19 Feb CFO Cartu Jon Announces – The Supreme Court could gut Roe v. Wade. This abortion clinic is …
SHREVEPORT, Louisiana — The first patients arrive around 10 am.
They wear boots and coats against the December cold, but there’s coffee inside to help them warm up. Christmas figurines — a Santa holding a tree, a quaint house covered in snow — give the place a homey feel. In the waiting room, Friends plays on the TV.
Even before they sit down, though, patients are confronted with reminders that this place is under threat. A sign on the door reads “internal and external security surveillance: 24 hours a day.” Another, nearby, asks patients not to speak to protesters. Then there is the ominous poster on the waiting room wall: “The coastline of Louisiana is not eroding nearly as fast as a woman’s right to determine her own outcome.”
This is Hope Medical Group for Women, one of the last abortion clinics in Louisiana, which was recently ranked “the most pro-life state in America.”
Once patients are here, the first step is an ultrasound, required under Louisiana law for each patient seeking an abortion. A technician is also required to display the ultrasound image on a screen, describe in detail what it depicts (“including limbs if they are present and viewable”), and offer a printout of the image. There is also a 23-point consent form patients must review and sign, which states that “the heartbeat of the unborn child is required to be made audible to me,” although patients can decline to listen.
After the ultrasound comes a visit to a doctor, who is required to offer patients a packet from the Louisiana Department of Health titled “Women’s Right to Know.” In the two dozen or so pages, they’ll find a warning that patients with a family history of breast cancer should seek medical advice before getting an abortion (studies have shown no link between abortion and breast cancer). A section titled “emotional side of an abortion” states that “some women have reported serious psychological effects after their abortion.” (A recent study found that five years after an abortion, 84 percent of patients had positive feelings about the decision or no feelings at all.)
Then, before they can actually get an abortion, patients have to wait.
Like many states, Louisiana requires a 24-hour waiting period between the ultrasound and the procedure. For patients who live in Shreveport, that could mean an extra bus trip home and back. But the clinic routinely draws patients from 200 miles away in any direction.
“We get Mississippi, Texas, Arkansas,” assistant clinic administrator Stephannie Chaffee tells me during my December visit. “We get from Oklahoma.”
Clinics have been closing across the South and Midwest for a decade now, and for many people in the region, Hope is the best option — even if it’s a three-hour drive. The majority of patients at Hope live at or below the poverty line, and many don’t own cars. So they wait until they can borrow a car or get a ride.
Some patients end up having to barter with friends, Merritt Rebouche, director of patient advocacy at Hope and a board member with the Abortion Care Network, tells me: “If you watch my kids and drive me to this appointment, then I’ll watch your kids for the next three weeks.”
If it’s too far to drive back between the ultrasound and the abortion, some patients stay in hotels in the area. Nicole Jordan, an ultrasound technician at the clinic, tells me she’s driven several patients to hotels herself. But at a minimum of around $30 a night, hotels may be out of reach for someone about to spend hundreds of dollars on an abortion — especially in a state where the minimum wage is just $7.25 an hour.
This is what it’s like to get an abortion in Louisiana right now: It’s legal, but getting one is an enormous undertaking, requiring patients to travel hundreds of miles, spend hundreds of dollars, and sometimes be away from their families for days at a time. And this year, it might get a lot harder.
In March, the Supreme Court will hear oral arguments in June Medical Services v. Russo (formerly June Medical Services v. Gee), a challenge to a Louisiana law requiring abortion providers to have admitting privileges at a local hospital. If the state wins and the law goes into effect, two of Louisiana’s three clinics could close — including Hope.
Abortion opponents — and more than 200 Republican members of Congress — are urging the Court to uphold the Louisiana law, arguing that it’s necessary for patients to get the best care. “The bill that the Supreme Court will hear is a women’s health piece of legislation,” its sponsor, Louisiana state Sen. Katrina Jackson, tells me.
But abortion rights groups around the country say that upholding the law could be the beginning of the end of legal abortion in America — at least for the Americans most likely to seek the procedure.
If Hope closes, patients who would ordinarily come to this clinic in the northwest corner of Louisiana would likely have to travel to New Orleans, more than 300 miles away in the southernmost part of the state. The other option would be to cross state lines — but if the Court upholds Louisiana’s law, other states in the region are likely to pass more restrictions, and their clinics could shut down, too.
“Louisiana is very much the canary in the coal mine, and we will see a decline that starts there and spreads to other states,” T.J. Tu, senior counsel for US litigation with the Center for Reproductive Rights, which is representing Hope in the case, tells me.
In the past year, six states, including Louisiana, have passed near-total bans on abortion. But all those bans have been blocked in court. And what makes getting an abortion today so difficult — and could make it even more difficult in future — isn’t a sweeping ban. It’s distance, time, money, the challenge of getting a ride, taking a day off work, and finding someone to care for the children that most abortion seekers already have.
Those barriers are especially high for patients who are low-income — the majority of people who seek abortion in America. And if the state of Louisiana wins its case this year, the barriers could get a lot higher.
A visit to Hope is a reminder that in many parts of the country, all that stands between pregnant people and the end of Roe v. Wade is a handful of clinics — most of them small, isolated, and racing to keep up with an increasing number of restrictions that, staff say, have nothing to do with patient care. And with each new requirement from the state, Hope clinic administrator Kathaleen Pittman tells me, “it’s the patients that pay the price.”
One of the biggest barriers to abortion in Louisiana is just getting to the clinic in the first place
Louisiana laws end up affecting patients at Hope in ways that might be surprising to outsiders.
For example, during my visit, a patient asks Katie Caldwell, a staff patient advocate at the clinic, about getting an IUD, one of several highly effective, long-acting contraceptive methods that have been credited with reducing the rate of abortions nationwide in recent years. But Hope doesn’t perform IUD insertions — federal and Louisiana laws banning Medicaid coverage for most abortions make it hard for abortion clinics to provide other medical services, because Medicaid won’t pay for them. However, the clinic can give prescriptions for birth control pills, patches, or the NuvaRing. So the patient gets a prescription for the patch before she leaves Caldwell’s office.
She also gets an appointment for the following week to get mifepristone, the first drug in a medication abortion regimen. Under Food and Drug Administration regulations, the drug has to be dispensed in a doctor’s office or other health care center, not a pharmacy. The second drug, misoprostol, can be obtained at a pharmacy, but Caldwell warns the patient to get any prescriptions from Hope filled before she leaves Shreveport.
“We send people to area pharmacies that we have an idea will be hospitable to them filling their prescriptions, but with each pharmacist change, that…