WASHINGTON—The Trump administration is poised to issue a rule unwinding an Obama -era requirement that employee health benefits include contraception, which will spark a fresh round of litigation over an issue that has been before courts for six years.

Federal health officials are expected to finalize a regulation that would allow employers with religious or moral objections to birth control to omit coverage for contraception from their workers’ plans, according to two people familiar with its contents. The regulation closely mirrors an earlier, leaked draft, they said.

The Supreme Court has ruled, in a case brought by the arts-and-crafts chain Hobby Lobby, that “closely held” private companies can invoke religious objections to avoid covering contraception.

The Trump administration rule would allow a much broader set of employers to opt out of offering coverage for birth control, making moot a “workaround’’ designed by the Obama administration that allowed women in some cases to obtain coverage even if their employers had declined to offer it directly.

The rule would fulfill a promise by President Donald Trump to social conservatives, who backed his candidacy but have been frustrated by the pace of his administration has moved to address one of their most significant grievances.

Based on early indications, the expected rule “would go a very long way to restoring religious freedom and conscience rights,” said Hillary Byrnes, assistant general counsel at the U.S. Conference of Catholic Bishops.

She said the rule couldn’t come soon enough. “We’ve been dealing with this mandate for over six years now,” she said. “A lot of people thought the administration would do something pretty quickly, yet here we are in August.”

Reproductive-rights activists say they will sue the Trump administration if it moves ahead with the rule, arguing that the change would unfairly impose employers’ beliefs on their workers and that the administration has cut regulatory corners in writing the policy.

“We are preparing various different legal theories to fight the rule very quickly,” said Mara Gandal-Powers, senior counsel at the National Women’s Law Center, an advocacy group. “We think we have a really strong claim.”

A spokeswoman for the Department of Health and Human Services declined to comment.

As a presidential candidate, Mr. Trump pledged support for Catholics and evangelical Christians who sued President Barack Obama and his top officials over the contraception requirement, contending that it forced them to violate their religious beliefs.

They also opposed a process, which the Obama administration dubbed an accommodation, in which an employer notifies the government of its unwillingness to cover contraceptives. That prompts the insurer administering the employer’s health benefits to assume the cost and administration of providing contraceptives, effectively cutting out the employer.

Religious employers challenged the policy in court, saying it made them complicit in a sin. The Supreme Court last year sent the case back to lower courts.

The Trump administration plans to offer the plaintiffs precisely what they sought: an exemption from the contraception requirement for all employers who want one, according to people familiar with the plan, ending the need for litigation.

Others regard the expected rule as a step back in a decadeslong fight to secure women’s access to contraceptive care.

Lawyers preparing potential legal cases for opponents of the change say that if the rule resembles the leaked draft, the policy could qualify as sex discrimination, since it would disproportionately affect women’s health care. They also plan to argue that leaving a decision on contraceptive coverage to employers could amount to religious discrimination by subjecting workers to the beliefs of their employers.

“If the rule says any employer can withhold this benefit from employees, then you have a whole set of questions about whether the government is enabling employers to impose their beliefs on others,” said Louise Melling, deputy legal director at the American Civil Liberties Union.

People familiar with the proposed rule say the Trump administration plans for it to take effect as it is published. Nicholas Bagley, a University of Michigan law professor who has analyzed much of the health-law litigation of the last six years, has said that could open the administration to lawsuits for implementing the rule without time for public comment and consideration.

“The argument they make is, ‘We’ve thoroughly vetted this issue, and we’re only making a minor change,’” he said. “If that was true, that argument would hold water. But that’s not true in this case.”

Write to Michelle Hackman at Michelle.Hackman@wsj.com and Louise Radnofsky at louise.radnofsky@wsj.com

Appeared in the August 17, 2017, print edition as ‘Contraceptive Rule to Be Reversed.’

A much larger group of employers will be able to opt out of offering insurance plans that cover birth control. Photo: Adam Hart-Davis/Science Photo Library/Getty Images/Science Photo Libra

On Thursday, The Wall Street Journal reported that the White House is on the verge of implementing a rule to roll back the Obama-era requirement that employers offer health-insurance plans that include contraception. The news was confirmed by “two people familiar” with the new rule’s contents, which they say is very similar to a draft leaked in late May.

Much like the draft, this rule would reportedly let a “much broader” set of employers opt out of offering plans that cover birth control, if offering that coverage conflicts with their religious beliefs. It also abolishes a “work-around” the Obama White House put in place that would let women circumvent their employers to get free birth control:

[The] process, which the Obama administration dubbed an accommodation, in which an employer notifies the government of its unwillingness to cover contraceptives. That prompts the insurer administering the employer’s health benefits to assume the cost and administration of providing contraceptives, effectively cutting out the employer.

Trump’s religious base has been after him for months about implementing the rule, which they said “would go a very long way to restoring religious freedom and conscience rights.” But reproductive-rights advocates say it “allow[s] an employer’s religious beliefs to keep birth control away from women,” and is therefore vulnerable to a legal challenge.

From a practical standpoint, this could mean that some of the more than 50 million women the rule has benefited could be forced to pay for their contraception out of pocket — something one in three women voters have struggled to do, according to a 2010 poll. And much like his presidency as a whole, Trump’s new rule would go against popular opinion; according to a January Kaiser poll, 77 percent of women and 64 percent of men supportno-co-pay contraception coverage.

Those “familiar” with the rule told WSJ that, rather than open the rule to public comment, they expect it to take effect as soon as it’s published.


Hundreds of bills aimed at restricting abortion access are introduced in state legislatures every year, and the ones that become law can have an immediate impact on providers across the country. States that currently have just one abortion clinic are proof of how strict, superfluous requirements force clinics to shutter, leaving women with fewer healthcare options.

Kentucky, Mississippi, Missouri, North Dakota, South Dakota, West Virginia, and Wyoming each have only one abortion clinic. One. For the whole state.
“Of course, states that have shut down all but a single clinic didn’t get there by accident, but as the result of deliberate steps to deny women access to constitutionally protected healthcare,” James Owens, a NARAL Pro-Choice America spokesperson, told Refinery29. “Unfortunately, these states are not alone, as there has been a concerted, nationwide effort to undermine a woman’s access to abortion for more than a decade.”
Mississippi was left with just one clinic providing abortion procedures 11 years ago — Jackson Women’s Health — and it’s been fighting to stay open ever since. Most recently, a crisis pregnancy center moved in right across the street. These types of anti-abortion organizations advertise as clinics offering women advice on pregnancy options, but in reality, they distribute misleading or false information, exaggerate the risks of having an abortion, and pose “counselors” as medical professionals.
So far, Jackson Women’s Health has managed to keep its door open, but now another one-abortion-clinic state is battling to not become the first state with zero clinics.
Kentucky’s Republican governor, Matt Bevin, has effectively shut down abortion clinics and kept an existing Planned Parenthood from providing abortion procedures, leaving the E.M.W. Women’s Surgical Center as the only abortion provider in the state. The American Civil Liberties Union (ACLU) sued Kentucky on behalf of the E.M.W. Women’s Surgical Center in April after the state threatened to revoke the clinic’s license because its agreements with a local hospital and ambulance service allegedly weren’t sufficient. A federal judge allowed the E.M.W. Women’s Surgical Center to stay open until the case concludes.
State requirements forcing abortion clinics to have admitting privileges at nearby hospitals are known as TRAP laws — targeted regulation of abortion providers — because the American Medical Association and the American College of Obstetricians and Gynecologists consider them medically unnecessary and they force clinics that can’t meet those strict standards to close.
In fact, the Supreme Court ruled last summer that similar laws in Texas were unconstitutionalbecause they create an undue burden for women seeking to end a pregnancy, but other states (like Kentucky) still have these types of laws on the books.
Besides the fact that abortion is legal in the U.S., the main problem with having just one (or zero) abortion clinics in an entire state comes down to access. Do women really have the right to choose an abortion if there’s no feasible way for them to get one?
A lack of clinics forces women to travel really far to get healthcare. When Texas abortion clinics closed after the state withheld their funding in 2011, women whose closest clinic shuttered drove an average of 85 miles for health services. This means an increase in travel costs, childcare expenses, and time off work, all of which make it more difficult for anyone — but especially low-income women — to get an abortion. And if a state is left without any abortion clinics, all of those factors would escalate even further.
The ACLU’s case in Kentucky is set to go to trial in September and will determine whether or not the war against abortion will succeed in creating an abortion-free state in 2017.

HB 214 bars private, state-offered, and ACA abortion coverage

Sen. Brandon Creighton, R-Conroe, carried the Senate’s version of HB 214, a bill that bans insurance coverage of abortion care. He failed to accept amendments carving out exceptions for rape or incest survivors. (Photo by Jana Birchum)

Ecstatic to bring their first child into the world, Austin residents Scott Ross and Jeni-Putalavage Ross approached the 21st week of pregnancy with joy.

But a routine trip to the doctor soon revealed a rare and severe chromosomal fetal abnormality. Their future baby would not survive birth. The doctor recommended termination of pregnancy, a decision the couple did not make lightly. Scott said: “We felt a lot of mental anguish, but we knew the anguish – physical and mental – would be even harder if we carried the baby to term.”

Due to complications, Jeni spent seven days in the ICU. All said and done, the Rosses’ medical bill totaled a whopping $64,000. Thankfully, employer-based insurance covered 90% of the tab. However, an anti-choice Texas bill – inches away from becoming law – would have prevented the Rosses and couples like them from receiving insurance coverage for abortion care. “Under the bill, we would have had to pay out of pocket and would have been in dire financial straits, on top of the pain we felt losing our child,” said Scott, who likened the bill to a “pregnancy tax.”

One of Gov. Greg Abbott’s special session agenda items, HB 214 by Rep. John Smithee, R–Amarillo, (and Senate counterpart SB 8 by Sen. Brandon Creighton, R-Conroe) bars abortion coverage from private, state-offered, and Affordable Care Act (ACA) insurance plans, with an exception for a narrowly defined “medical emergency” but no exceptions for rape, incest, or fetal abnormalities – an especially cruel aspect of the bill that compelled critics and some legislators to dub it the “rape insurance” bill. Women would be forced to somehow anticipate the need for abortion care – an unpredictable life event – and purchase supplemental coverage, defying the point of insurance.

“It’s so frustrating to hear lawmakers call it an ‘elective abortion’ – we didn’t elect to have a child who is incompatible with life,” said Scott. “Like all abortions, it was unforeseen.”

Further, the bill doesn’t require insurance plans to offer the added coverage, or even notify clients if they don’t offer it. “You can be basically flying blind when choosing your insurance plan and not know the plan you’re buying for your family didn’t cover pregnancy termination even if it’s the result of rape or incest,” health care attorney Blake Rocap of NARAL Pro-Choice Texas, pointed out to the Senate’s Business and Commerce committee during a Friday hearing (Aug. 11).Bill authors claim the legislation is about “economic freedom” and allowing those who “philosophically disagree” with abortion to not have to subsidize the procedure, but the measure will end up unnecessarily and unfairly pushing abortion further out of reach for women, especially low-income women, pro-choice advocates caution. Texas isn’t alone in banning abortion insurance coverage; other GOP-controlled states have taken on similar laws: 10 states ban abortion from private insurance, and 25 states bar the procedure from health exchanges, according to the Guttmacher Institute.

On Saturday, during a hearing held well after 5pm, Senate Republicans left their empathy and compassion at the door while swatting down Democrat-authored amendments that sought to carve out exceptions for rape and incest victims and for women with severe fetal abnormalities, before eventually ushering the bill along to third reading in a 20-10 vote on party lines. It’s highly expected to pass the Senate’s final hurdle and eventually head to Abbott’s desk to become law. (House Democrats similarly attempted to include those exceptions, but Republicans callously shot them down when passing through HB 214 earlier this week, as noted in this week’s issue.)

“No one plans to be raped. No one plans to have an abortion. This is what I find so egregious about this bill,” said Sen. José Menéndez, D-San Antonio, who offered an amendment to protect victims of sexual assault from the potential new law – it was knocked down in a 20-10 vote. “This shouldn’t be a partisan issue. It should be about us caring about sexual assault survivors.”

With his amendments killed on the floor, the Senate GOP showed Texans how much they care about sexual assault survivors and all women, loud and clear.


Uganda’s highway A-109 shoots across the plain from Kampala past the occasional storefront shops and open-air kiosks common to the continent’s roadsides. After rising into the verdant tea plantations of the country’s Western Region, it passes through Fort Portal near the Congolese border. From there, a turn off the main road leaves the reasonably well-maintained tarmac behind in favor of red clay washboard and bone-shaking potholes. Finally, it devolves into a footpath running between a few dozen housing compounds in a village called Kalera.

Though Kalera is poor by western standards, it doesn’t approach the desperation found in many poorer parts of Africa. Flinty, hard-working women tend small plots of bananas, potatoes, maize and soybeans. These plots border larger fields of tea, a cash crop. Goats and chickens roam. The village teems with children. Today, at least, there are no men in sight.

 By limiting women’s family planning options in Uganda, “we are likely to get a higher number of abortion cases and more maternal deaths.” Jemiima Mutooro is a village health worker trained by Reproductive Health Uganda (RHU) using U.S. Agency for International Development (USAID) funds provided through the International Family Planning Foundation. She walks through Kalera carrying a black satchel. Inside the satchel is a day planner, pens, bandages, alcohol swabs and, most important, several small tamper-proof foil packages. Sayana Press, the novel, possibly revolutionary, family planning device within those packages is the subject of a pilot program sponsored by an international consortium that, along with RHU, includes the Uganda Ministry of Health and the Bill and Melinda Gates Foundation.

Global Gag Rule Uganda
Akiiki Jemiima Mutooro is one of 40 village health workers trained by Reproductive Health Uganda using USAID funds. (Charles Ledford)

Developed by Pfizer and the Seattle-based non-profit PATH, Sayana Press is as simple in form as it is obvious in function: a fingernail-sized clear plastic bubble holds a milky liquid – a three-month dose of the contraceptive progestin – and is attached to a short needle. The device is small, easy to use, disposable and effective. And because it’s also suitable for self-dosing, Sayana Press could give women in remote areas like Kalera – where isolation, cultural pressures and economic marginalization severely constrict contraceptive options – a previously unimaginable degree of reproductive autonomy.

Or the initiative could be severely curtailed – an early victim of a radical and asymmetric “America first” doctrine that pits the richest country on the planet against, among others, more than 200 million women worldwide who are in need of family planning services.

Global Gag Rule Uganda
A health worker holds a Sayana Press progestin-only contraceptive before administering it in Kalera Village.(Charles Ledford)

By any measure, most of those women are far removed from the White House, Trump Tower, Mar-a-Lago and the fundamentalist churches and cathedrals of America’s conservative faithful. But what geography, wealth and power once separated, Republican President Donald Trump brought together three days after his inauguration when he reinstatedRonald Reagan’s Mexico City Policy.

Also known as the Global Gag Rule, the Reagan-era document cut off US family planning assistance funds to foreign non-governmental organizations (NGOs) that perform abortions or even so much as mention the option of legal abortion to their clients. Since its inception in 1984, the policy has been a convenient political ping pong ball. Each subsequent Republican administration has renewed it, and each Democratic administration has rescinded it.

Global Gag Rule Uganda
A patient receives the injection of the contraceptive progestin from the Sayana Press. (Charles Ledford)

Trump’s version of the policy expands the restricted funds beyond family planning assistance to include all US “global health assistance.” According to the Kaiser Family Foundation, that’s at least $9.5 billion that now go toward efforts to fight malaria, Zika, HIV/AIDS and even malnutrition.

Just as the flawed rollout of the president’s immigration ban sowed widespread chaos, Trump’s gag rule has left NGOs involved in sexual and reproductive health worldwide scrambling to fully understand its scope. No one is yet sure exactly what this expanded language will mean or how the new restrictions will be implemented.

One thing is certain: More than 150 organizations have denounced the global gag rule’s previous iterations as having caused serious harm around the world. And legacy organizations like the International Planned Parenthood Federation (IPPF) and Marie Stopes International have said that, on principle, they will refuse to accede to the new policy’s restrictions. That means their local member associations, like Reproductive Health Uganda, will lose USAID funding and could be crippled.

Global Gag Rule Uganda
Surrounded by pregnant women and their caretakers, Jackeline Nikungu, 32, (center) waits to give birth to her fifth child. (Charles Ledford)

During an interview in his office in Fort Portal, Dr. Richard Obeti, assistant district health officer for Uganda’s Kabarole District, which includes Kalera, acknowledged both the uncertainty and the risk. “We are worried,” he said. “We rely on groups like Reproductive Health Uganda to bridge the gaps in our health care system.” He finds the Global Gag Rule’s potential negative impact on programs like the Sayana Press initiative to be particularly troubling: “Sayana Press prevents unwanted pregnancies which would otherwise end in abortion,” he said. By limiting women’s family planning options in a country where abortions have for years been legal only under the most extraordinary of circumstances, he said, “we are likely to get a higher number of abortion cases and more maternal deaths.”

And therein lies the irony. In 2011, the most recent year for which government figures are available, half of all pregnancies in the country were unintentional, according to the Uganda Bureau of Statistics. A 2017 Guttmacher Institute study estimates that 26 percent of these unintended pregnancies end in abortion.

More unintended pregnancies mean more unsafe abortions and more children than a family can afford. The original Mexico City Policy claims that “U.S. support for family planning programs is based on respect for human life, enhancement of human dignity, and strengthening of the family.”

On the ground in countries like Uganda, the actual consequences of the policy may be more ruined lives, more undignified death and more poverty.

These are the consequences of the 2017 version of US’ anti-abortion Global Gag rule


A college student has traveled to the D.C.-area from Georgia for an abortion, only to learn at her check-up at the clinic that the procedure will cost $4,000 more than she anticipated.

The D.C. Abortion Fund shared the student’s story, without providing identifying details, to help raise money on her behalf. The nonprofit provides grants to pregnant people who need assistance paying for the procedure. While a majority of the patients are local, about 15-20 percent of their cases are from other parts of the country.

“By the time she figured out that she was pregnant, she was too far along to be seen by a clinic in Georgia,” says Meghan Faulkner, the co-director of case management at DCAF. The cut-off for abortions in Georgia, and 23 other states, is 20 weeks post-fertilization. “One of the closest clinics available [for her procedure] was a clinic in Germantown … It’s not uncommon at all for patients to be traveling that far.

Compared to Georgia and, more nearby, Virginia, Maryland has significantly fewer restrictionson abortion. There is no waiting period (Virginia requires patients to get an ultrasound and then, in most cases, wait 24 hours before an abortion), and can be performed any time before the fetus is viable.

The patient was largely paying her own way, with some assistance from DCAF and other abortion funds.

The cost of an abortion varies, depending on how far along in a pregnancy the patient is, the type of anesthetic, and whether there are health complications. A first trimester procedure costs a couple hundred dollars on average, and increases as the pregnancy progresses.

“The later second-trimester procedures that patients come to our area for, it can be $5,000, $6,000, $7,000. $8,000 is the highest we see on a more regular basis,” says Faulkner. What can be tricky is that, as women are trying to raise money for the procedure, the cost for it continues to rise. “A lot of the reason patients need our support and face high costs is because they aren’t able to get coverage.”

The Hyde Amendment, a budget rider attached annually to Congressional appropriations bills since 1976, prevents the use of federal funds to pay for abortion, with few exceptions, affecting people on Medicaid, federal employees, Peace Corps volunteers, federally incarcerated women and women in immigration detention centers, military personnel, and Native Americans. A similar rider called the Dornan Amendment ties D.C.’s hands when it comes to using locally raised funds to pay for the procedure (Congress keeps trying to make the policy permanent law). Virginia doesn’t use its state funds to pay for the procedure in most cases, a choice made by commonwealth officials.

Plus, there are costs beyond the actual abortion. “If someone is traveling from out of state, they’re paying for travel,” says Faulkner. “There’s a hotel cost. There’s also your companion—folks usually travel with someone to have an escort to be with them. There’s lost wages, because most of the people that we are helping don’t have paid sick leave or much, if any, vacation time. And childcare is another big one.” Later second trimester abortions generally take at least two days, unlike the outpatient procedure for those undergone in the first trimester.

DCAF exists to help fill the monetary gap. In fiscal year 2015, the organization assisted 1,200 patients, according to Faulkner, a number they well exceeded the following year, though they haven’t finalized the numbers for 2016 yet.

For the student from Georgia, her costs rose by $4,000 because she miscalculated when her pregnancy began. DCAF has already pledged to help pay the difference. “This particular patient was a college student who doesn’t have a ton of resources to say, ‘great, l’ll just pay $5,000 on my credit card.”

“We’ve worked with a number of patients who’ve faced similar things, especially if they’ve already come up with the money and gotten themselves here,” says Faulkner. “It”s often panic and feeling like, ‘How is this happening? I’ve done everything I possibly could and I’m facing another barrier.'”


I lived in liberal Washington, D.C., with a tight-knit circle of progressive pro-choice friends, and I still wasn’t sure whom I could lean on for support.


If the test was positive, I was going to have an abortion. I made my decision in the aisle of CVS when I was calculating whether I could afford FirstResponse Early Result or if I should just go generic.

I was 24, just two years out of college, living in a group house, with a career that had just started to take off. I wasn’t financially or emotionally prepared to carry, have, or raise a child. Nor did I want to. That’s why I was on birth control. It was why I’d taken Plan B. Neither, in this instance, had worked.

If you’d been in my bedroom the night I found out, you would have seen used tissues scattered on the floor next to the pregnancy-test packaging. I wasn’t crying about my decision, or even about the pregnancy. I was crying because of how alone I felt.

I lived in liberal Washington, D.C., with a tight-knit circle of progressive pro-choice friends and a family I trusted just a phone call away. But we weren’t having frank, open conversations about abortion — and when we did, they were rarely grounded in personal experiences. So I wasn’t sure whom I could talk to, whom I could lean on for support. Worse, I found myself worrying that people might judge me for my decision, for not feeling the slightest bit guilty, remorseful, or sad about it.

That’s how potent the stigma surrounding abortion is.

Because of stigma, women are made to feel ashamed about a routine procedure. Because of stigma, women are made to feel isolated — even though 1 in 3 will have an abortion in her lifetime. Because of stigma, there are women who go through this process on their own — and never tell a soul.

Many women, like me, choose abortion because they don’t want children yet. Other women don’t want children, period. Some desperately want children but find out during their pregnancy that the fetus isn’t viable. Some women, already mothers, know they can’t afford to raise more children.

The decisions and experiences and reasons surrounding abortions are as different as the many women who choose to have them. But stigma — albeit, varying levels of it — is something we all have in common.

Ultimately, I told my best friend — someone I trust deeply — because I needed someone to take me in for my procedure. Her outpouring of love and support prompted me to tell others close to me. They all responded with some variation of “I’m here for you. How are you? Let me know what I can do to help.”

Not one of them questioned my decision or my character. No one jumped in with their personal opinions or asked me to explain myself. I know I was fortunate though: Not all women in this situation have this kind of experience. Ultimately, talking about my abortion became a sort of healing process — a way to break down that stigma for myself and assuage the fear that those close to me might judge me for the choice I made.

And somewhere along the way, I realized that people weren’t just offering their support — they were really listening, they were really engaging. Friends would ask about my experience because they had questions they could never ask anyone else before: Was it painful? Where did you go? How long did it take? What was your recovery like? Others started sharing stories about their own pregnancy scares and abortions for the first time. Some began reaching out because they needed support themselves.

And so, the circle of people who I’d tell about my abortion began to widen — from friends, to friends of friends, to family, to colleagues. With every candid conversation — especially those that happened in person — abortion (not just my own) began to feel a bit more relatable, for everyone. So I made the circle wider still. I talked to new acquaintances about my abortion, posted about it on social media, and would even — given the opportunity — bring it up on dates.

Recently, a woman I hadn’t spoken to in five years contacted me. She’d seen that I had shared my story and advocated for Planned Parenthood on social media. “Hey Tania! This is still your number right?” It was. “Full disclosure, I’m in a panic. I may be pregnant. Who can I call?” I gave her the number to Planned Parenthood and also to an abortion provider in her area.

When I talk about my abortion now, I talk about how — because I had missed the window during which the abortion pill is most effective (the first seven to nine weeks of pregnancy) — I had a 15-minute procedure called a dilation and evacuation (or D&E). I always mention the nurse who stood by my side and let me squeeze her hand when I felt cramps the pain medication didn’t dull.

I talk about how, yes, the weekend after the Thursday afternoon procedure was physically draining; I took off work Friday because I was bloated, reeling from cramps, and dealing with what resembled the absolute worst period I’d ever had.

I talk about the relief I felt after my abortion — and how my doctor nodded when I told her, saying that’s how the vast majority of women feel after their procedures.

And I always, always talk about how lucky I was to be employed, with quality insurance, and living in Washington, D.C, which meant I could call and schedule my appointment within one week. Had I lived in a state like Missouri, I would have had to drive across the state (local lawmakers have shut down all but one abortion-providing clinic), sit through state-directed counseling designed to discourage abortion, and then wait 72 hours before being provided the procedure.

Even if I weren’t talking about it, I would still think about it every day. Because every day, I’m living the life I chose for myself — with a career, ambitions, and a lifestyle that wouldn’t have been possible had I been forced to carry the pregnancy to term. My sense of relief hasn’t faded and I don’t expect it ever will.

It’s been two years since my abortion, and I talk about it openly, out loud and often, because I know that there are women out there who might, one day, benefit from hearing about it.

Of course, not everyone has been so receptive to my story. Someone else I know confronted me through Instagram for my support for “killing babies.” When I offered to talk about our views by phone, she refused.

Her inflammatory language, though, wasn’t what bothered me most. She has daughters, and I imagine what they would do if they ever found themselves with pregnancy tests and tissues scattered on the floor of their bedrooms, and needed someone who wouldn’t judge them for asking, “What do I do?”

So I’m going to keep talking about my abortion.

Because every woman should know she’s not alone. Because abortion is a safe, normal procedure — and should be talked about as such. And because every woman should have the right to choose, and she should feel empowered — never ashamed — to make the choice that’s right for her.