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Hudson Valley Abortion Rights at the Crossroads

What does this historic moment for abortion rights in the US and New York State mean for residents of the Hudson Valley?

A 1970 poster advertising a protest against abortion restrictions in New York State.
Image from the Library of Congress

Less than two months into the new year, 2019 has already proved to be a historic moment for abortion rights in the US. January saw the passage of the Reproductive Health Act, a New York State law intended to ensure access to abortion in the state if federal protections enshrined by Roe v. Wade should fall. This month, the Supreme Court surprised many observers by ruling 5-4 against a restrictive Louisiana abortion law, with Chief Justice John Roberts joining the court’s more liberal members in the decision.

The winds may soon be blowing in the other direction. Ariana Eunjung Cha of the Washington Post reports that at least 20 more lawsuits that could deliver deep blows to Roe or its 1992 successor, Planned Parenthood v. Casey, are now in the pipeline. Cha writes:

Both supporters and opponents of abortion rights describe this as the most fraught time for Roe v. Wade since the early 1990s, when the high court was filled with Republican appointees selected by presidents Ronald Reagan and George H.W. Bush, and instances of blockades, bombings, and arson at clinics were on the rise. In 1991′s “Summer of Mercy” campaign in Wichita, thousands of antiabortion protesters gathered in the hometown of George Tiller, a physician who performed late-term abortions. Tiller was killed at his church 18 years later, in 2009, by an antiabortion extremist.

New York State’s recent expansion of abortion access under the new law has put us squarely at the center of the national abortion debate. Prior to the passage of the Reproductive Health Act, so-called “late-term” abortions, those performed after 24 weeks of gestation, were illegal in the state unless there was a direct threat to the mother’s life. Late-term abortions are now permitted in New York if the fetus is non-viable, or if the pregnancy threatens the mother’s health.

The expansion of late-term abortions has galvanized opposition to pro-choice efforts. According to a recent article in the Indianapolis Daily Star, antiabortion activists are using local outrage at New York’s new law to fuel public support for more restrictive state laws on abortion.  

The most controversial portion of the Reproductive Health Act also now has a public face: Erika Christensen, who found out 30 weeks into her pregnancy that a rare condition called polyhydramnios, or high amniotic fluid levels, meant that her baby would not survive more than a few minutes past birth. In 2016, Christensen wrote publicly about her decision to have a late-term abortion that was illegal in New York State:

We were referred to Dr. Warren Hern in Colorado, one of four doctors in the entire country who will treat patients from out of state for later abortion care. Our doctor in New York assured us that “patients who have received care at this clinic have gone on to have healthy pregnancies, which we want for you.” I couldn’t remotely fathom ever putting myself through this again, but I nodded anyway. Due to a pre-existing health condition, my doctors decided the best course of action would be for me to fly to Boulder so Dr. Hern could administer a shot that would stop the baby’s heart. Then that same night I would fly back to New York, where I would be induced the next evening to deliver a stillbirth.

The shot alone cost $10,000, and we had to pay cash upfront because these procedures aren’t fully reimbursed by insurance companies. My mom gave us the money, taking it out of her retirement fund. We wondered why it was so expensive, but couldn’t figure out how to place a monetary value on Dr. Hern and his staff having to go to work behind bulletproof glass.

Spurred on by her ordeal, Christensen became a fierce public advocate for the Reproductive Health Act, going public with her story to illustrate the personal burden of late-term abortion bans on people already facing private tragedy.

Ultrasound of a pregnancy with polyhydramnios, a condition that in severe cases can be fatal to the fetus. Image source: Wikimedia Commons

Reproductive Health Act: More Access, In Theory

According to listings compiled by BookOfChoices, a project of NARAL Pro-Choice New York, almost all of the abortion providers in the Hudson Valley are practicing at Planned Parenthood clinics. Most counties in the heavily rural region have just one clinic.

Still, even in the more rural parts of the region and the state, most patients seeking an abortion in New York can find one within their own county. In contrast, Louisiana, where state law has chipped away steadily at abortion rights over the last decade, has just three clinics in the entire state, down from 7 in 2011. If the Supreme Court had not struck down the state’s new law, the practice would have been restricted to just one physician working at a single clinic in New Orleans.

The availability of abortion in a region is often limited by the small number of doctors willing to perform them. Women’s reproductive health advocates are hoping that the Reproductive Health Act will increase access to abortion in New York by expanding the pool of potential providers.

Before the passage of the Reproductive Health Act, only physicians could perform abortions in New York State, or even prescribe mifepristone, the so-called “abortion pill” that allows non-surgical termination in the first trimester. The new law allows nurse practitioners, physician’s assistants, and licensed midwives to perform abortions.

Although late-term abortions are now technically legal in New York State, only a tiny handful of clinics in the country perform abortions in the last trimester. None of them are in New York State.

Last January, the Washington Post ran a story about an unusual ceremony at one of those clinics: an interfaith religious blessing of a clinic in Bethesda, Maryland.

Everyday conversation about abortion tends to cast it as a question of faith on one side—the antiabortion side—versus secular liberalism on the other. The clergy at this ceremony said that’s not the case. Many women who seek abortions are people of faith who pray about their decision, the clergy said.

LeRoy Carhart, the doctor at this clinic, said he hears many of those prayers. “They’ll sit on the table and say, ‘Is God going to forgive me?’ I’ll say, ‘I take it you’ve prayed a lot about this.’ They all say yes.”

A month after the Reproductive Health Act became New York State law, it’s too soon to tell whether the bill’s new provisions will increase access to abortions in our region, or give New Yorkers who discover profound late-term pregnancy problems any real options beyond traveling out of state. But doctors like Meera Shah, associate medical director for Planned Parenthood Hudson Peconic, are relieved by the bill’s passage. In a recent editorial for Jezebel, Shah writes:

My patients have unique lives and circumstances that bring them to the decision to have an abortion, and it is my job, as a physician, to trust them and to support them.