Georgia's 'contraceptive deserts' raise concerns for women and providers ahead of midterm elections

As abortion remains a key issue in the upcoming midterm elections, advocates for access to reproductive care say that the roughly 632,000 women who live in Georgia’s “contraceptive deserts” — areas where access to a health center that provides a full range of contraceptive methods is severely limited — will be among the most affected by the outcome in November.

“Only half of all [Georgia] counties have an ob-gyn living in them,” Alexis McGill Johnson, president and CEO of Planned Parenthood, told Yahoo News before a “Women for Warnock” event for incumbent candidate Sen. Raphael Warnock, D-Ga., in Roswell, Ga., on Sunday.

According to a report from the Georgia Board of Health Care Workforce, 76 of the state’s 159 counties had no ob-gyn and 60 were without a pediatrician in 2018.

A gynecological cabinet with chair and other medical equipment in a clinic.
A gynecological cabinet with chair and other medical equipment in a clinic. According to the Georgia Board of Health Care Workforce, 76 of the state’s 159 counties had no ob-gyn in 2018. (Getty Images)

“Just the health care infrastructure itself is limited around reproductive rights,” Johnson said. “Then you layer on the abortion ban and what that means practically around the six-week ban. Patients find out in about four weeks, and then they have to make a decision and then travel in that time.”

The ban Johnson highlighted refers to H.B. 481, Georgia’s so-called fetal heartbeat law, passed by the state's General Assembly in 2019. Republican Gov. Brian Kemp implemented the law after the Supreme Court overturned Roe v. Wade in June. The Georgia law bans abortions when the state says a fetal heartbeat is detected, which is typically around six weeks. It allows exceptions for medical emergencies to prevent the death of the pregnant person or physical impairment.

After years of abortion rate decline, Georgia has seen a yearly jump in the procedure since 2017, according to a 2021 Georgia Department of Health report. Johnson says people seeking access to reproductive care like abortion services will now have an “extra burden” that typically affects Black, brown, low-income and rural communities the most.

Additionally, data published in June by the Statista Research Department found that about 14.5% of Georgians have no health insurance. The state is tied with Oklahoma for the worst rate in the country.

Of those uninsured, a recent Georgetown University report found that over 19% of women of reproductive age (18 to 44) have no health insurance, leaving the state with one of the highest rates in the U.S.

“Essentially, what you’re doing is continuing to limit access to care, and Georgia will look a lot [like] what we’ve seen elsewhere,” Johnson said.

Johnson believes that the frustration among those affected by Georgia’s contraceptive deserts will fuel registered voters, as well as new voters, as early voting in Georgia begins on Oct. 14. Republicans in the purple state currently control the offices of governor, secretary of state and attorney general, as well as both chambers of the Legislature.

Georgia Gov. Brian Kemp and Democratic gubernatorial candidate Stacey Abrams.
Georgia Gov. Brian Kemp and Democratic gubernatorial candidate Stacey Abrams are running against each other for a second time. (Brynn Anderson/AP)

For the second time, Stacey Abrams, Georgia’s Democratic gubernatorial candidate, is running against Kemp, while Warnock is locked in a tight race to fight for his full term with former NFL star and Trump-endorsed candidate Herschel Walker.

“We have seen, since Roe vs. Wade was overturned in June, a massive increase in voter registration,” Johnson said. “We have seen young people, people of color and women register in droves, and I think they’ve seen not just access to abortion being an issue, but also a connection to voting rights and all of the ways in which democracy itself is under attack, and I think that’s what’s driving that energy.”

An Atlanta Journal-Constitution poll conducted in January found that 68% of registered voters in Georgia did not want Roe v. Wade overturned. A July poll from the newspaper found that 42% of Georgians were more likely to vote for a candidate who wants to protect access to abortion. About 26% said they would vote for a candidate who wants to limit that access.

Warnock, who worked as a sexual health educator before becoming a pastor at the historic Ebenezer Baptist Church in Atlanta, has labeled himself pro-abortion and reproductive rights, and has been an avid supporter of abortion rights.

Sen. Raphael Warnock, D-Ga.
Sen. Raphael Warnock, D-Ga., worked as a sexual health educator before becoming a pastor at Ebenezer Baptist Church in Atlanta and has labeled himself pro-abortion and reproductive rights. (Tom Williams/AP)

Last year, Walker — who has said his position is “from the womb to the tomb”completed a survey from the Georgia Life Alliance indicating that he supports outlawing abortion, including in instances of rape and incest.

“I am 100% pro-life. As Georgia’s next senator, I will vote for any legislation which protects the sanctity of human life, even if the legislation is not perfect,” he told the organization. “Every human life is valuable and absolutely worth saving.”

Access to contraception has also picked up steam in Georgia, particularly after Kemp made headlines at a University of Georgia College Republicans tailgate in early September. He was asked by a student whether he could ban the Plan B morning-after pill in the wake of the Dobbs v. Jackson Women’s Health Organization decision, which resulted in the overturning of Roe.

Kemp replied that the legislative body can “take up pretty much anything” during a session, but that it depends on “where the legislators are.” When pressed by the student on whether he could do it, Kemp said, “I think, I’d have to check and see, because there are a lot of legalities.”

A spokesperson for Kemp defended the governor’s stance on the ability of Georgians to obtain contraception.

“The governor has never opposed access to contraception, and — despite the attempts of desperate Democrats and their media allies to spread a complete lie — the full audio proves the governor’s position remains the same,” the spokesperson said via email.

Yahoo News reached out to Kemp’s office for comment on the state’s strategy to generate more access to reproductive health care. His office had not commented at the time of publishing.

Kemp, however, has touted a health care plan he rolled out during his first year in office — including a decrease of health care costs and a narrow expansion of Medicaid coverage across the state. The plan, called Pathways to Coverage, would have covered about 50,000 adults who met the work requirements and who earned no more than 100% of the federal poverty level, which is just under $12,900.

The plan has been only partially implemented due to a block by the Biden administration that came out of concerns it would disrupt pandemic-era policies. A work requirement must be satisfied in order to maintain coverage. A federal judge rejected the White House’s rationale and cleared the way for the implementation of Kemp’s plan. In August, a Kemp spokesman said his office is still reviewing its options after the ruling.

According to Abrams’s campaign website, she has vowed to collaborate with medical schools to create programs that provide tuition for people who will commit to serve at least four years postgraduate in “medically underserved rural Georgia.”

In a photo from 2014, the emergency room of Flint River Community Hospital sits closed in Montezuma, Ga.
In a photo from 2014, the emergency room of Flint River Community Hospital sits closed in Montezuma, Ga. Hospitals are closing in Georgia's rural areas, and reproductive health care services are scarce. (David Goldman/AP)

There are now almost 2 million Georgians living in what is considered a rural area. With hospitals closing in those communities and reproductive health care services effectively out of reach for hundreds of thousands of women living in Georgia’s contraceptive deserts, Evelyn A. Reynolds, MD, a specialist in gynecologic oncology and an ob-gyn based in Georgia, says both women and providers are affected.

“I’m in national physician groups on social media, and already it has had an impact because ... obviously if you don’t have enough ob-gyns locally, what do hospital systems do? They get locum providers to come in,” Reynolds said during the “Women for Warnock” event. Locum providers are doctors who step in to provide care when other doctors are absent.

“Now, with these bans,” Reynolds said, “already you see chatter of ‘Well, I’m not going to that state anymore because I can’t do the full scope of my practice,’ which doesn’t sit right with them. So whatever these laws are doing, it has an impact on women’s health.”