Healthcare facilities across the country are struggling to help the influx of patients affected by the novel coronavirus. A hospital in New York brought in refrigerated trucks to use as a morgue; states worried about running out of hospital beds.
In order to ease the burden and conserve resources, some nonessential and elective surgeries are on hold across the country. According to CNN, at least 25 states implemented the federal recommendation to delay elective surgical procedures.
Anti-choice activists and politicians in different states have used this recommendation as a way to try and stop people from accessing abortion, by labeling the procedure as "nonessential." This comes even after the American College of Obstetricians and Gynecologists and the American Board of Obstetrics & Gynecology released a statement on March 18th naming abortion “an essential component of comprehensive health care.” They write, “It is also a time-sensitive service for which a delay of several weeks, or in some cases days, may increase the risks or potentially make it completely inaccessible.” For example, in Ohio, where most abortions are banned after 20 weeks, a delay could make a legal abortion nearly impossible.
But the restrictions are also coming from the federal level. The $2.2 trillion coronavirus stimulus package that passed included provisions that created "new funding hurdles for Planned Parenthood and other abortion clinics that provide health services to the poor," according to Ms Magazine.
During this pandemic, it's already difficult for people to access reproductive health services; millions have lost their job and source of income, not to mention health insurance. The ever-evolving news can also make it difficult to track how your state is handling access during the outbreak. Below, a look into the states that have moved recently to restrict access so far.
Shortly after health authorities in Ohio issued an order to stop nonessential surgeries, the state’s attorney general told abortion clinics in Dayton, Cincinnati, and Cleveland to “immediately stop performing nonessential and elective surgical abortions,” according to the New York Times.
The presidents and CEOs of Planned Parenthood of Greater Ohio and Planned Parenthood Southwest Ohio Region, Iris E. Harvey and Kersha Deibel, responded in a statement: "We are complying with the Ohio Department of Health’s order regarding personal protective equipment, which requires hospitals and surgical facilities to stop providing nonessential surgeries and procedures and take other steps to reduce the use of equipment in short supply...Under that order, Planned Parenthood can still continue providing essential procedures, including surgical abortion, and our health centers continue to offer other health care services that our patients depend on. Our doors remain open for this care."
Kellie Copeland, the executive director of NARAL Pro-Choice Ohio, also emphasized the necessity of continuing to provide during this time, saying, "The reasons that people make a decision to end a pregnancy include the impact on their health, ability to work, strained economic circumstances. All of these things are heightened during a pandemic. Denying or delaying a patient's access to abortion care puts an incredible burden on these people and their families."
Abortion rights advocates ended up filing a lawsuit in Ohio, and as a result, a district court judge issued a two-week temporary restraining order so that abortions can continue. It was then extended another two weeks, and on Thursday, April 23rd, a federal court continued to block the Department of Health from restricting access.
An executive order from Texas’s Governor Greg Abbott stated that healthcare facilities must postpone surgeries and procedures that are not immediately medically necessary. Texas’s Attorney General Ken Paxton then confirmed that included “any type of abortion that is not medically necessary to preserve the life or health of the mother.” The order is set to expire April 21, according to the Texas Tribune, and providers can be fined up to $1,000 or face up to 180 days in jail for violating the order.
After several Texas abortion providers sued Abbott and other state officials, a federal district judge granted providers a temporary restraining order. The appeals court then ruled it would pause the temporary restraining order, and on Tuesday, April 7th, the Fifth Circuit Court of Appeals ruled the abortion ban can stay.
On Thursday, April 9th, the district court issued another temporary restraining order, allowing for patients to access medication abortion. Any person who would be unable to access an abortion after the executive order expired due to gestational limits was also then able to access abortion care. But that Friday, the Fifth Circuit Court of Appeals reversed the medication abortion exemption.
From there, abortion providers filed the case with the U.S. Supreme Court but withdrew after the Fifth Circuit Court of Appeals ruled that medication abortion can now continue. However, on April 20th, the Fifth Circuit Court of Appeals reversed and said that medication abortion can again be restricted at this time.
Then, a new executive order in the state loosened restrictions, allowing elective medical procedures to take place if a facility reserves "at least 25% of its hospital capacity for treatment of COVID-19 patients" and doesn't "request personal protective equipment from any public source throughout the pandemic," according to CNN. As of April 22nd, the New York Times reports that all abortions clinics had complied and were performing abortions again.
Mississippi Governor Tate Reeves said the single abortion clinic in the state should be following state health department's guidelines and temporarily pausing elective surgeries, according to U.S. News and World Report. Reeves said, “It is without question that the lone clinic in Jackson does, in fact, operate doing procedures that are elective and not required,” before explaining he would “be prepared to try to take additional action” if the clinic did not stop.
The Center for Reproductive Rights confirmed to The Cut that as of now Mississippi’s abortion clinic remains open and active.
Louisiana's Attorney General Jeff Landry announced a "task force" to assist the Louisiana Department of Health in enforcing public health orders, including stopping elective procedures. According to The Hill, Landry stated that "elective abortions are not essential procedures," and in his task force announcement, he called out outpatient abortion clinics specifically. In response, the Center for Reproductive Rights filed a lawsuit on Tuesday, April 14th.
Kathaleen Pittman, clinic administrator for Hope Medical Group for Women in Shreveport, Louisiana, said in a statement: "If women can’t access abortion here in Louisiana, they will no doubt attempt to access care in other states, which will only hurt efforts to contain the spread of the coronavirus."
Maryland’s Governor Larry Hogan briefly appeared to be considering abortion clinics nonessential. After he issued a “stay-at-home” order for the state, he responded to a reporter’s question about abortion by saying, “We included in our directive an order to limit all elective surgeries...because we need to free up beds for the things that are going to save people’s lives.” However, according to Politico, Hogan’s office clarified that abortion providers could remain open.
According to U.S. News & World Report, in late March a spokesperson for Tennessee's Governor Bill Lee said the governor hopes no "elective" procedural abortions will be performed in the state due to the executive order that bans nonessential medical procedures. The spokesperson said in a statement: "Gov. Lee believes elective abortions aren’t essential procedures and given the state of PPE in Tennessee and across the country, his hope and expectation would be that those procedures not take place during this crisis."
On April 14th, the Center for Reproductive Rights, Planned Parenthood Federation of America, and the American Civil Liberties Union filed a lawsuit in the state. Then on April 17th, a federal judge temporarily blocked the order. The state appealed, and on April 24th, the 6th Circuit Court of Appeals affirmed the lower court’s preliminary injunction, thereby allowing procedural abortions to continue.
At first, Iowa's Governor Kim Reynolds confirmed that the state's order to suspend nonessential medical procedures included surgical abortions. A spokesperson for Reynolds told the Des Moines Register: "Proclamation suspends all nonessential or elective surgeries and procedures until April 16th, that includes surgical abortion procedures." In response, on March 30th, the ACLU of Iowa and Planned Parenthood Federation of America filed a lawsuit against Reynolds and state officials, but on April 1st, it was announced that people would be able to obtain abortion services once again and the case was dropped.
Oklahoma's Governor Kevin Stitt confirmed that abortions were included in the state's executive order that postponed all elective medical procedures. The Oklahoman reports that the governor's office said the only exceptions were abortions deemed a medical emergency or "necessary to prevent serious health risks to the unborn child's mother." Abortion rights advocates filed a lawsuit in Oklahoma, and on April 6th, a federal district judge granted a temporary restraining order, allowing abortion care to resume. Then on April 13th, an appeals court upheld the ruling and continued to block the executive order. Most recently, on April 20th, a federal district judge granted a preliminary injunction that continues to block the ban; full abortion access can resume on April 24th. The 10th Circuit Court of Appeals then upheld the lower court's ruling on April 27th.
Kentucky's Attorney General Daniel Cameron has said Governor Andy Beshear should temporarily ban abortion as part of the state's executive order to postpone elective surgeries. However, the day before Cameron's statement, Beshear told reporters he was going to "leave it to our health professionals to determine what falls into elective and the essential." On April 24th, Beshear vetoed Senate Bill 9, which would declared abortion to be an elective procedure, according to the Lexington Herald Leader.
The Hill reported that while Alabama has suspended elective surgeries, abortion providers had not gotten clarification on whether that includes surgical abortions. However, doctors performing "nonessential" procedures could be subject to criminal penalties, leading abortion rights advocates to file a lawsuit in the state. A district judge then issued a temporary restraining order, and on April 12th, a federal judge ruled that the state cannot ban abortions.
After Arkansas's Governor Asa Hutchinson ordered non-essential medical procedures be postponed, he announced the state's sole abortion clinic was under investigation for potentially violating the order, according to BuzzFeed News. The state sent a cease-and-desist letter to the clinic, stating that if they did not stop "the performance of surgical abortions, except where immediately necessary to protect the life or health of the patient" their facility license would be suspended. In response, on April 13th, the ACLU filed a lawsuit in the state. Soon after, a federal judge issued a temporary restraining order that now protects abortion services in the state.
This post will continue to be updated.
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