Access to abortion in Pennsylvania could erode if Roe v. Wade is canceled

Twelve weeks into a pregnancy that no one in her rural Pennsylvania hometown knew about, Sarah Hammond started driving to get an abortion.

There was no clinic in the 23-year-old small town of York County, where she worked in a manufacturing plant paying off college loans. His partner had recently been deployed overseas. And the pregnancy, she had just learned, was to end in miscarriage. An abortion would allow her to control how her body went through the experience.

But first she had to drive to the nearest clinic – an hour and a half round trip. Pennsylvania law then required him to listen to a doctor read the alternatives and make the trip again after a mandatory 24-hour waiting period.

“I kind of passed out,” she said. “It’s a nightmare when you have an experience like that.” Hammond didn’t speak publicly about his experience until more than two years later, during a 2020 run for public office.

In the vast swath of Pennsylvania between Pittsburgh and Philadelphia, getting an abortion can be nearly as difficult as in Mississippi, the state at the center of a leaked draft U.S. Supreme Court decision that appears on the to overturn abortion rights nationwide. Although Pennsylvania has never enacted restrictions as strict as Mississippi’s ban on abortions after 15 weeks, existing laws have still effectively wiped out access in much of the Commonwealth. Over 90% of abortions take place in eight of Pennsylvania’s 67 counties; only 14 counties even have an abortion provider.

Although abortion opponents say such laws are necessary to ensure safe medical care, Pennsylvania has reduced access to abortions and made the process cumbersome for patients and providers.

Living near a clinic is pointless for those who cannot afford hundreds of dollars for a medical service not covered by Medicaid or most private insurance plans. Those who can find the money must go through mandatory counseling and then wait 24 hours. Minors need permission from a legal guardian. And everyone has to perform tests that medical experts consider unnecessary for most patients.

This is the legacy of Pennsylvania’s pivotal role in a decades-long legal debate over abortion rights.

“If you’re someone who doesn’t have a lot of money, who’s limited in your support system, who lives in a rural area, you’re underage, or you’re part of a historically marginalized community, these burdens are insurmountable,” said Roxanne Sutocky, director of community engagement for Women’s Centers, which operates abortion clinics in Philadelphia, Cherry Hill, Connecticut and Georgia.

Pennsylvania was among the first states to restrict access to abortion after the US Supreme Court affirmed it as a right Roe vs. Wade. The Pennsylvania Abortion Control Act of 1982 mandated mandatory counseling, the 24-hour waiting period, and parental consent for minors, and also required spousal notification for married people.

A Supreme Court ruling in a case brought by Planned Parenthood against then-Pennsylvania Governor Bob Casey Sr. in the 1990s upheld all but the spousal notification requirement, creating the legal framework for increasingly restrictive state laws that followed elsewhere in the country.

At least 14 states have since passed bills banning abortion after six weeks and 26 states are “certain or likely” to ban abortion immediately if deer is reversed, according to an analysis by the Guttmacher Institute, which campaigns for the right to abortion.

Pennsylvania has never gone this far, but has forced clinics to close by enacting building and operating requirements that clinic operators find difficult to meet.

Corridors must have a certain width, examination rooms must have a specific size; there are requirements for parking spaces and front door canopies. It costs $2 million to $5 million to build a clinic or retrofit an existing medical building to comply, said Melissa Reed, CEO of Planned Parenthood Keystone, which operates reproductive health clinics in eastern and southern Pennsylvania.

All consultations and procedures must be performed by a doctor, even medical abortion appointments via telehealth, where a doctor watches on video the patient swallowing a pill to end a pregnancy.

After many of these rules came into effect in the 2000s, the number of abortion clinics fell to 18 clinics in 2017. There are currently about two dozen abortion providers, a combination of clinics and hospitals, according to a list maintained by Abortion Liberation. PA Fund, which helps pay for abortions. The majority are concentrated around Philadelphia and Pittsburgh, leaving 53 counties without an abortion provider.

Following the recently leaked court opinion, Democratic Governor Tom Wolf has pledged to protect abortion rights while in office. But her term ends in January, and Pennsylvania’s Republican-led legislature is already preparing bills to roll back abortion rights.

“[T]here is a lot more heavy work that needs to be done at the state level to help usher in the post-deer generation,” said State Rep. Kathy Rapp, majority co-chair of the Pro-Life Caucus, which represents northwestern Pennsylvania.

Abortion – and access to an abortion – can be difficult for anyone. But the barriers tend to be tougher for blacks, Latinos and Indigenous people, who are already more likely to struggle to access health care, said Rachel Villanueva, a New York-based obstetrician and president of the National Medical Association. , a professional. Association of Black Physicians.

“It is the population that already does not have access to quality care that will suffer disproportionately,” Villanueva said.

In Pennsylvania, blacks are nearly seven times more likely than whites to have abortions, according to health department statistics.

According to most recent report from the Pennsylvania Department of Health.

With clinics so rare in Pennsylvania, the 24-hour wait often requires an overnight stay, which can mean lost wages, lodging and childcare costs — all on top of the $450 to $550 how much does the procedure cost.

Medicaid, the state-funded health insurance program for low-income families, does not cover the procedure. Several patient advocacy groups are fighting in court to change that.

“The financial burdens are overwhelming for many people,” said Elicia Gonzales, executive director of the Palestinian Authority’s Abortion Liberation Fund.

Medical abortion, which uses oral and vaginal medications, has become as common in Pennsylvania as abortions performed surgically in clinics. Many patients prefer this option because they do not need to travel to a clinic, as these appointments can be held virtually.

But Pennsylvania requires blood and urine protein tests first — lab work that is not medically necessary for the vast majority of patients, said Sutocky of the Women’s Centers.

The organization’s Cherry Hill Clinic orders these tests only when the patient’s medical history warrants it.

“Our Philadelphia and Cherry Hill centers are 15 minutes apart, but worlds apart when it comes to regulatory oversight and impact on providers and patients. .”

Roxanne Sutocky, director of community engagement for women’s centers that operate abortion clinics in Philadelphia and Cherry Hill

New Jersey does not have a waiting period or require family notification, and the state’s Medicaid program can pay for abortions. The state also allows medical professionals other than doctors to perform abortions.

Earlier this year, Governor Phil Murphy signed into law the right to have an abortion.

“Our Philadelphia and Cherry Hill centers are 15 minutes apart, but worlds apart when it comes to regulatory oversight and impact on providers and patients. “said Sutocky.

After her abortion in 2017, Hammond often thought about the distance she traveled, the cost, the fact that she couldn’t take more than a day off to recuperate and cope. The pregnancy was unplanned and Hammond did not feel ready to be a mother, but more importantly, she had already begun to miscarry. The possibility of obtaining a surgical abortion was emotionally and physically more acceptable than waiting for her pregnancy to end naturally.

What bothers her the most, she says, is that the experience is even more difficult for people with fewer resources than she had.

Hammond began talking about her experience campaigning in 2019 as the Democratic candidate for Pennsylvania’s 11th congressional district, which represents Lancaster County and parts of York County. She lost the election, but continued to advocate for women’s rights by sharing her story at rallies and Planned Parenthood events. Talking was scary at first, but her voice gets louder each time she tells her story.

“I draw strength from it now,” she said.

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