EXPLAINED: States shift as America’s abortion landscape shifts

COLUMBUS, Ohio (AP) – Nearly three months after Roe v. Wade was overturnedthe abortion access landscape is still changing significantly in some states, sometimes very rapidly.

Changing restrictions and lawsuits in neighboring Indiana and Ohio this week illustrate the whiplash for providers and patients navigating sudden changes in what’s allowed where.

Sister clinics that just weeks ago was sending patients from Ohio, where most abortions were banned, to Indiana, where the procedure was allowed, now has flip-flopped roles after the two states’ access restrictions were reversed, at least temporarily.

Here’s a deeper look at the current state of the changing national landscape:

WHAT’S CHANGED THIS WEEK?

An Ohio judge blocked enforcement Wednesday of the state’s ban on most abortions after fetal heart activity is detected. The ban had been in effect since shortly after the US Supreme Court overturned Roe on June 24. The judge’s action allows abortions to resume in pregnancies up to 20 weeks’ gestation for 14 days.

So on Thursday, a new Indiana law went into effect that bans most abortions, marking its status as the first state in the nation to approve new abortion restrictions since the High Court’s abortion ruling. Republican Gov. Eric Holcomb signed the ban into law on August 5.

Under the new law, abortion is only permitted in cases of rape and incest before 10 weeks after conception; to protect the patient’s life and physical health; or if a fetus is diagnosed with a fatal anomaly. A doctor who performs an illegal abortion or who fails to file the required reports must lose their medical license.

HOW DOES THIS AFFECT PROVIDERS?

All seven abortion clinics in Indiana lost their licenses Thursday under the state’s new law, which allows abortions to be performed only in hospitals or hospital-owned ambulatory surgery centers. More than 98% of the state’s abortions were performed by these clinics in 2021.

Abortion clinics in the state told The Associated Press they will remain open to referring patients out of state, including to neighboring Ohio.

“I thought today would be the worst day,” said Dr. Katie McHugh, a provider at the Indianapolis abortion clinic Women’s Med, told the AP Thursday. “But I think the worst day was yesterday when I knew that the patients we saw in the office yesterday were the last ones we would see and know how much that meant to all of us who were there – the staff, the doctors and the patients – that we were able to provide that care until the last minute.”

Dr. Alison Case – who has provided medication abortions at South Bend abortion clinic Whole Woman’s Health since 2020 – will continue her work as a family practice physician in Indianapolis.

She said she worries about the labor and delivery patients she oversees at a city hospital.

“I think there will be more people forced to continue their pregnancies, so I think we will see more births,” she said. “But I think it’s important to note that we’re also going to see more of these complications.”

In Ohio, clinics braced for a surge of patients coming from surrounding states after the judge’s ruling — though they realize that could be short-lived.

“Well, I never expected to be a wave state,” said Iris Harvey, president and CEO of Planned Parenthood of Greater Ohio, using the field’s new language. “For 14 days we might be.”

Ohio clinics that had been banned from performing most abortions will resume those services starting Friday.

HOW DOES THIS AFFECT PATIENTS?

The changing legal landscape has required patients in affected states to regroup, sometimes repeatedly. Kellie Copeland, executive director of Pro-Choice Ohio, an abortion rights advocacy group, said some have been unable to terminate their pregnancies.

Harvey said Planned Parenthood has created a central location for abortion requests and hired additional staff, often social workers, to help people navigate different states’ laws as they change.

McHugh said Women’s Med received “dozens” of calls Wednesday from patients who couldn’t schedule an abortion that day because of Indiana’s 18-hour wait for the procedure.

“Each time it was a difficult conversation because each time it was like breaking the news to someone that they couldn’t get their care,” McHugh said.

Lawyers were still investigating whether patients who traveled from Indiana to Ohio would be able to get anything other than a surgical abortion. The two-pill regimen used for medication abortions would generally mean taking one pill in a permissive state and one in a restrictive state, with the latter potentially breaking the law, providers said.

Anti-abortion groups continue to tout existing restrictions, and new ones are being passed in states in the wake of the Supreme Court ruling.

“Ohio is pro-life, and this law was supported by the people,” said Margie Christie, president of the Right to Life Action Coalition of Ohio. “Women do not need abortion in Ohio. We have abundant resources for mothers and their children to thrive.”

WHEN WILL THE LANDSCAPE CHANGE AGAIN?

With Indiana’s ban taking effect, the nation has 13 states with current bans on abortion at any point in pregnancy, and one more, Georgia, with a ban on abortions after fetal heart activity can be detected — usually around six weeks, often before women realize they are pregnant.

Although it had not yet been signed by the governor, a ban had been approved by West Virginia lawmakers Wednesday had already caused the state’s only abortion clinic to close, potentially pushing more patients to neighboring Ohio. Arizona’s ban is scheduled to take effect on Sept. 24, with lawsuits and legislative moves expected to continue changing the status of abortion access in some states.

Then, on Nov. 8, abortion-related measures will be on ballots in at least five states. In California, Michigan and Vermont, voters will be asked to protect the right to abortion. In Kentucky, the question is whether to amend the state constitution to declare that it does not include the right to abortion. And Montana voters will decide on a measure to require medical care for infants born alive after an attempted abortion.

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Reporter Geoff Mulvihill in Cherry Hill, New Jersey, contributed to this report. Arleigh Rodgers is a staff member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places reporters in local newsrooms to report on undercover issues. Follow Arleigh Rodgers on Twitter: @arleighrodgers

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