Arkansas sure loves its religious freedom, but how about a person's freedom to choose — choose to lawfully terminate a pregnancy, that is? According to a new report from the Guttmacher Institute, the answer is: not so much. Guttmacher found that Arkansas passed six new abortion bills in just one month. These provisions could severely limit access to abortion in the state, which has only three abortion providers.
Two telemedicine abortion bans; a parental consent provision barring judicial bypass from teenage rape and incest victims; and a 48-hour mandatory waiting period are among the measures passed in Arkansas over the last month. Included in the "informed consent" 48-hour waiting period bill is a provision requiring abortion providers to tell patients that their medical abortions can be "reversed," following in Arizona's footsteps. Arizona became the first state to mandate "abortion reversal" consent just last month.
Another bill requires abortion providers to use FDA protocol when administering medication, or drug-induced, abortions. The FDA protocol requires both abortion-inducing drugs to be administered in the physical presence of a doctor; however, a majority of U.S. abortion providers now use an evidence-based method, which requires just the first drug in the process, mifepristone, to be taken at the clinic. Many providers have said the FDA protocol is outdated, having been enacted more than 14 years ago. For example, Little Rock Family Planning Services states on its website:
After FDA approval of Mifepristone/Misoprostol there has been new clinical data about the effectiveness of various regimes that vary from the one that the FDA approved. We are using one of these regimes which has been shown to be safe, effective and is more convenient for women using the method.
The two bans on telemedicine abortion also prohibit doctors from counseling and guiding patients via video-conferencing on how to properly take the drugs. Gov. Asa Hutchinson has already signed the ban into law — the first official abortion restriction of 2015. "It’s crystal clear that these laws are motivated by a desire to keep a woman who has decided to have an abortion from getting one," Jennifer Dalven, director of the ACLU’s Reproductive Freedom Project, said following the signing.
This telemedicine abortion procedure has been developed and used successfully by Planned Parenthood of the Heartland in Iowa, typically for women who live in rural areas where both clinics and abortion doctors are scarce. However, telemedicine abortion remains more of a pipe dream for reproductive health advocates, as 17 states (not including Arkansas) currently ban the procedure. The telemedicine abortion practice used in Iowa is also tied up in litigation, with the Iowa Supreme Court hearing arguments in March on the state's latest telemedicine abortion ban.
The regulations on medication abortions may have a severe impact in Arkansas, as two of the state's three clinics only provide medication abortions. With the FDA protocols in place, clinics would be forced to adapt their procedure or be unable to administer the drug at all. If clinics do adapt their protocols, then it would also limit the time in which a patient can receive a medication abortion. Although clinics such as Little Rock Family Planning Services provide medication abortions up until eight or even nine weeks of pregnancy, the FDA guidelines state the procedure can only be done within the first seven weeks.
Following the FDA guidelines would also require more trips to the clinic, which may burden women who do not have the funds, resources, or privacy to take time off and travel. While the evidence-based protocol currently used by abortion providers usually requires just one trip to the clinic, women in Arkansas could expect to make up to four visits between the newly enacted medication abortion protocol and the 48-hour waiting period. The process would look something like this:
- one trip for the in-person, state-mandated counseling (patients and providers will have to sign off that the counseling and materials were given and received)
- one trip 48 hours later for the dosage of mifepristone
- one trip 48 hours later for the dosage of misoprostol
- one trip a week or two later for an ultrasound follow up
When working in tandem, doctors and advocates fear the 48-hour waiting period — one of the longest in the nation — and limitations on the abortion pill may economically burden women, particularly those who live outside the metropolitan area of Little Rock. (Keep in mind that Arkansas does not provide Medicaid funding for abortion.)
"Politicians are not medical experts, yet politicians have written these laws as part of a broader effort to end access to safe, legal abortion in Arkansas and in states across the country," Cecile Richards, president of Planned Parenthood Action Fund, said in a statement sent to Bustle. "These restrictions hurt women by blocking access to safe medical care and are deeply unpopular with the American public."
But the restrictions keep on coming. According to Guttmacher, 791 provisions related to sexual and reproductive health and rights have been introduced by U.S. legislators in the first three months of 2015. More than 40 percent of those bills directly target abortion and abortion providers.
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