. Ninety percent of these were referred to clinics outside of Georgia and Mississippi. Most chose clinics in the Carolinas, Virginia and Illinois, she said. The rest came to Georgia.
Planned Parenthood’s clinics in North, East and South Florida used to average about 30 patients per month in Georgia, now it averages 80, said Michelle Quesada, spokeswoman for Planned Parenthood in South, East and North Florida. Most of the organization’s out-of-state patients are from Georgia, she said.
Earlier this year, Florida passed legislation banning abortions once a doctor can determine the fetus’ heart activity. The law, which provides exceptions for cases of rape, incest or to save the life of the mother, will only go into effect if the state’s current 15-week ban is upheld in an ongoing litigation in the Florida Supreme Court.
Jackson, executive director of the Feminist Women’s Health Center, said it is “heartbreaking” that the patients who are turned away from their clinic because their pregnancy is too advanced may no longer be able to travel to a state , in which they could later live Abortions are legal.
“We’ve seen people find a way out of nowhere — and they’re persistent,” Jackson said. “People act quickly as soon as they have a positive pregnancy test and make decisions to ensure they are getting the medical care they want.”
Medical “Dilemma”
Georgian law has also caused some confusion and concern in the medical world.
Since the restrictive abortion law went into effect, Dr. Jeffrey Marcus of North Atlanta Women’s Specialists OB/GYN practice said he has seen very difficult situations, including cases where fetal cardiac activity is still present, but the woman’s water has ruptured too early for the pregnancy to be viable.
He said doctors have to wait hours — sometimes days — for an infection or other complication that threatens a woman’s health before they can medically intervene and prescribe a treatment that induces labor to start. The abortion law prevents them from inducing labor by other means.
“It’s a predicament,” he said. “You have to wait for something to happen that puts the mother in danger. But it’s a very, very difficult situation and the doctors are very, very worried and concerned that you could be prosecuted and reported by a member of staff for doing something that they didn’t exactly agree with. It’s gotten very, very tricky.”
Before the abortion law changed, Marcus said, “You would use your clinical judgment and make a decision that you thought was right. You no longer have that luxury.”
“You know, I understand all sides,” he said, “but I think it took a lot of autonomy away from the patient and it really hampers the patient-doctor relationship that allows for a respectful approach to the patient’s wants.”
Future of Abortion in Georgia
Lawmakers on both sides of the issue have introduced bills that would either ban or allow full abortion in Georgia. None of them caught on this year.
Georgia’s abortion law remains subject to court decision, including a challenge in the state Supreme Court. In November, a Fulton County Superior Court judge overturned the state law that allowed abortions to be resumed after fetal heart activity was detected. About a week later, the state Supreme Court ruled that the law should remain in effect throughout the trial.
Judges will soon decide whether the law should stay in effect — or, as abortion-provider advocates argue, it was illegal in the first place because Roe v. Wade, which guaranteed the constitutional right to abortion, was the state law in 2019 when the state law was passed.
State Senator Ed Setzler, an Acworth Republican who supported Georgia’s law in 2019, said he was “pleased” with the decline in the number of abortions in the state since last year.
“The (abortion law) has carefully balanced the difficult circumstances that women find themselves in with the fundamental rights of the child,” he said. “I think people see the value of life in a way that makes them fall under the callousness and deadly grip of Roe v. Wade might have been able to ignore in years past. … There are children in the world today who are here – I think we can say that they are here because of the ramifications of the law.”
(Contributors Alia Malik and Helena Oliviero contributed to this article.)
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