Jul. 3—With Ohio's handful of abortion clinics severely restricted and potentially threatened with closure, options for people seeking to end their pregnancy are limited — but not necessarily out of reach.
On June 24, the same day the U.S. Supreme Court's overturned Roe v. Wade, a federal judge lifted the injunction blocking Ohio's 2019 "Heartbeat Bill," which banned almost all abortions after five or six weeks' gestation — before many women know they're pregnant.
Nothing in current Ohio law prohibits traveling out of state for an abortion or criminalizes having an abortion elsewhere, said Jessie Hill, professor of law at Case Western Reserve University.
"You can never control what some prosecutor is likely to try, but it is my understanding that that conduct is not forbidden under Ohio law," she said.
In general, Ohio's laws against abortion target the providers of those services, not the people who receive them, Hill said.
The "Heartbeat Bill" criminalizes performing an abortion after the first five or six weeks of pregnancy. Similarly, the "Born Alive" bill passed late last year penalizes medical personnel who don't take extensive measures to keep alive an infant born after an attempted abortion.
Planned Parenthood of Greater Ohio is still providing medication and surgical abortions up to six weeks' gestation, said Iris Harvey, the group's president and CEO. For those who may have already passed that mark, Planned Parenthood can still help, she said.
"We still encourage patients to call our clinics, so we can assist them in knowing whether they are eligible for an abortion in Ohio or whether they need to go to another state," Harvey said.
Patients can receive ultrasounds to determine how many weeks along they are, and if it's more than six, Planned Parenthood has trained "navigators" who will help match them to clinics in other states, she said.
"We encourage patients to come in, let us do the work for them," Harvey said.
But that is a complex process, since every state's laws are different and clinics offer different services, she said. Differences include mandatory waiting periods, required pre-abortion education and limits on medical procedures.
"We match that to the patient's needs," Harvey said.
The YWCA is a resource for women in poverty, experiencing domestic violence or sexual violence, said Shannon Isom, president and CEO of YWCA Dayton and a member of the Antioch College board of trustees
Now those calls are increasing from women, including minors, who suddenly need to make decisions about their pregnancy, she said.
The organization is stockpiling pregnancy tests and Plan B, and preparing to help women get to other states for services, Isom said.
Dozens of major companies, from Amazon to Zillow, announced they will pay for or reimburse travel expenses for abortion-related medical care. Some are also paying for those medical costs or covering them under employee health insurance. The firms include many with large numbers of employees in Ohio.
Several national nonprofit groups have also announced or reiterated their willingness to help pay for individuals' travel or abortion services.
Planned Parenthood works with abortion funds to help cover some of those costs if necessary, Harvey said.
But there's also the issue of whether the patient can take the time to drive out of state. Clinics in Illinois or Pennsylvania can be a one-day trip, but gestational progress and legal limitations might require traveling further, Harvey said.
According to the National Abortion Federation, as of July 1 clinics providing medication and/or surgical abortion remained open in Detroit, Michigan; Pittsburgh, Pennsylvania; Louisville, Kentucky; Indianapolis and South Bend, Indiana; and Charleston, West Virginia. But the group noted that many states are rapidly changing laws in the wake of Roe's overturn, and multiple lawsuits further confuse the picture.
Kentucky and Michigan have abortion bans as strict or more so than Ohio's, which also went into effect with the overturn of Roe, but judges in both states have blocked their enforcement for now. Both court actions were due to lawsuits by Planned Parenthood and the ACLU. On Friday, the Ohio Supreme Court rejected a request by those groups to block the Heartbeat Bill's enforcement here.
The drug Levonorgestrel, known as the "morning-after pill" and often sold under the brand name Plan B, is an emergency contraceptive that can be bought in stores or online without a prescription.
"That does not involve abortion, and that is not illegal" Hill said. "There's nothing in Ohio law that could be read to forbid accessing that."
But the "morning-after pill" is distinct from the medications Mifepristone and Misoprostol, a two-drug combination that ends pregnancy if taken within about the first 10 weeks of gestation.
"That is considered an abortion, so it is regulated like abortion," Hill said. It would fall under the standards of the Heartbeat Bill, limiting its use to the first five or six weeks of pregnancy, she said.
"There are websites where you can order it online and have it sent to you," Hill said. "Some of them may be complying with various states' laws and some may not be."
In many places medication abortion is available from Planned Parenthood, other health clinics and doctors. In some states it's available by mail via telehealth, but in Ohio the drugs must be dispensed in-person by a physician, according to the Kaiser Family Foundation.
Hill said she hasn't researched Ohio's law in detail on the subject but doesn't know of anything that would allow prosecution of a person who orders abortion medication for their own use.
"I think it does get into more of a gray area in terms of helping people access those services," she said.
Ohio's abortion laws generally exempt from prosecution the person receiving an abortion, but the law against "aiding and abetting" criminal acts could put the providers of abortion medication at risk, Hill said.
About half of the 20,605 abortions in Ohio were chemically induced in 2020, the most recent year for which the Ohio Department of Health has compiled a report. Of the statewide total, 98% of all abortions were performed by 18 weeks' gestation. Only 0.5% took place beyond 20 weeks.
Ohio Attorney General Dave Yost's office did not answer questions on the continuing legality of contraceptive and abortifacient medication.
"The Heartbeat Bill is now in effect. We will work with our client agencies who have a role in enforcement, but will withhold comment at this time," Yost's communications director, Bethany McCorkle, said in an email.
The "Heartbeat Bill" prohibits abortion after a fetal heartbeat is detectable. It allows exceptions if the mother risks death or serious physical harm but does not permit later abortions in cases of rape or incest. Prior to that bill's effective date, abortion was legal in Ohio for up to 20 weeks' gestation, or about 22 weeks after the start of a woman's last menstrual period.
Under Ohio's new restrictions, even when abortion is technically legal, a "threatening environment" is created through ambiguity, burdening people with navigating new laws and timelines in addition to the previous difficulty of accessing the handful of locations where abortions were available, Isom said.
"All of these things, when you add them up, become an additional burden that we did not have," she said. "We are a state that is unsafe for Brown and Black women, if you are pregnant."
Ohio is in the top 10 states of dangers to maternal health for minorities, and restricting abortion access will make that worse, Isom said.
If Ohio continues restricting abortion access, she said, those laws will result in more deaths — particularly among the poor and minority communities who already have the least access to quality health care.
Women's organizations have always relied on allied advocates and activists, and that's needed now, Isom said. Instead of "whispering about how awful these laws are," people need to get involved and speak openly, she said.
The implementation of the "Heartbeat Bill" here, and various restrictions or bans in other states, sent a "surge" of thousands to clinics in states where abortion is legally protected, Harvey said.
"When Ohio went to the six-week ban, immediately people had to triage their patients and send a large number at the same time (to clinics in other states)," she said. "I would stay that definitely all of the out-of-state and still-operating abortion providers are having a tremendous surge. Whether or not they are able to take any more patients, it depends day by day."
The people impacted the most are the ones who can least afford the time and money to travel elsewhere, a result of politics dictating medical care, Harvey said.
"That should not be the way healthcare is delivered," she said. "The best that we can do is comfort them in knowing that we will help them get there."
Abortion laws in nearby states
Indiana: Abortion is banned after 22 weeks of pregnancy, with some exceptions built into law. Patients must have an 18-hour waiting period before having an abortion
Kentucky: A judge last week granted a request to temporarily suspend the state's law that went into effect after the Roe v. Wade overturning that banned all abortions.
Michigan: Republicans want to enforce a 1931 law that banned abortion, but Democrats in the state have said they will work to prevent that from happening. A state judge issued a temporary injunction on enforcement last week, so abortion remains legal.
Pennsylvania: Abortion is banned after 24 weeks after a person's last menstrual period. Those seeking an abortion must wait 24 hours before the procedure.
West Virginia: Abortion is banned with no exceptions for rape or incest. A lawsuit filed last week seeks to block enforcement of the law.