A surgical technician and recovery room staff member escorts a Texas patient to the recovery room after her abortion at the Trust Women clinic in Oklahoma City, U.S., on Dec. 6, 2021.
Evelyn Hockstein | Reuters
The Tulsa Women’s Clinic, one of four abortion providers in Oklahoma, may have to close entirely as soon as this summer if the Supreme Court overturns Roe v. Wade as expected later this year.
A leaked draft high court opinion last week showed the Conservative majority is prepared to overturn the landmark 1973 ruling which legalized abortion throughout the country. If the court goes ahead with the draft opinion, it would drive a wedge between states where abortion remains legal and those where it is prohibited, leaving millions of women with little or no access to abortion.
Oklahoma is one of 26 states planning to ban all abortions if Roe is struck down, according to the Guttmacher Institute, a nonprofit organization that supports abortion rights.
Oklahoma Governor Kevin Stitt signed legislation in April that makes performing an abortion a felony punishable by up to 10 years in prison or a $100,000 fine. The law makes an exception for medical emergencies where the life of the mother is in danger, but not for cases of rape or incest. The abortion ban goes into effect in August, after the current Supreme Court term ends and a Roe ruling would presumably have been delivered.
“It would mean no abortion, so it means no clinic,” said Andrea Gallegos, executive administrator of the Tulsa Women’s Clinic. “We could not continue to offer the service that we provide,” Gallegos said.
Dr. Georges Benjamin, executive director of the American Public Health Association, said striking down Roe would further entrench inequality in the US health care system and primarily punish low-income women, including minority communities. already struggling to access quality health care. People of financial means who live in states where abortion faces an outright ban will be able to travel to other states where the procedure remains legal, Benjamin said.
“Affluent women won’t have this as a major barrier. Low-income women will,” she said.
Some women who need an abortion are already forced to cross state lines even with Roe in place. When Texas spent a law last year banning most abortions, patients began fleeing to clinics in neighboring Oklahoma for care. The Tulsa Women’s Clinic saw its patients nearly triple as its sister facility in San Antonio, Alamo Women’s Reproductive Services, began referring patients there, according to Gallegos.
“We became a safe haven for Texas patients who had to flee the state to seek care,” Gallegos said.
However, Oklahoma is no longer a safe haven. The governor signed a law last week implementing the same restrictions as Texas. Abortions are now illegal after a heartbeat is detected in the embryo on an ultrasound, which occurs as early as the sixth week of pregnancy. The law, called the Oklahoma Heartbeat Law, makes no exceptions for rape or incest. It only allows abortions in medical emergencies, such as if the mother’s life is at risk.
“A lot of women find out they’re pregnant around the same time, so the window for abortion has shrunk dramatically,” Gallegos said.
The law prohibits most abortions in Oklahoma. In 2019, 56.4% of abortions in the state were performed after the sixth week of pregnancy, when a heartbeat is normally detected, while 43.6% were performed at or before week six. according to the Centers for Disease Control and Prevention.
The law empowers individuals to sue virtually anyone who performs or “aides and abets” an abortion within six years of the procedure. The defendant would face $10,000 in damages for each abortion performed. Patients requesting abortions cannot be sued.
“Now it doesn’t make sense for women from Texas to travel to Oklahoma,” Gallegos said. Since the law was passed, the Tulsa Women’s Clinic has been unable to perform abortions on about half of the patients seeking the procedure because they did not arrive before cardiac activity was detected in the embryo, Gallegos said.
Some women who are rejected in Oklahoma will likely cross state lines to get abortions at neighboring clinics. Arkansas Y Kansas, where the laws are not so restrictive. However, if the Supreme Court overturns Roe, Arkansas also plans to ban abortion. That would leave just four clinics in Kansas, where the state Supreme Court ruled in favor of abortion rights in 2019, to serve millions of people in the region.
In that scenario, wait times at Kansas clinics would increase substantially due to an influx of patients from neighboring states, further limiting access, according to Zack Gingrich-Gaylord, a spokesman for Trust Women, which has clinics in Wichita. , Kansas and Oklahoma City. that provide abortions.
“The clinic system in this region is simply not strong enough to withstand the loss of so many clinics,” Gingrich-Gaylord said.
Although the Food and Drug Administration now allows women to receive the abortion pill by mail, Oklahoma also prohibits doctors from using telemedicine appointments to prescribe the pill and monitor patients who take it. the pill, mifepristone, is approved for use up to 10 weeks of pregnancy. In 2019, about 54% of early pregnancy abortions were medical abortions with the pill, According to the Centers for Disease Control and Prevention.
Dozens of the country’s leading medical groups, in briefs filed with the Supreme Court last year, argued that abortion is a safe and essential component of health care. They included the American Public Health Association, the American Medical Association, the American College of Obstetricians and Gynecologists, and many others.
Benjamin, of the public health group, said repealing Roe creates a “huge risk to women’s health.”
“When the procedure is not performed with proper guidance in an appropriate sterile environment, there is a risk of septic infection and death,” he said. “There is a risk of sterility. There is a risk of bleeding to death.”
Obstetricians and gynecologists are concerned that proper medical training on how to perform abortions safely could plummet if Roe is struck down. The percentage of residents receiving abortion training could drop from 92% as of 2020 to 56% if state abortion bans take effect, according to a study published last week in Obstetrics and Gynecology, a peer-reviewed medical journal. peers. The authors said the training is important not only for abortion care, but also for other medical skills, such as managing miscarriages.
Dr. Jen Villavicencio, of the American College of Obstetricians and Gynecologists, called the Supreme Court’s draft ruling an unprecedented attack on women’s health care that will create fear, confusion and impede patients’ access to care. of pregnancy in general. Now that many women face the reality of having to travel to get an abortion, Villavicencio said the group is working to create an expanded network of doctors to help patients access care wherever they live.
“It is critical that we expand access in states where it is not restricted to help those traveling from where it is,” he told CNBC in an emailed statement.
In the Northeast, Governor Kathy Hochul promised that New York, which legalized abortion three years before Roe v. Wade, will offer safe harbor to anyone who needs it.
“This is a fundamental right under attack,” hochul said Thursday. “Come to New York. This is the birthplace of the women’s rights movement.”