A Year Without Roe: How Health Care Has Changed Under Louisianas Strict Abortion Ban
A year after the US Supreme Court's landmark decision on abortion rights, Roe v. Wade overturned, marking a sea change for fertility care in Louisiana as abortions declined and attorneys on both sides of the issue shifted positions.
When Louisiana's abortion ban went into effect, pro-abortion groups began helping women get to states that offer legal abortions and educate doctors and patients about how the abortion system works. Abortion opponents have called for increased funding for "maternity centers" and have fiercely fought legislative efforts to clarify or soften the ban, citing the need for resources to help new mothers.
"The pro-life movement has always stood for mothers and children, and its mission is more important than ever," said Sara Zagorski, Louisiana State Press Secretary for Right to Life.
Louisiana state law prohibits surgical and medical abortions, except in rare cases where the procedure can save the life of the pregnant woman or the fetus cannot be saved after birth. After efforts to exclude these circumstances failed in the last legislative session, the law makes no exceptions for rape or domestic relations.
Advocates are now bracing for further battles to clarify or weaken the ban — something pro-life and other anti-abortion groups have vowed to fight hard. And while people on both sides of the debate voice the need for expanded health care, anti-abortion groups say support for pregnant women in the state is stronger than ever, while pro-abortion groups challenge that statement.
Abortion victims also had a hard time understanding the new laws — in some cases, their pregnancies were terminated out of state, even though state laws allow such terminations. Doctors who refuse to break the law are viewed with suspicion in the care they provide.
"Physicians in rural areas are afraid to deal with this," said Michelle Ehrenberg, executive director of Lift Louisiana, which advocates for increased access to abortion. They don't even want to deal with pregnant women who have any kind of complications, it's really terrible."
The changing landscape of healthcare
After the Supreme Court ruled in the Dobbs case, all three abortion clinics in Louisiana were closed and the procedure became more common.
In the six years from 2015 to 2021, the number of abortions performed in the state has already declined, according to data from the Louisiana Department of Health. About 9,300 abortions were performed in 2015, up from 7,444 in 2021. It is not known how many abortions were performed. Exported in 2022; But medical professionals and pro-abortion groups say elective abortions have stopped.
Abortion activists and politicians say the ban's ambiguities have created a culture of fear in which doctors choose to perform abortions, especially in serious cases, such as when the mother's health may be at risk.
Alex Seeger, Right to Life Director of Education, and Ashley Gilliam, Director of Youth Programs, will discuss upcoming events on Friday, June 23, 2023, at the Louisiana Right to Life office in New Orleans. . (Photo by Chris Granger | The Times-Picayune | NOLA.com)
Dr. Jennifer Avegna, director of public health for the city of New Orleans, said last year the changes continued after Attorney General Jeff Landry sent a letter to providers declaring abortion a crime. He supported the expansion of abortion.
"This has caused real confusion and fear among providers," Avegno said.
Pro-abortion lawmakers supported the law's wording, which spells out exceptions quite clearly. Later, the Department of Health published a list of cases where this procedure is allowed.
But news reports are full of stories of women having abortions for fear of violating the ban: A Baton Rouge woman carrying a fetus without a skull traveled to New York to have an abortion after doctors in the state refused. An Acadiana woman travels to Colorado to terminate an unviable pregnancy.
Changing political priorities
State Sen. Beth Mizell, R-Franklinton, sponsored a bill in the last legislative session to create tax credits for maternity health centers. The measure has been controversial because it does not give the same benefits to facilities that provide abortions and because abortions require complex medical standards and a licensing process for abortion providers in medical facilities.
Mitzel said her bill aims to remove barriers for pregnant women in rural areas who cannot easily access conventional hospitals. Often the centers are the only aspect of reproductive care in rural areas, she says.
The Dobbs decision alone underscores a problem that was serious in Louisiana, Mizell said: appalling infant and maternal mortality rates.
"Most of the women who get these services don't go to these centers, it has nothing to do with Roe v. Wade," she said. They go there because they are pregnant and need help."
His efforts are an example of what some conservative and anti-abortion groups in Dobba are calling for: more health care, adoption programs and other services that align with pro-life values.
But Avenue, like many other abortion advocates, doubts the staunchly conservative legislature's commitment to providing such help.
"A $100 million cut to LDH does not indicate increased access to health care," she said, referring to the drastic health department budget cuts that occurred in the final moments of the legislative session. "I think what we have seen does not live up to these words. I don't see a significant expansion of pro-life policies.
In the new situation, pro-abortion organizations like Planned Parenthood, which supports abortion access but never knew about the procedure in Louisiana, stepped in to help people get abortions out of state. In the 10 months since Dobbs' decision, the group's Gulf Coast chapter has helped more than 1,500 Louisiana and Texas women get out-of-state abortions, said Kendra Parks, the group's communications manager.
The group also continues to offer birth control, testing and treatment for sexually transmitted infections, cancer screening and gender-affirming health care, among others, to people over 18.
Planned Parenthood Medical Center in Baton Rouge is pictured on June 23, 2023.
The suspension should settle down
An April poll by Rep. John Couvillon, a Baton Rouge Republican from Lift Louisiana, found that a majority of Louisiana voters approve of some exceptions to the abortion ban, with 73% saying a doctor should be allowed to perform an abortion if necessary. Abortions are supported by 70% in the interest of the patient's health and in cases involving crimes such as rape and sexual offenses between relatives.
However, this spring, lawmakers in the House of Representatives rejected bills aimed at explaining the dark side of the abortion ban, including health professionals and abortion advocates.
One such bill sought to clarify that doctors could surgically terminate an ectopic pregnancy. The current law allows such a termination (called annulment), but does not explicitly say that surgical intervention can be used. Otherwise, doctors do not need to rely on an ultrasound to diagnose a miscarriage.
A bill to create special circumstances when pregnancy is the result of rape or domestic relations.
Right to Life, a powerful anti-abortion group, opposed the bills as a threat to unborn children. Zagorski, the group's spokeswoman, said Right to Life welcomes future discussions "as long as legislative changes do not cause further harm" to how Louisiana law treats pregnant women.
She said the group is focused on defeating legislation that "threatens our pro-life laws."
These kinds of exemptions should serve as unification, Avegno said. She hopes the legislature will revisit them next year.
"The instruments approved in this session did not require the repeal of the ban on abortion; they tried to explain and advocate for patients in order to eliminate this unnecessary confusion,” she said. I still hope for a democratic process.
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