By Melissa Patrick
Kentucky Health News
Two days before the leak of a U.S. Supreme Court draft opinion that proposes to overturn abortion rights under its 1973 Roe v. Wade decision, a panel of experts participated in a roundtable discussion anticipating such a decision. It was titled “Women’s reproductive health in a post-Roe world.”
At the 2022 Association of Health Care Journalists conference in Austin, the experts largely discussed what’s happening in Texas — which has a near-ban on abortions since abortions are now illegal after fetal cardiac activity is detected, usually around six weeks of pregnancy and before most women know they are pregnant — as a way to paint a picture of what it could look like if the Supreme Court strikes down Roe.
Sonja Miller, interim managing director of Whole Woman’s Health Alliance in Austin, a nonprofit abortion provider that has unsuccessfully challenged the new law, talked about how the clinic has had to deny abortion care to the “vast majority of Texans” who come to the clinic since the law took effect.
“Our staff are constantly in the position of having to look at another human being in the eye and telling them that they can’t help them,” she said. “We have not seen an abortion ban this inhumane since pre-Roe v. Wade.”
She added that the Texas law, which also deputizes private citizens to sue anyone who aids or abets an abortion after fetal cardiac activity has been detected, has a chilling effect and has placed everyone who works in abortion “on extreme alert.” She said it has resulted in many of their patients seeking care long before they have even missed a period or have any idea that they are pregnant and forced many of their patients who don’t “qualify” for an abortion to ask: “Where do I go now? What’s next?”
To meet patients’ needs, she said the clinic launched the Abortion Wayfinder Program
to help pregnant people travel out of state for an abortion. The health alliance has clinics in Texas, Minnesota, Indiana and Virginia.
Another challenge is that by the time a woman finds out she’s pregnant in Texas, which is often beyond the six-week ban, and is able to make out-of-state travel arrangements — coordinating transportation, housing, care for existing children, time off work and ensuring they have enough money to pay for the procedure — they are often in their second trimester, which begins at 14 weeks of pregnancy, said Dr. Crystal Berry-Roberts, an obstetrics and gynecological physician at Austin Regional Clinic.
This matters, she said, because an abortion provided in the second trimester comes with an increased risk of bleeding and infection.
Further, she said most offices don’t offer new obstetric visits until eight to 10 weeks into a pregnancy, and that the first time a woman can find out if there is something genetically wrong or lack of brain development is around 11 or 12 weeks.
“We’re talking about an unrealistic timeline,” Berry-Roberts said, referring to the six-week abortion ban.
Berry-Roberts, who only provides medically indicated abortions, added that laws that limit abortion and the political discourse around this topic increases stigma, drives pregnant people seeking abortion “into the shadows” and makes it harder for women to talk candidly about their pregnancy with their physicians. “It is unfair, it is unrealistic and it is doing harm,” she said about the Texas law
Dr. Lisa Harris, an obstetrician-gynecologist at the University of Michigan, pointed to a long list of things that must be considered beyond the impacts on reproductive health care for pregnant people if Roe is overturned, including: issues of equity; medical providers concerns about whether they are breaking the law if they counsel patients to end their pregnancies; increases in births and maternal deaths; and the implications of restrictive laws on self-managed abortions.
Further, she said the language is vague in states where abortions would be permitted if the mother’s life is at risk. “How much risk does someone need to take on to have an abortion count as life saving?” she asked.
“For example, there are patients with cardiac disease who we will quote a 25 to 30% chance of dying if they continue the pregnancy and give birth. Is that enough of a risk of dying to have qualified, I guess, to use that word, to qualify for an abortion? Or does it need to be 50% or 100%? How are we to know this?” she asked
Advice for journalists covering abortion
Sophie Novack, an independent journalist who has closely covered reproductive rights for the Texas Observer, encouraged journalists at the conference to cover abortion as a health issue, not a political one.
“So often coverage of it is siloed from other areas of reproductive health care,” she said.
Novack encouraged journalists to look at abortion through the lens of health-care access, and to offer context around percentages of people who are uninsured, teen pregnancy trends, state funding for family planning services, access to maternal health care, access to public assistance, and information that helps audiences understand how abortion restrictions affect the overall, long-term health of women.
“So thinking about all those kinds of factors together and how they fit together in the context of someone’s ability to terminate the pregnancy and hurdles that exist,” Novack said.
She also encouraged journalists to use medically accurate language. For example, she said the Texas law is not a “fetal heartbeat law” because an embryo does not have a heart at six weeks of pregnancy.
The Associated Press has recently updated its Stylebook:
Phrasing like “pregnant people” or “people who seek an abortion” seeks to include people who have those experiences but do not identify as women, such as some transgender men and some nonbinary people. Such phrasing should be confined to stories that specifically address the experiences of people who do not identify as women. See gender, sex and sexual orientation.
And our long-standing entry on abortion:
Use the modifiers anti-abortion or abortion-rights; don’t use pro-life, pro-choice or pro-abortion unless they are in quotes or proper names. Avoid abortionist, which connotes a person who performs clandestine abortions. Instead of pregnant women, use “pregnant people” or “people who seek an abortion” in stories that specifically address the experiences of people who can get pregnant but are not women. Such phrasing seeks to include people who have those experiences but do not identify as women, such as some transgender men and some nonbinary people.
The Supreme Court is expected to rule on the case of Dobbs v. Jackson Women’s Health Organization by the end of June, which will determine the constitutionality of Mississippi’s 15-week abortion ban, which raises the issue of whether a state can ban abortion before fetal viability. The court could do that without fully overturning Roe, by setting a stricter standard, but Justice Samuel Alito wrote in a leaked draft opinion that there is no constitutional right to abortion.