“They told me if I get an abortion, I will get breast cancer or bleed to death, or become infertile and never be able to have a child!” says Maleeha Aziz describing her visit to a pregnancy centre in Dallas, Texas.
The Pakistani American needed an abortion and her cousin quickly helped her locate clinic with a low priced ultrasound, via an internet search.
Young and nervous, Maleeha was horrified – the clinic showed her a 30-minute ‘propaganda’ video, then tried to scare and dissuade her by narrating ‘inaccurate risks’ of getting her pregnancy terminated, and even misguided her about its legality.
“There were two women in white lab coats who I thought were physicians. They told me that Texas has banned medical abortions because they are dangerous. I played along till I could get the ultrasound, which they performed only after assurances that I will not go ahead with the abortion. I never returned. They tried to track me down by phone for many months,” shares Maleeha, who then travelled to a Colorado for her abortion.
This was before the ban that Texas enforced from September 2021. Later she discovered that, “The women in white lab coats were not doctors. It was a hoax clinic. And I didn’t have to travel out of state to get the abortion pills, as it was legal in Texas then!”
Crisis Pregnancy Centres
The terrain that an American woman, especially in conservative states, has to traverse to find an abortion is riddled with misinformation and fear mongering.
Maleeha, like numerous others daily, had walked into a CPC – crisis pregnancy centre. Referred to as ‘fake clinics’ by pro-choice advocates, these are not medical facilities and have no medical professionals in them. Offering cheap or free ultrasound scans and pregnancy tests, often times located close to licensed abortion clinics and colleges, with deliberately similar sounding names, CPCs exist to trick people in.
Amidst religious imagery their videos of ‘happy foetuses who love their mothers’ are meant to leave pregnant women conflicted. According to Guttmacher Institute, 87 percent of centres contacted provided false or misleading medical information (2012).
A February 2022 Mother Jones article mentions, “As Texas abortion clinics have dwindled over the years due to increasingly restrictive state laws –from around 40 before 2013 to 20 today – CPCs have proliferated. There are now nearly 200 of them in Texas – the most in any state – including about 60 that receive taxpayer funds and are not regulated by the state health commission. In the United States overall, CPCs outnumber abortion clinics three to one."
In some states it is many times more. There are four abortion clinics in Oklahoma and 36 CPCs.
“We have a huge crisis of fake pregnancy centres. Set up by anti-abortion activists, these are non-medical people making medical decisions to mislead people in the name of God. They outnumber abortion clinics in the country. Many of our patients have run into them, with horrible experiences,” says a reproductive rights advocate who wishes to remain anonymous.
The Hyde Amendment
Although CPCs are funded by federal and state governments, medical abortion providers are barred from tax dollars. “There is a policy called Hyde amendment that prohibits the use of federal funds to cover abortion (except for rape, incest, or if the pregnancy endangers the woman’s life),” says Jeana Nam, who works at a medical abortion clinic, and is a member of the Texas chapter of NAPAWF (National Asian Pacific American Women’s Forum).
Reproductive rights are a core issue for NAPAWF. Soon after abortion was legalised in the US in 1973, the Hyde amendment was pushed in by anti-abortion legislators and enacted by Congress. Not technically a law, it is an attachment to the budget and has been approved annually. The US House passed a spending bill without the Hyde amendment for the first time in 2021.
Hence, after tackling the floating myths and impediments created over years by the well-funded anti-choice movement, when a pregnant person is able to reach one of the few medical abortion providers, they might not have adequate funds to pay for it. Several states have restricted abortion coverage in private health insurance plans. This is where abortion funds step in.
NARAL Pro-Choice America, Planned Parenthood, and other organisers are accumulate abortion funds, supported by philanthropy.
“We are constantly directing our members to send to the Roe fund. We also coordinate with other organisations in other states. Our abortion funds run regularly, though they do dip lower than we would like at times,” says Priya Desai of Oklahoma Call for Reproductive Justice.
Abortion Access Curtailed By Lack of Funds, Stigma
Those women who have sought abortions face societal pressure, anxiety, shame, and judgement. They are reluctant to share facts as they fear facing harassment, which in turn feeds misinformation and moralistic messaging.
With an aim to have pro-choice abortion experiences out in the public sphere, organisations like We Testify have created abortion storyteller programs.
“The slogan 'Everyone Loves Someone Who Had an Abortion' was originally said by the Executive Director of We Testify. We want to destigmatise abortion. Story sharing is a huge part of our movement to make people think it is a completely normal health care decision which allows people to have the life and family of their choice,” says Anvita Kandru, Coordinator of Texas Outreach.
Her mother is translating into Telugu, instructions on how to access abortion for Texas residents. “Some laws are intentionally worded to confuse or scare people. It is difficult for even English-speaking people to navigate, and even more difficult for non-English speakers,” adds Kandru.
Rapidly changing bills brought in by state legislatures create panic among people about legality. The leak of a draft Supreme Court document related to Dobb vs Jackson hearing, immediately resulted in numerous clinics receiving hundreds of phone calls asking if abortion is still legal.
Women already have complicated feelings about their pregnancies when they seek abortions. In more than half of the US, women have been driving hundreds of miles to reach the nearest abortion clinics in their state – there are very few, and far apart.
For example, Oklahoma has four, there are three in Louisiana, and North Dakota has just one. Upon reaching these clinics, women invariably wade through cross wielding protestors holding up pictures of aborted foetuses, shouting out to them to not kill babies.
Once they are inside, they have to navigate a medical system made confusing by conservative state regulations.
New York-based Dr Meera Shah is the Chief Medical Officer at Planned Parenthood (Hudson Peconic). She travels to South Bend, Indiana, once a month to perform abortions, as there are very few physicians in the state who do so.
She finds the rules in the two states to be starkly different: “In New York people call an ObGyn (Gynaecologist) or their doctor, visit the centre the same day, are seen by a midwife or physician, who are able to provide a medical abortion that same day. This happens six days a week. Abortion is covered by private insurances, and we reach out to abortion funds for the uninsured. But Indiana is a restrictive state and there is a shortage of abortion providers (clinics and physicians).”
She goes on to describe the clinic (the only in the area) in South Bend that she visits monthly. “The clinic is a once-a-week place. Patients have to wait to get appointments. The law demands that they be handed a copy of their ultrasound. The state requires doctors to read out a mandatory script to the patient, (given all the options including the possibility of keeping the baby to term), and then sent home for 18 hours. The law requires doctors to give abortion pills only when the patient returns,” says Dr Shah, who is also the author of The Stories Behind Abortion.
Waiting periods, required second visits, compulsory counselling, mandatory ‘life begins at conception’ scripts, complicated legal ‘informed consent’ documents, and imperative ultrasounds – all are obstacles meant to pressure patients away.
Legal Obstacles, Myths, and Restrictions
To deter people from getting abortions, states have restrictions related to the number of weeks within which abortions are possible. The September 2021 Texas Heartbeat Act made it illegal to terminate a pregnancy beyond six weeks.
Kandru says, “The deadline is so early! A lot of people are not able to get their abortions within that time, especially with just a few clinics and other legal restrictions. First you make an appointment, then wait for 48 hours. Two ultrasounds are needed in two separate appointments. Only then can you make up your mind. I vividly remember a South Asian medical student about to start her residency who had very conflicted emotional feelings and didn’t have the time to make that decision. The patients are facing a ticking time bomb.”
Then there are TRAP laws – targeted restrictions on abortion clinics. Providers believe that these are medically unnecessary and costly under-hand tactics to close down clinics.
These laws dictate width of clinic hallways, compulsory pro-life signage on walls and in restrooms, mandate admitting privileges with nearby hospitals for clinicians (such alliances are difficult because most hospitals in restrictive states are hostile to abortion), require providers to report abortion-seeking patients’ data to governments, etc.
According to Center for Disease Control, abortion has a 99 percent safety record, hence Planned Parenthood says on their site, “Politicians are not medical experts, and yet they have written TRAP legislation to chip away at abortion access — law by law, state by state — and undermine Roe v Wade. Their end goal? Shutting down health centers; making safe, legal abortion hard or even impossible to access; and leaving hundreds of thousands without care.”
The system is pregnant with legal obstacles and floating myths, regulating women’s bodies by white-male-dominated state legislatures. Planned Parenthood’s Press officer for State Media Campaigns, Olivia Cappello says, “The motivation is based in white supremacy. It is about controlling who is able to make decisions about whom, impacting lives and health. It’s just astonishing!”
One in four American women will have an abortion in their life, 75 percent of them are persons of colour and from low-income communities. The prospect of the speed at which doors will start closing on abortions in a post-Roe US is not impossible to imagine given that the odds of not being able to access one are already very high, in at least half the country, even while it is legal.
As per Center for Reproductive Rights, about 60 countries have relaxed abortion laws in the last 25 years. Only three countries have rolled back abortion rights since 1994 – the US would join El Salvador, Nicaragua, and Poland if Roe vs Wade is overturned.
(Savita Patel is a San Francisco Bay Area-based journalist and producer. She reports on Indian diaspora, India-US ties, geopolitics, technology, public health, and environment. She tweets at @SsavitaPatel.)