As access to abortion has dried up across the South and Midwest, nowhere is it less secure than Louisiana, where a looming Supreme Court decision has the potential to leave the state with just one abortion clinic. While one side says the law in question makes the procedure safer for women, pro-abortion rights advocates argue the regulation is designed with one goal: to regulate abortion out of existence.

The Supreme Court announced this month it would hear arguments in the case of June Medical Services v. Gee, which challenges one of Louisiana’s many restrictions on abortion. For those on both sides of the abortion debate, the court’s decision to take up the case was vitally important: It’s the first abortion-related case since the high court’s ideology shifted conservative with the confirmation of Justice Brett Kavanaugh.

For the first installment of “Abortion in America: Louisiana,” CBS News reporter Kate Smith spoke to T.J. Tu, senior counsel for litigation at the Center for Reproductive Rights and the lead counsel for June Medical Services v. Gee. Tu told CBS News the Louisiana law at the center of the Supreme Court case  – the “Unsafe Abortion Protection Act” – isn’t about safety, but rather is a way for the state to eliminate abortion access without having to overturn Roe v. Wade, the 1973 Supreme Court decision that legalized abortion nationwide.

“[Anti-abortion rights politicians] understand full well that these laws are a very surgical strike on abortion clinics and will force them to close,” Tu told CBS News in an interview on October 10. “And if they can do that with bogus laws like this one, then the Supreme Court never even has to consider whether Roe v. Wade is good law, they can just make abortion inaccessible for women throughout the state.”

In June Medical Services v. Gee, the Supreme Court will consider a Louisiana state law that requires doctors who provide abortions to have admitting privileges at a hospital no less than 30 miles away. Tu, who’s arguing to strike down Louisiana’s law, explained to CBS News why that specific requirement has been so effective in shutting down abortion access. Tu said that if the Supreme Court upholds the law, he expects even more anti-abortion regulations to be introduced and more clinics to close.

Below is a transcript of the interview with Tu. It has been edited lightly for clarity.

Kate SmithWhat’s at the heart of the Supreme Court case?

T.J. Tu: At the heart of this case is whether states like Louisiana can regulate abortion providers out of the practice of medicine. In this particular case, the law requires admitting privileges, which is a law that the Supreme Court already looked at only three years ago, out of Texas, where they struck down the law. And the question is whether the Louisiana law should meet the same fate.

SmithWhole Woman’s Health [the case that considered the admitting privileges requirement in Texas] is extremely similar to this June Medical Services case. What’s the difference?

Tu: There is no difference. The law is identical. And it’s not identical by coincidence. It’s identical on purpose. So the legislators in Louisiana saw Texas passed the same law that closed half the clinics in that state and said, ‘We want to do that, too.’

So the law is word for word the same. In Louisiana, like Texas, it has no medical benefit for patients and the disastrous effect would actually be worse in Louisiana. In Texas, the law closed half the clinics. In Louisiana, it would close all of the clinics except one and leave only one doctor for roughly a million women.

SmithSo if this law is so similar, why did the Supreme Court take this case?

Tu: The Supreme Court had to take the case. They had to take it because the lower court in our case actually upheld the law, despite the fact that the Supreme Court only three years ago struck the same law down. And that’s really untenable. The Supreme Court can’t stand back and let lower courts violate their own precedents. So they had to jump in and look at this because it’s very clear that the law is identical.

SmithThere is one major difference between three years ago and today. There’s an ideological shift on the Supreme Court. Is that something that concerns you?

Tu: The makeup of the court is different, but the Constitution is the same. A law that the Supreme Court struck down only three years ago in Texas has to be unconstitutional. In [the case out of] Louisiana today, the Supreme Court, many of the justices have said that they believe in precedent. And that means following the rulings that have been laid down before. If that concept of precedent has any meaning, it means that this law has to meet the same fate as the Texas law.

Smith: I’d love to get in a little bit more about the law in question. What are admitting privileges?

Tu: Admitting privileges give doctors the right to actually admit patients to a local hospital. And what people really need to understand is, they’re totally medically unnecessary when it comes to abortion care. Abortion today is an extremely safe procedure. So the likelihood that a patient is ever going to need to be admitted to a hospital is pretty much near zero. So doctors who perform abortions don’t need admitting privileges.

But here’s the kicker: they also can’t get admitting privileges for a whole host of reasons. Doctors who perform abortions are excluded from admitting privileges. Many hospitals only give privileges to doctors who send them lots of patients. Abortion providers don’t send lots of patients to a hospital, precisely because abortion care is so safe. So when you outlaw abortions unless doctors have admitting privileges, you basically put a lot of really good doctors out of the practice of medicine, you close clinics, and you leave patients with literally nowhere to go.

SmithYou’re representing Hope Clinic, one of the three clinics left in the state. Can you tell me a little bit about the doctor’s experience trying to get admitting privileges?

Tu: Absolutely. So let’s just take one of the doctors who’s actually a plaintiff in this case – ob gyn, decades of experience, he went to a hospital to try and get admitting privileges where he actually had been on faculty for 18 years. And they said, ‘You know, now that you’re providing abortion care, we’d really not like to get involved.’

Then he went to a second hospital. And that hospital said, ‘We’ll consider your application, but only if you give us a list of all the patients you’ve seen in a hospital in the last year.’

But of course, he hasn’t seen any patients in a hospital because none of his patients had any complications. So they refuse to even consider his application.

So then he goes to a third hospital. And he says, ‘I’m really out of options. I need admitting privileges.’ And they say to him, ‘There’s some people on staff who think giving you admitting privileges given the nature of your work would be bad for hospital business.’ So through no fault of his own, he doesn’t have admitting privileges, and he has to tell his patients, ‘I’m sorry, I can no longer be your doctor.’

SmithWhat you’re describing doesn’t seem to have anything to do with safety.

Tu: These laws have literally nothing to do with safety. And you don’t have to take my word for it. Leading medical organizations like the American Medical Association, the American College of Obstetrics and Gynecology – they all oppose these laws. And even more than that, the Supreme Court only three years ago said these laws are unnecessary for women’s health and safety because abortion care today is already so safe. In fact, the Supreme Court said there’s not even a single woman in the entire state of Texas who would have had a better result if her doctor had admitting privileges. And the same is true in Louisiana. We have been litigating this case now for five years, and Louisiana has never been able to point to even a single woman in the state whose care would be better if the doctor had admitting privileges.

SmithThere has to be another side to this, there has to be a reason why someone in a state house would believe that admitting privileges would help someone seeking an abortion.

Tu: I don’t think so. We’re talking about a state like Louisiana, that has gone on record saying that its end goal is to ban abortion. Just this past year, it passed a six-week ban on abortion. Next year, they’re going to consider a constitutional amendment to ban all abortions. We know what the end goal is. And admitting privileges laws are just a short circuit to get there.

They understand full well that these laws are a very surgical strike on abortion clinics and will force them to close. If they can do that with bogus laws like this one, then the Supreme Court never even has to consider whether Roe v. Wade is good law. They can just make abortion inaccessible for women throughout the state.

SmithSo you’re saying through all of these new smaller regulations, you can effectively overturn Roe v. Wade in a completely different way.

Tu: Absolutely. And they’ve been at this now for over 10 years. If you look across the country, we have seen over 400 of these laws, restrictions on abortion providers that basically make it impossible for them to continue providing good quality, cost-effective care to patients. So they shut their doors. And if you’re a patient in Louisiana, what does it matter if Roe v. Wade is still good law if you literally can’t find a single doctor to provide the care that you need.

Smith: On the other side, people believe that there is a moral problem with abortion, and some people believe it is akin to murder. What does that mean for you? If someone truly believes that, is that problematic to you?

Tu: I understand that we live in a country where people’s views are very diverse, especially on this issue. But we also live in a country where women are allowed to make this decision for themselves, in consultation with their families and with their physicians. And as long as that’s the law, I’m here to defend their right.

SmithThis law would not only impact access to abortion in Louisiana, it could impact nationally how women access abortion. Can you speak to what women outside of Louisiana might see if the Supreme Court upholds this law?

Tu: Absolutely. If the Supreme Court does not strike down this bogus Louisiana law, you are going to see anti-abortion activists double down, triple down on these types of restrictions. And it won’t just be admitting privileges laws. It’ll be any number of sham restrictions that are nominally about women’s health, but of course, are really just designed to shut down clinics.

We’ve already seen over 400 of these laws in the last decade and we’re going to see tons more unless the Supreme Court does what it did three years ago and says, ‘Not so fast, you can’t just run roughshod over women’s constitutional rights.’

SmithWe’ve seen an unprecedented wave of anti-abortion restrictions just this year. Do you think that’s a response to a new ideological makeup of the Supreme Court?

Tu: I don’t think there’s much mystery about that, because the anti-abortion activists have said that’s what they’re doing. They see the change in the court as an opportunity for them to do things that even a couple of years ago would have been considered really unconstitutional.

The makeup of the Supreme Court is not supposed to radically change our underlying fundamental constitutional rights. But of course, it’s inspired them to have a go at it. And that’s where the country finds itself today.

Smith: If the Supreme Court does uphold this law, Louisiana would go down to one clinic for all of the women in the state. What kind of burden does that put on people seeking abortion?

Tu: It puts a tremendous burden on patients. For many of them, that will mean that there’s literally nowhere to go in the state, because of course, one doctor cannot possibly treat all the women in the state. So plenty of women will have no doctor at all.

Women who actually can find their way to this doctor are going to face longer wait times. They’re going to push their procedures later into pregnancy. It’s going to be more expensive. Overcrowded clinics, less time with the doctor, and many women will have to go out of state.

And you have to realize that the campaign to restrict abortion access in the south has been ruthless, so there are very few clinics even in the neighboring states. What we have to worry about also is that when women have diminished options, some may take matters into their own hands and pursue things that are really unsafe, or even illegal.

SmithLouisiana wouldn’t be the only state with one clinic left. Nationally, how might this impact access?

Tu: Louisiana could [join] six states down to only one clinic. And really, that’s remarkable. But it’s a sign of what anti-abortion activists have been up to for the last decade. While much of the public has been talking about Roe v. Wade, anti-abortion activists have been steadily passing laws that put clinics out of business. So Roe v. Wade stays on the books, but abortion access goes away. Think about Louisiana: In 2001, that state had 11 clinics. Since then, year after year, they’ve passed regulation after regulation after regulation culminating in the admitting privileges law that we’re talking about today. And now we’re down to only three clinics, and this law would reduce it down to one.

SmithHow many other states might go down to one clinic, or even none?

Tu: Only time will tell, but I’m worried it may be plenty, because it’s not just admitting privileges laws. Anti-abortion activists have come up with loads of ways to put clinics out of business. And the Supreme Court’s decision three years ago was a real push on the brakes to say, ‘Hold on a minute, you can’t get away with this.’

If the Supreme Court takes its foot off the brake, we’re just going to see a whole bunch of the same bogus restrictions that are going to close clinics overnight.

Smith: Are you saying that if a Supreme Court upholds Louisiana’s law, politicians would pass even more anti-abortion restrictions than we’ve seen?

Tu: Absolutely. This past year was a terrible year when it comes to women’s constitutional rights. If the Supreme Court doesn’t stick by its precedent, it’s only going to take the lid off things. And I worry the country may be consumed with ridiculous laws that are meant to close clinics.


The bifurcation of abortion access in the United States means more clinics should be built on the border of states with onerous anti-choice restrictions, advocates say.

The location of the new Planned Parenthood clinic in Fairview Heights, Illinois, was strategically chosen to reach as many patients in the region as possible.
Michael Thomas / Getty Images

After 18 months of secret construction, Planned Parenthood will open one of the nation’s largest abortion clinics in southern Illinois this month, expanding access not just in the state but across the midwest.

The new health center in Fairview Heights, Illinois, will replace the city’s smaller Planned Parenthood clinic, which provided family planning and medication abortion services to more than 5,000 patients in 2018. The location of the new facility, just 13 miles from Missouri’s last remaining abortion clinic in St. Louis, was strategically chosen to reach as many patients in the region as possible, said Yamelsie Rodriguez, president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri.

The 18,000-square-foot facility, equipped to serve 11,000 patients a year, is the latest abortion clinic to be built near the border of a state where lawmakers have restricted access to abortion care at every turn. Reproductive rights advocates say it will be critically important to construct abortion-providing facilities near states where people are burdened by medically unnecessary anti-choice laws.

“We specifically chose Illinois because we know the policies in that state have made Illinois an oasis for access to the entire spectrum of reproductive health-care services,” Rodriguez told Rewire.News.

Missouri is one of six states with only one abortion provider, and that provider’s state license has been in jeopardy this year as anti-choice politicians continue to adjust licensing requirements. Conversely, Democrats in Illinois have passed legislation to protect and expand abortion access, making it one of the least restrictive states in the country. An increasing number of patients from surrounding states are traveling to Illinois to receive abortion care.

“Planned Parenthood of the St. Louis Region and Southwest Missouri has been looking to expand and protect access to comprehensive reproductive health care not just in Missouri, where we know abortion access hangs on by a thread, but in the Midwest region, where we have states like Arkansas and Kentucky increasing restrictions to limit women’s access to these services,” Rodriguez said.

The divide between Illinois and Missouri illustrates an emerging trend across the country, as states with Republican-held legislatures, primarily in the South and Midwest, continue to make abortion care inaccessible, while states with Democratic-majority legislatures in the West and Northeast protect and expand access. In the first six months of 2019, state legislatures enacted 58 abortion restrictions, 26 of which would ban the procedure in all, most, or some cases, according to the Guttmacher Institute.

In Colorado, another state many people travel to for abortion care, the location of abortion clinics is strategically chosen to reach those needing services, said Laura Chapin, spokesperson for NARAL Pro-Choice Colorado. Colorado is one of seven states that doesn’t restrict abortion at any stage of pregnancy. Colorado clinics served women from 34 states in 2018, the Denver Post reported.

“There’s a Planned Parenthood facility on the eastern side of Denver off I-70. That’s not an accident,” Chapin told Rewire.News. “There should be a national standard of care across the country. That’s why you have constitutional rights that aren’t dependent on your geography.”

While 2019 has brought a surge of GOP-backed abortion bans, spurred by hopes that conservatives on the U.S. Supreme Court will overturn Roe v. Wade, Democratic-led state legislatures have passed a record number of bills meant to secure and expand abortion access, said Elizabeth Nash, senior state issues manager for the Guttmacher Institute. In the first six months of 2019, states have enacted 93 proactive provisions, including 29 that protect abortion rights, 11 that increase access to contraception, and 15 that seek to improve comprehensive sex education.

“The immediate catalyst is a more conservative Supreme Court, but these proactive bills are also a reaction to a longer trend of abortion restrictions,” Nash told Rewire.News. “And there isn’t a lot of overlap. States are either looking to ban abortion or protect it.”

Planned Parenthood built the new Fairview Heights facility using a shell company to avoid interference from protestors, CBS News reported. Other Planned Parenthood projects have been halted by protestors harassing contractors and putting pressure on other vendors The new clinic will begin serving patients in mid-October and will provide a broad spectrum of reproductive health-care services including medication and surgical abortions, cancer screenings, annual exams, family planning, HIV prevention, and STI testing.

Though the new Planned Parenthood facility in Illinois will be equipped to serve thousands of patients, many across the Midwest will still have to travel long distances to receive care. People in the middle or southern regions of Missouri will need to drive at least a couple hours to reach an abortion provider in either St. Louis or Illinois. People in western Missouri could seek care in eastern Kansas, but will still need to travel to get there.

“We know that increasing one access point doesn’t necessarily mean all people will be able to seek the care they need, but Planned Parenthood is committed to reducing as many barriers as we can,” Rodriguez said.

While the new Planned Parenthood facility will expand access in Missouri and Illinois, the same strategy may not be as effective in other parts of the country where neighboring states have onerous restrictions, Nash said.

“If we are looking at the current political environment, particularly in the South, you aren’t going to find many states where building a facility on a border will really increase access,” Nash said. “Certainly for Illinois, building capacity there is part of a solution, but if you’re in Alabama or Mississippi, where potentially could the next clinic be?”

As state legislatures continue to pass laws aimed at either restricting or expanding access to abortion care, more patients will be forced to travel or go without the care they need.

“I do think the existing divide in access will continue and be exacerbated, and that isn’t where we need to be,” Nash said. “We need to be looking at what patients need, and making sure they get the services they desire and deserve with respect and dignity.”


Mary Kay Culp, executive director of the anti-abortion group Kansans for Life, speaks to a legislative study committee, Tuesday, Oct. 1, 2019, at the Statehouse in Topeka, Kansas. The committee is considering whether lawmakers should propose an amendment to the Kansas Constitution to overturn a state Supreme Court decision declaring access to abortion a fundamental right. (AP Photo/John Hanna)

Kansas conservatives are trying to overturn a state Supreme Court decision that protects abortion rights and threatens years’ worth of Republican-enacted restrictions, guaranteeing an election-year fight over amending the state constitution.

A legislative study committee opened two days of hearings Tuesday on a ruling in April by the state’s highest court that access to abortion is a fundamental right under the Kansas Constitution. The Republican-led committee is expected to urge the full, GOP-controlled Legislature to put a proposed constitutional change on the ballot next year for voters to consider.

Anti-abortion groups and legislators said Tuesday that they’re still drafting their proposal. Mary Kay Culp, executive director of Kansans for Life, said the measure wouldn’t seek to ban abortion outright but would declare that the Legislature determines how it is regulated.

If the effort succeeds, Kansas would be among a handful of states in which voters have added provisions to their state constitutions to declare that they don’t grant a right to an abortion. Alabama and West Virginia approved theirs last year, and Louisiana voters are considering a ballot question next year.

“We’re really stuck here,” Culp told the committee. “There is no other way to do it.”

Abortion rights opponents didn’t push for action before lawmakers adjourned their annual session in May, saying they wanted to confer with lawyers throughout the country and build political support.

The Legislature has long had anti-abortion majorities, but abortion opponents were a bit spooked in early May, when anti-abortion lawmakers narrowly failed to override Democratic Gov. Laura Kelly’s veto of a bill that would have required providers to tell patients about a disputed treatment to stop a medication-induced abortion after it has been started.

Overriding a veto requires the same two-thirds majorities in both chambers that are required to put a proposed constitutional amendment on the ballot for a statewide vote.

And in Iowa, another Republican-leaning state where the highest court issued an abortion-rights ruling in 2018, lawmakers have failed to move forward with a constitutional change, and one couldn’t go before voters there until 2022.

“Those politicians who are very opposed to abortion, for whom this is their No. 1 issue, realize that this isn’t an easy task anymore,” said Rachel Sweet, a lobbyist for Planned Parenthood Great Plains. “It’s going to be tricky for them to get the votes that they need.”

The Kansas court decision came as other states moved to ban most abortions in direct challenges to the U.S. Supreme Court’s historic 1973 Roe v. Wade decision. In Kansas, the April decision means that even if Roe were overturned, state courts could reject new restrictions or invalidate those enacted under Kelly’s conservative Republican predecessors.

The Kansas Supreme Court declared that the state constitution’s Bill of Rights grants a “natural right of personal autonomy” protecting a woman’s right to end her pregnancy. Critics see that as an overreach because most abortions were illegal in Kansas Territory when the state constitution was adopted in 1859.

Two justices in the 6-1 majority have announced their retirements, and Kelly, an abortion rights supporter, will name their replacements in the coming months, with no oversight from lawmakers. Abortion foes also are pushing a proposed constitutional change to require state Senate confirmation of Supreme Court justices, hoping that the court eventually would move to the right.

“Then, we are inserting politics into the judicial decision-making process, and that’s a very bad idea,” said state Rep. John Carmichael, a Wichita Democrat who supports abortion rights.

The Kansas court’s abortion decision blocked enforcement of a first-in-the-nation ban on a common second-trimester procedure. Special health and safety regulators for abortion providers have been tied up in state court since 2011.

Abortion opponents worry that even long-standing laws, such as one requiring a parent’s consent for a minor’s abortion, could be in jeopardy if the decision isn’t overturned.

“Personally, it’s my top priority,” Kansas Senate President Susan Wagle, a conservative Wichita Republican, said in an interview. “And I have a lot of colleagues who agree that this is most important.”


Michigan Gov. Gretchen Whitmer (D) threw a wrench into Republicans’ plans to funnel state funding to clinics that lie to pregnant people and don’t provide a full range of reproductive health services.

Whitmer, who won the governorship in 2018, last week used her line-item veto power to prevent Pennsylvania-based Real Alternatives from using more state dollars to line Real Alternatives executives’ pockets while failing to meet the promised metrics for success and promoting an anti-abortion agenda.
Bill Pugliano / Getty Images

Michigan’s reproductive rights powerhouse Gov. Gretchen Whitmer (D) recently smacked down $700,000 in state funding for a group with a long history of misspending taxpayer dollars and deceiving pregnant people.

Whitmer, who won the governorship in 2018, last week used her line-item veto power to prevent Pennsylvania-based Real Alternatives from receiving more state dollars while failing to meet the promised metrics for success and promoting an anti-choice agenda.

Funding for Real Alternatives should have never made it into the Michigan budget, much less to our governor’s desk. The idea of increasing what the state was giving the anti-choice group is an insult to me as a woman, a taxpayer, and a person capable of reading a simple balance sheet. But given the absurdist theater of state politics of the past few years, I’m not the least bit surprised.

Months after Whitmer proposed her budget, Republican lawmakers tried to corner her by taking a summer vacation and giving her mere days to prevent a government shutdown. It wasn’t fair, and it wasn’t right. But what do you expect from GOP officials with a history of taking money away from needy families and children?

Real Alternatives has been proven to misuse money intended to serve vulnerable households with newborn children. They grew their own executives’ paychecks, missed yearly goals they promised to fulfill for the Michigan Pregnancy and Parenting Support Program, and funded anti-choice crisis pregnancy centers that lie to and manipulate people who seek abortion care.

We’ve known Whitmer is a powerful ally for reproductive rights. As a state senator and a representative, she was no stranger to the uphill battle against nonsense anti-abortion legislation. She fought back against attacks on later abortion care in 2008, and tried to fend off so-called rape insurance in 2014, although—unfortunately—both eventually passed with Republican support.

But it shouldn’t take an effective ally to see through Real Alternatives’ charade. Real Alternatives is just one piece of the growing anti-abortion movement in Michigan and across the country.

Since the spring, anti-choice groups Michigan Values Life (backed by Right to Life Michigan) and the Michigan Heartbeat Coalition have launched two ballot initiatives to make second-trimester abortions inaccessible and criminalize abortion at six weeks’ gestation, respectively.

But even without those ballot initiatives, abortion care is barely accessible for Michiganders. From Detroit to Kalamazoo, people have to wait for available appointments at clinics, pay for abortion out of pocket unless they purchase an additional insurance rider, and plan around a 24-hour forced waiting period to obtain an abortion.

And while legislators are trying to pay Real Alternatives to fund fake programs, our Planned Parenthood affiliates are under financial stress after a Trump administration policy forced the organization to reject federal family planning funding in order to keep providing abortion services.

When we find the small victories in the long list of battles pro-choice advocates face here in Michigan, we’ll take them.

If not for Whitmer’s strong pro-choice leadership, Republicans would’ve handed over the money to Real Alternatives. This would have been one more win for the right’s nationally coordinated attack on reproductive freedom in the United States.

Everyone knows abortion restrictions are not about protection or medical necessity—bad-faith arguments put forth by anti-choice Republicans. Making abortion illegal or inaccessible is a way for conservatives to oppress and punish people who seek necessary health care.

Funding groups like Real Alternatives is about taking money away from those who need it. Even without mentioning the word, “abortion,” funneling taxpayer money into Real Alternatives was a direct attack on abortion rights.


Banning abortions isn’t particularly effective. When governments restrict access to abortion, abortions actually continue to take place at roughly the same rate, according to the World Health Organization. But they get less safe. When abortion services are denied or limited, coat hangers, toxic herbal medicines and unqualified practitioners step into the breach, while medical professionals who provide proper care are criminalized.

Total bans or restrictive abortion laws in countries like El SalvadorPoland and more recently several U.S. states (including Louisiana, Ohio, Kentucky, Mississippi, Georgia, Alabama and Missouri) are designed to control and confine women and girls to stereotypical gender roles. They are an affront to their human rights and dignity and constitute gender discrimination. For transgender and queer people who need abortions, such restrictive laws are the latest in a long line of attacks on their rights and freedoms.

Organizations defending human rights have documented the agony and despair stemming from restrictive abortion laws around the world. One of the most harrowing stories is that of “Ms Y”, a woman who was granted asylum in Ireland after being beaten and raped by paramilitaries in her own country. Ms Y tried to kill herself several times when she was told she could not end her pregnancy, which was the result of rape. She was eventually forced to give birth by C-section. At every step of the way, the Irish authorities’ concern for the protection of the fetus trumped any consideration of Ms Y’s mental and physical health.

Last year Ireland joined the list of nearly 50 countries that have expanded access to lawful abortion over the last few decades. It was a historic move which came too late for Ms Y, but which will protect others from suffering the same trauma.

More recently, we have seen the horrific impact of criminal abortion laws being used to punish people for suffering pregnancy-related complications. In El Salvador, women who suffer miscarriages or stillbirths are routinely “suspected of having abortions” and charged with homicide.

In April 2016, Evelyn Hernández, a 21-year-old El Salvadorian woman, suffered an obstetric emergency at home, resulting in the loss of her pregnancy. She was arrested, tried and sentenced to 30 years in jail for aggravated homicide. In February this year, a higher court overturned this ruling and ordered a re-trial — which found Evelyn innocent. However, on Sept. 6, the Salvadoran Public Prosecutor’s Office announced that it would appeal that judgement – showing the authorities’ obsession with charging her under the country’s draconian laws.

We must continue to stand up to governments’ efforts to control women’s and girls’ bodies. According to the US-based reproductive health non-profit the Guttmacher Institute’s latest report, as of 2017, 42% of women of reproductive age live in the 125 countries where abortion is highly restricted (prohibited altogether, or allowed only to save a woman’s life or protect her health). Jurisdictions around the world are going to extreme lengths to restrict abortion access — stripping those who can get pregnant of their human rights and bodily autonomy.

Any person who does not control what happens to their body cannot be free. The debate around abortion should go beyond whether a person’s life is endangered by pregnancy. At the core of the issue is a person’s right to make decisions about what happens to their body. This right is critical to enabling all people who can get pregnant to fully exercise their human rights and to live their lives with dignity. Governments must not only decriminalize abortion and ensure access to safe abortion in practice, but also create social conditions in which people can make pregnancy-related decisions free of oppression, discrimination, stigma, coercion, violence, lack of opportunities or punishment.

More and more countries have woken up to this fact, despite the alarming rollback of reproductive rights in some countries, like the United States or Poland, driven by anti-choice groups and supported by populist politicians. Over the last 25 years, around 50 countries have changed their laws to allow for greater access to abortion. Although national contexts vary, one thing has united all successful campaigns to reform abortion laws: women speaking out. From Ireland to South Korea, activists have helped dispel the stigma and secrecy surrounding abortion by sharing their stories. In Argentina and Poland, over a million women have marched to demand that their voices be heard.

People who need, or have had, abortions deserve our support and solidarity. Whether by donating time and resources to national abortion networks, taking to the streets in protest or educating people in our lives about the need for safe abortion, we all have a role to play in reclaiming our rights.

At the same time, governments must expand access to safe, lawful and affordable abortion and contraception for all people. Not only is it the humane thing to do, it is a state obligation under international law. It will prevent countless deaths, life-long trauma and life-changing injuries.


In 1962, a woman named Sherri Chessen Finkbine, who was the host of a children’s TV show, learned that a tranquilizer she had been taking for chest pains contained a drug known to cause birth defects. This was definitely troubling enough, but Finkbine was pregnant too. Knowing that the fetus was in danger, the mother of four, accompanied by her husband, sought an abortion at a hospital in Phoenix, Arizona.

A doctor agreed to do the procedure, which at the time was illegal except in atypical health circumstances. But after Finkbine’s story made it into the press, the hospital reversed the decision, and the family of six was at the center of a fiery national moral debate. Eventually Finkbine went to Sweden and obtained an abortion. She was able to exercise her reproductive freedom, but she also lost her job as a result.

That August, the nonpartisan polling group Gallup conducted its first-ever poll concerning abortion, specifically about Finkbine (called “an Arizona woman” in the poll) and her decision to have the procedure. The poll asked: “As you may have heard or read, an Arizona woman recently had a LEGAL abortion in Sweden after having taken the drug thalidomide, which has been linked to birth defects. Do you think this woman did the right thing or the wrong thing in having this abortion operation?” When the poll was released in September 1962, 52% of the nation said the Arizona woman did the right thing; 32% said the abortion was the wrong thing; and 16% had no opinion.

Among those surveyed, 54% of men said it was the right thing, as did 50% of women.

The Gallup press release announcing that poll was headlined “Public Agrees With Abortion Action Taken by Mrs. Finkbine.” Nearly 60 years after the American public was asked to judge a working mother from Arizona, the subject of abortion, in one form or another, continues to have support from a majority of Americans. It just may not feel that way.

Abortion is almost always presented as a divisive and contentious issue. How can it not be when clinic workers know their protesters by name? When clinicians have reported more than 3,000 incidents of protester obstruction and more than 1,000 cases of trespassing at facilities? Since at least the first major wave of murders of abortion providers and their staffers in the 1990s, abortion has been largely presented as a ride-or-(literally)-die issue.

The truth is, though, abortion is largely condoned. One could even say abortion is popular. And while abortion may become more divisive when you dive into party identification, many other societal markers show that the medical procedure and the freedom it allows remain popular issues. Gallup has been tracking abortion as a social issue since 1975, two years after Roe v. Wade was decided by the Supreme Court, with one consistent question used to gauge public opinion: “Do you think abortions should be legal under any circumstances, legal only under certain circumstances or illegal in all circumstances?”(The analytics company has tracked abortion through other questions starting earlier, but the 1975 question lets us measure (un)favorability over decades.)

When that question was asked in 1975, 55% of Republican voters said abortion should be legal under certain circumstances, with another 18% believing abortion should be legal under any circumstances. Only 25% of Republican voters in 1975 said abortion should be illegal no matter what. When looking at independent voters, these numbers were similar: 58% said abortion should be legal in certain conditions; 24% said legal under any conditions; and only 16% said abortion should be illegal.

These numbers were relatively similar when polling Democratic voters in 1975. Fifty-one percent said abortion should be legal under certain circumstances and 19% thought abortion should be legal under any circumstances. The Democratic voting pie was rounded out with 26% saying abortion should be illegal. This means that among the self-identified Republicans and Democrats polled, abortion had roughly the same amount of broad support, 18% and 19% respectively.

In 44 years the numbers haven’t moved that much. In 2019, 55% of Republican voters still said that abortion should be legal under certain circumstances. The number of Republicans who said abortion should be legal under any circumstances dropped 6 points to 12%. The number of Republicans who said abortion should be illegal increased by seven points from 25% to 32%. For independents, the numbers have changed even less: The only movement in 44 years was for those who believe abortion should be legal only under certain circumstances, which decreased from 58% to 56%.

Numbers among Democrats have seen real shake-ups, despite the trend lines staying at roughly the same level. Fewer people believe abortion should be legal in only certain circumstances (51% to 45%), but the number who believe abortion should be legal in all cases increased from 19% all the way to 39%. Additionally, the percentage of people who believe abortion should be illegal in all circumstances decreased from 26% in 1975 to 14% in 2019.

“The overall trend hasn’t moved very much, but that’s masking the fact that Democrats have become more supportive of abortion rights and Republicans have become more entrenched in the pro-life position,” Gallup senior editor Lydia Saad told Teen Vogue.

To Saad’s point, Republicans who identify as “pro-life,” as opposed to “pro-choice,” increased from 51% in 1995, when Gallup first started asking the question, to 75% in 2019. Those who identify as pro-choice dropped by 21 points during those 24 years. Democrats who identify as pro-choice increased by 10 points to 68% and those who identify as pro-life dropped by 4 points to 29%.

Polling shows that support for abortion is up on both sides of the aisle. A poll by NBC News and the Wall Street Journal found that the number of Democrats agreeing that “abortion should be legal all or most of the time” grew by 13 points between 2008 and early June 2019, when the poll was conducted. Republicans increased their broad support for abortion by four points during that same period.

That support was cited by National Abortion Federation interim president and CEO, the Very Rev. Dr. Katherine Hancock Ragsdale: “The majority of people in this country want [people] to have safe, compassionate, quality health care,” Hancock Ragsdale told Teen Vogue. “Even if that were not true, [if] the majority didn’t agree, that doesn’t mean it’s okay to deny women safe, compassionate, quality health care. This is a basic human right that cannot be denied because of numbers, and a majority of people know that.”

Oddly, party identification is one of the only societal identifications where this split in opinions on abortion is so clear. Saad said that while the partisan entrenchment is real, it overlooks the crossover Americans have in their views on the procedure: “People are so nuanced on abortion that it oversimplifies public opinion. It makes it sound like this intransigent two different camps when there’s, in fact, a lot of overlap [in] views among both groups about when abortion should be legal.” Saad continued, “I always like to tell people there’s a lot more opportunity for compromise than you would think from the politics of it, or even these labels.”

Interestingly, views on abortion are not divided along gender lines. In May 2018, 26% of men and 31% of women favored legal abortion under all circumstances. This number has only grown since Gallup started tracking the opinion in the late 1970s; it was then 21% of men and 22% of women.

“Gender is one of the least differentiating demographics on abortion,” Saad told Teen Vogue. “Year to year, it goes back and forth whether men or women are more pro-choice or more pro-life. If you average it out over our history, it comes out pretty even-steven.”

Saad’s assessment remains true for the participants who favor abortion legalization but only in certain circumstances. In 1979, 54% of men and women said they favor legal abortion in certain circumstances. By 2018, the numbers had barely moved: 53% of men and 48% of women.

These numbers track with what Linda Greenhouse, coauthor of Before Roe v. Wade: Voices That Shaped the Abortion Debate Before the Supreme Court’s Ruling, witnessed for decades while covering the Supreme Court for The New York Times. “All that’s changed is our politics. And the politics have been driven by particular, very engaged interest groups and politicians, not by anything that the public wants changed,” she said.

There have always been conflicts about abortion despite its popularity, Greenhouse added. “Public support for the right to abortion has basically not changed. It’s a little up, a little down. It’s been the case since Roe v. Wade; there’s a solid majority of the public that support women’s access to abortion,” she said. “One part of our efforts of the Before Roe v. Wade book was to show that it wasn’t the court in Roe v. Wade that created the conflicts over abortion. There were conflicts over abortion before then.”

Abortion may have incredibly vocal opponents, but polling that’s been conducted since before abortion was legal shows that reproductive choice was and remains popular. Maybe it’s time for the national media to treat abortion supporters as the loudest voices in the room.


A fund in Georgia is responding to restrictive legislation with a familial kind of care.

Oriaku and Dirichi Njoku, of the abortion fund arc-Southeast.Photograph by Andrew Lyman for The New Yorker

n June, 1994, at a pro-choice conference in Chicago, twelve black women gathered together to talk. One, Loretta Ross, was the executive director of the first rape crisis center in this country. Another, Toni Bond, was the executive director of the Chicago Abortion Fund. A third, Cynthia Newbille, was the leader of the National Black Women’s Health Project, which was among the first national organizations to be devoted to the wellness of black women and girls. After the first day of the event, which was hosted by the Illinois Pro-Choice Alliance and the Ms. Foundation, the group met in a hotel room. “We did what black women do when we’re in spaces where there are just a handful of us,” Bond, who is now a religious scholar, recalled. “We pulled the sistas together and talked about what was missing.”

Abortion had been decriminalized in 1973, with the Supreme Court’s Roe v. Wade decision, but, with the passage, in 1977, of the Hyde Amendment, which banned federal funding for almost all abortions, the procedure had become too expensive for many women. In 1993, Bill and Hillary Clinton had proposed an overhaul of the health-care system, but reproductive-health coverage was sacrificed to make the reforms more palatable to Republican lawmakers. To the women in the hotel room, the conversation at the conference about reproductive health focussed too narrowly on “choice.” There had been no discussion of the services that black women needed most, such as fibroid-tumor screenings, mammograms, and pre- and postnatal care. (Black women have a higher risk of fibroids than white women, higher percentages of late-detected breast cancer, and a maternal-mortality rate that is more than three times higher.) Nor was there an acknowledgment that the reproductive and parenting decisions of black women were limited by poverty, unequal pay, lack of access to adequate housing and schools, and the abuses of the policing and criminal-justice systems.“No one was talking about black women’s health as a whole,” Ross told me, not long ago. “Too many people were examining policies through the lens of white supremacy.”

The women created the term “reproductive justice” to describe the scope of their activism. They were inspired by the work of the black legal scholar Dorothy Roberts, whose research traced the history of efforts in this country to control black women’s reproductive freedom, beginning with the forced procreation of enslaved women. Abuses had continued into the nineteen-seventies, when thousands of women—including some who were receiving public assistance in North Carolina and others who were incarcerated in California—were involuntarily sterilized. In Arizona, South Carolina, Tennessee, and Washington, state-court judges often offered black female defendants reduced prison sentences if they agreed to get birth-control shots or implants. (This practice was happening as recently as two years ago.) As Roberts observed, black people had turned to their families, friends, and neighbors for the family-planning services and child care that the government had denied them. Bond said, “Reproductive justice offers us an opportunity to talk about the ways in which black women have exercised agency and been resilient even in the midst of reproductive and sexual oppression.”

The twelve women called themselves Women of African Descent for Reproductive Justice. After the meeting in the hotel room, they bought full-page ads in the Washington Post and Roll Call, publishing a letter to Congress that argued for “unimpeded access to abortion as part of the full range of reproductive health services offered under health care reform,” which should be available “regardless of ability to pay, with no interference from the government.” The letter stressed that reform should be comprehensive, and “must include strong anti-discriminatory provisions.”

During the following months, Ross and some of the other women led a reproductive-justice discussion in Cairo, Egypt, and wrote a public letter in support of Joycelyn Elders, the former Surgeon General, whom Bill Clinton had asked to resign after she said that she approved of educating children about masturbation to avoid the spread of aids. In 1997, with funding from the Ford Foundation, sixteen groups representing African-American, Asian-American, Pacific Islander, Latina, and indigenous women came together to form SisterSong, a national collective advocating for the reproductive and sexual health of women of color. SisterSong was based in Atlanta, the birthplace of the civil-rights student protests and the home of several historically black colleges; the city also had the largest black gay population in the South. Activists there had already created a parallel system of care, encompassing the Feminist Women’s Health Center, an abortion and gynecological clinic in the North Druid Hills, which grew out of a women’s self-help health group, in 1976; the National Black Women’s Health Project (now the Black Women’s Health Imperative); and SisterLove, founded, in 1989, to tackle H.I.V./aids.

In the next few years, the leaders of SisterSong and of newer reproductive-justice organizations—such as Spark Reproductive Justice Now, founded, in 2007, to include queer perspectives in the movement—held round-table discussions and met up for dinners and happy hours, as well as get-togethers at Charis Books, a feminist bookstore downtown. In 2004, after the passage of the Partial-Birth Abortion Ban Act, SisterSong, Planned Parenthood, and the National Organization for Women, among other groups, put together the March for Women’s Lives on the National Mall in Washington, D.C. In 2010, after the passage of the Affordable Care Act, several Atlanta-based reproductive-justice groups sent their members to D.C., to protest the Stupak-Pitts Amendment, which aimed to prevent federal funds from being used to pay for insurance plans that covered abortions. The current Democratic Presidential candidate Julián Castro, one of several politicians who have recently spoken about the importance of reproductive justice, told me that he was thankful to the Atlanta community who had launched the movement. “Their voices are crucial, especially now, to get us out of our comfort zone,” he said.

Oriaku Njoku was twenty-five when she visited Atlanta, in October, 2010, to attend the Atlanta Pride Festival. The daughter of middle-class Nigerian immigrants, Njoku had grown up in a mostly white neighborhood in Bowling Green, Kentucky. While attending the University of Kentucky, she came out to her siblings, then to her parents, and participated in L.G.B.T.Q. activism. After graduating, she worked in retail in Kentucky and Indiana. At the Pride celebrations, she was drawn to Atlanta, with its ambitious black residents and its queer scene, and moved there a few months later. In January, 2013, she attended an event held by Spark that was an introduction to reproductive-justice organizing, and later volunteered on a Spark initiative to stop the practice in Georgia prisons of shackling pregnant women during childbirth. “Doing reproductive-justice work has been the one place where I feel like I can bring my full self to the table,” she told me recently. “Being a first-generation queer black Southern fat femme, I can bring all those identities to work and do it unapologetically.” Njoku, who is now thirty-four, calls herself “a giver.” She has the Southern female tendency to go out of her way to put others at ease, filling in an awkward silence with a caring question, a compliment, or a wavering “um.” When she is frustrated, she is just as accommodating, but her voice takes on a slight edge. She likes to wear Igbo dresses and head wraps in vivid colors, and has a sprawling tattoo on her forearm that reads “Love is lifeforce”—a quote from the queer Jamaican-American poet and activist June Jordan.

After the 2013 Spark event, Njoku started travelling to other reproductive-justice gatherings, including the annual summit held by the National Network of Abortion Funds, where people talked about intersectionality and abortion access. She briefly dated a trans man, a human-rights defender from Uganda, who was seeking asylum and trying to bring his children to the United States; she realized that trans men also had trouble exercising their reproductive rights. She began to ask people for their gender pronouns.

In February, 2014, Njoku got a job taking patients’ information and making appointments at the Atlanta Women’s Center, an abortion clinic near the wealthy enclave of North Buckhead. As of that year, legislatures in Georgia and twenty-five other states had enacted laws restricting the coverage of abortion in the Affordable Care Act health-insurance marketplaces. Women who contacted the clinic were often struggling to come up with the money for their abortions, which became more expensive as their pregnancies progressed.

Njoku regularly directed such women to call the National Abortion Federation, which, in 2014, donated to more than a hundred thousand women based on their needs, with the expectation that the women would raise as much as they could themselves. Its hotline was often busy for hours on end. When Njoku looked for regional sources of assistance, she discovered only one in Georgia: the Magnolia Fund, which helped women pay for abortions performed at the Feminist Women’s Health Center. (Magnolia closed last year.)

In May, 2014, Njoku and two colleagues decided to set up their own abortion fund to help women in Georgia, Alabama, Florida, Mississippi, South Carolina, and Tennessee. “I was, like, We gotta do right by our people,” she recalled. “There’s no reason that our folks should be calling multiple numbers and waiting on hold forever to try and get in touch with someone for basic health care.” Kwajelyn Jackson, of the Feminist Women’s Health Center, called abortion funds “the conduit through which people are going to be able to get connected with care in the long run.” That November, Njoku took a job at Summit Medical Associates, assisting in the operating room and caring for women in post-abortion recovery. Meanwhile, she approached the National Network of Abortion Funds for advice. Njoku and her colleagues worked from coffee shops and buffet restaurants, applying for grants and organizing fund-raisers, including a fish fry. Their fund, Access Reproductive Care-Southeast, began operating in May, 2015. Its first grant paid for a headquarters, in an airy arts center in downtown Atlanta. By January, 2016, Njoku was working there full time.

The following spring, Njoku went on a tour of the Deep South, hoping to form relationships with employees at independent clinics, which, in that part of the country, are more numerous than Planned Parenthood centers. At each one, she made note of the affordable hotels nearby, the schedules for intakes and procedures, waiting lists and patient backlogs, and whether there were translators on hand. The fund set up a hotline in July, 2016. As it received more calls, she needed more volunteers to take women to and from appointments. (Clinics require that women receiving sedation have someone with them to take them home.)

That year, arc-Southeast gave funding and assistance to about fifty women each month; it now serves more than three hundred a month. The average cost of an abortion is around five hundred dollars, with later-term abortions sometimes in the thousands of dollars. arc-Southeast gives most women between seventy-five and a hundred dollars. The fund now employs a staff of seven, who are mostly black and queer, and has more than a hundred volunteers. They provide a kind of care that might be considered familial, booking travel and hotel rooms, taking women out for meals, and even putting them up for a night or two in their own homes. “We try to lead with love,” Njoku said. In 2017, Njoku’s sister Dirichi, who goes by Chi Chi, joined the organization to run the hotline. A former nurse, Chi Chi had little knowledge of reproductive justice, but she felt a connection to the fund’s mission. When she was nineteen, she got pregnant after being raped by a friend and had an abortion, an experience she often shares with callers.

arc-Southeast has found rooms for homeless women who would otherwise have spent the night outside the clinic, and counselled mothers and daughters who needed abortions at the same time. Not long ago, the fund referred an undocumented Honduran woman living in Atlanta with her two children, whose husband had been detained by Immigration and Customs Enforcement, to the National Abortion Federation, which agreed to pay for her procedure. The woman was twenty-six weeks pregnant, six weeks past the limit for abortions in Georgia. She could have taken a bus to a state where the gestational limit was higher, but she’d heard that immigration raids on buses were common. Njoku decided that the fund’s hotline operator, Crystal Zaragoza, who had previously run a clinic for queer migrants in Phoenix, should drive the woman in a rental car to a clinic in Bethesda, Maryland. Zaragoza and the woman stayed in an Airbnb for four days. The fund paid more than a thousand dollars for the car, the accommodation, the woman’s medication, and care for her children while she was away.

Abortion in Georgia is legal up to the twentieth week of pregnancy, and fourteen of the state’s seventeen clinics are in the Atlanta area. Calls come in to the fund from all over the Deep South; for some women, the clinics near them have closed, or offer only limited services. In South Carolina, there are just three abortion clinics. In 1995, the state put into place regulations requiring that all clinics terminating second-trimester pregnancies meet the same design and construction standards as “ambulatory surgical facilities.” Ostensibly meant to insure women’s safety, the regulations dictated, in overwhelming detail, specifications including the width of the corridors, the number and size of procedure rooms, and the size of the janitor’s closet. Pro-choice organizations and physicians agreed that the regulations were politically motivated; the necessary changes would be too costly for most clinics to make, and, ultimately, they would do little to improve patients’ care. More than half of the South Carolina women who had abortions in 2017 travelled outside the state for their procedures.

Spring is the fund’s busiest season. (As Chi Chi put it, “People get it on in the winter.”) In April, 2018, arc-Southeast assisted a hundred and eighty-two women. This past April, it helped three hundred and ninety-seven callers, and Njoku spent much of her time in her car. One morning, she woke up early to pick up a woman from her home in south Atlanta and took her to the Atlanta Women’s Center, in the northeast of the city. There, she met up with another woman, who was accompanied by her partner and their child, and gave her cash for food and a hotel. Then she took the first woman home and headed back to the office. In the parking lot, she received a call from Chi Chi about Naomi (a pseudonym), a woman who was waiting at Summit Medical Associates, four miles away, in need of an escort. Naomi had driven more than two hundred miles that morning, from Columbia, South Carolina, for her appointment. She believed that she was fourteen weeks pregnant. Twenty minutes after the call, Njoku arrived at the clinic and signed Naomi in. The process for second-trimester abortions, known as “dilation and evacuation,” usually takes place over two days. After the first appointment, Njoku gave Naomi a ride to her motel and learned that she and her partner were not speaking, that her best friend had wanted her to have the baby, and that she hadn’t told her parents she was pregnant, because she was too ashamed. Naomi knew that she needed an escort, but another friend, who had agreed to accompany her, had cancelled at the last minute. She had hoped to persuade the clinic to make an exception.

When I recently talked to Naomi, she still hadn’t told her family about her abortion, and she said she would take the secret of it to the grave with her. On her first night in Atlanta, she recalled, she had been in pain and lonely, and had slept badly. In the morning, when Njoku picked her up for her second appointment, Naomi was amused to see Njoku’s Pomeranian-Shiba Inu mix, Marley, in the passenger seat. She felt comforted by Njoku’s presence. “I didn’t have nobody there with me, and just in the moment of time being in that car with her—that really meant a lot,” Naomi said.

This past spring, after the confirmation of Brett Kavanaugh to the Supreme Court, in October, 2018, legislatures in Alabama, Arkansas, Georgia, Kentucky, Louisiana, Mississippi, Missouri, Ohio, and Utah all passed bills that placed restrictions on abortion, which were intended to undermine Roe v. Wade. In May, Alabama passed a bill that, if it goes into effect, would outlaw abortion, even when pregnancies are the result of rape or incest, except in cases where the mother’s life is at risk; doctors who performed the procedure could go to jail for up to ninety-nine years. The new law is being challenged in federal court by the American Civil Liberties Union and Planned Parenthood on behalf of Alabama abortion providers.