A fight over what counts as “essential” health care has created a crisis within a crisis for women across the country.

By Kaelyn Forde
Updated Mar 30, 2020 @ 1:30 pm
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At Preterm, an abortion clinic in Cleveland, Ohio, patients are screened for COVID-19 symptoms over the phone and before they walk through the door. Appointments have been staggered to limit the number of people in the building, and social distancing is in effect in the waiting room. Patients must arrive alone unless they are a minor, need a translator, or have a disability. But despite the growing pandemic that has already infected more than 143,000 people and killed more than 2,500 across the U.S., the clinic's doors remain open. There, providers aren't only safeguarding patients against the virus, but against an assault on their reproductive rights: anti-abortion groups are pushing lawmakers to ban abortions as "elective procedures" during the COVID-19 pandemic.

Ohio is just one of several states, including Iowa, Tennessee, Texas and Mississippi, where anti-abortion groups and Republican lawmakers have recently moved to curb access as part of a broader, nationwide effort. Groups including National Right To Life and the Family Research Council wrote a letter to Secretary of Health and Human Services Alex Azar on March 24 asking the Trump administration to use its "broad emergency authority" to urge abortion providers to "cease operations." In response, reproductive rights groups are sounding the alarm about the silent crisis within a crisis that could leave millions unable to end their pregnancies at all, given the uncertainty over how long the coronavirus pandemic could last.

"It is horrific to force people to remain pregnant during a global pandemic," Heidi Sieck, the co-founder and CEO of #VoteProChoice, tells InStyle. "It's a very dire situation for many people, and the politicians who first exploited this chance to close abortion clinics are the same politicians who have tried to ban abortion time and time again."

The restrictions stem from orders to limit non-essential medical procedures to stop the virus' spread and conserve precious personal protective equipment that could be needed by first responders, such as masks. As part of Ohio's order, the state's attorney general told abortion clinics they would have to stop performing "non-essential and elective surgical abortions" during the COVID-19 crisis. Ohio Planned Parenthood leaders fired back, saying that clinic doors will stay open for "essential procedures, including surgical abortion," and the "other healthcare services that our patients depend on."

Chrisse France, Preterm's executive director, says her clinic is doing the same. "Under their orders, Preterm is allowed to continue essential abortion care, and that's what we will do, taking all necessary measures to keep our patients and our staff safe," France tells InStyle. "States should not be using this moment as a reason or opportunity for limiting access to health care."

But many states are doing just that, and the legal battle over COVID-19-related abortion restrictions has already begun. "See you in court," Planned Parenthood wrote on Instagram after Texas' attorney general announced a prohibition on "any type of abortion that is not medically necessary to preserve the life or health of the mother," imposing a potential $1,000 fine or 180 days in jail on anyone who violates it. (The same state's attorney general rule that gun stores can remain open.)

But people need access to reproductive care now more than ever, including abortion, contraception, STD testing and treatment, advocates argue. The National Domestic Violence Hotline says it's already seen an increase in survivors reporting that their abusers are using fear about COVID-19 to coerce and control them. Sexual violence can lead to unwanted pregnancies — one of many legitimate reasons a person might need to terminate.

But whatever the reason, Sieck says, access to abortion is a right. "Whether due to a non-viable pregnancy, a result of increased domestic violence in quarantines, a crucial financial decision, or any other extremely personal reason, abortion procedures are time-sensitive, critical services," she says. "Weeks or even days can impact whether [a person is] ultimately able to receive an abortion or not. We have no idea how long calls for social distancing, employment interruptions, and this economic uncertainty will last." Ohio and Texas both ban abortion completely after 20 weeks gestation.

Ultimately, restrictions on abortions during the coronavirus crisis could disproportionately impact "patients who already face the highest barriers to health care and social services," France says, including women of color, people with disabilities, LGBTQ people, low-income people and undocumented immigrants. France says the longer a patient waits, the more expensive an abortion procedure becomes, and 90% of the patients at Preterm already receive some kind of financial assistance for their care. She expects that number to increase amid the ongoing economic and public health crisis.

"Everyone is being affected by this crisis, and all kinds of people need abortions," France says. "Our patients are often more likely to have jobs that don't offer paid sick leave; 65% of our patients are already parenting, and may have the new expense of finding childcare or taking time off work to be with their children since schools in Ohio have closed."

In addition to trying to close clinics, some states have also moved to limit the use of telehealth for abortion, which involves a provider guiding a patient over the phone through the use of pills to terminate their pregnancy. "We have extensive research showing the safety and acceptability of telemedicine in abortion care," says Kelly Treder, MD, an abortion provider at Boston Medical Center and a fellow with Physicians for Reproductive Health. "Telemedicine can ensure that patients receive accurate, comprehensive, timely information and care particularly in geographic areas where access to an abortion provider is limited. Bans on telemedicine in abortion care endanger patients who are trying to get the safe and timely care that they need."

Advocates say that banning both abortions at clinics and abortions through social-distancing-acceptable telehealth shows what the real motivation behind these restrictions are: curbing reproductive rights, not just the spread of the coronavirus. "Anti-abortion politicians cannot have it both ways — closing clinics so that patients have to travel for care while telling them to stay inside and wait it out, knowing they've made it impossible to get an abortion via telemedicine, via mail, and later in pregnancy," Renee Bracey Sherman, the founder of We Testify, an organization dedicated to the leadership and representation of people who have abortions, tells InStyle.

Most of all, reproductive rights advocates stress that restrictions imposed during the crisis could be difficult to undo and will ultimately undermine these rights long-term. "Every day that passes, we need more access to comprehensive reproductive healthcare services like birth control, emergency contraceptives, prenatal care, and abortion care," Sieck says. "This is about our freedom to make decisions for our own bodies, lives, and families, especially in times of crisis."

The Coronavirus pandemic is unfolding in real time, and guidelines change by the minute. We promise to give you the latest information at time of publishing, but please refer to the CDC and WHO for updates.