The Coronavirus Becomes an Excuse to Restrict Abortions

https://www.nytimes.com/2020/03/26/opinion/covid-abortion-ohio-texas.html

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Last week, Ohio’s attorney general ordered abortion clinics in the state to stop performing most surgical abortions. On Monday, the attorney general of Texas issued a stricter directive, applying to “any type of abortion that is not medically necessary to preserve the life or health of the mother” and threatening jail for providers.

And other states may soon join them.

Ohio and Texas have moved to make abortion inaccessible under the cover of broad directives seeking to free up hospital beds and preserve the supply of personal protective equipment for medical workers with the postponement of “elective” and “nonessential” procedures.

It’s obviously a good idea for states to make medical equipment and beds available as they brace for rising numbers of Covid-19 patients.

But abortion uses relatively few medical resources and is time-sensitive by definition. Delaying it increases the risk to the person who is seeking it. That’s why the American College of Obstetricians and Gynecologists and the American Board of Obstetrics and Gynecology recently issued a statement saying that abortion should not fall into the category of procedures that can be delayed during the coronavirus outbreak, calling it “an essential component of comprehensive health care.”

To put public health first, state officials should listen and heed the experts. Instead, officials in Ohio and Texas are using the coronavirus crisis to achieve the longstanding political goal of reducing or ending abortion, even if it means putting patients at risk.

Both states have long histories of trying to restrict abortion. An Ohio ban on the procedure after six weeks of pregnancy was quickly struck down last summer by a federal judge for being “unconstitutional on its face.” And in 2016, the U.S. Supreme Court struck down a Texas law that the court found would have forced half of the state’s abortion clinics to close.

In these pandemic-timed moves against abortion providers, the pretext is clear from the scope and application of the Ohio and Texas orders.

The Texas order barring “any type” of abortion could apply to medication abortions. And in Ohio, said David Pepper, the chairman of the Ohio Democratic Party, health institutions were told “you should only do essential procedures, and then were allowed to decide what that meant themselves” — with the exception of abortion clinics. “That differential treatment said everything,” Mr. Pepper said.

The impact of the Ohio order is unclear. Planned Parenthood and other groups argued that because abortion is an essential form of health care, clinics were operating as they should. Democratic lawmakers helped work out an agreement that has allowed the clinics to stay open.

But in Texas, at least one abortion provider, Whole Woman’s Health, has had to interrupt care, canceling appointments for more than 150 patients at three locations on Monday alone. On Wednesday, Whole Women’s Health sued the state in federal court over the restrictions.

“Patients were crying and begging us to still let them come in,” said Amy Hagstrom Miller, president of Whole Woman’s Health, the clinic that brought the Supreme Court suit over the Texas restrictions. “We have one woman who drove 250 miles to one of our clinics who is sort of camping out, not leaving, waiting for us to figure out a way for her to be seen.”

A doctor who provides abortions elsewhere in the state told me that her patients pleaded with her to do the procedure when they came in for ultrasounds before the order went into effect, but she couldn’t because Texas requires a 24-hour waiting period.

Abortion providers point out that they could use less scarce medical gear and reduce the risk of spreading the virus in waiting rooms if they could expand access to medication abortions via online consultation with a doctor. This kind of abortion involves dispensing pills; studies have shown it is safe and effective.

“During the pandemic, it would be possible to provide medication abortion through 11 weeks of pregnancy without an in-person visit and by mailing pills to a patient,” tweeted Dr. Daniel Grossman, a gynecology professor at the University of California, San Francisco. “This would reduce the patient and clinician’s risk of acquiring the virus” and without the need for personal protective equipment.

The problem is that at least 18 states, including Texas, require the doctor who prescribes the abortion pills to be present when the medication is taken, which means patients have to go to a clinic two or three times (to date the pregnancy with an ultrasound, to take the pills, and sometimes for a follow-up visit). The Ohio Senate passed a tele-medicine abortion ban on March 4; the bill now awaits action in the House.

Despite the downsides, the push to use the coronavirus crisis to block access to abortion may just be getting started. This week, Mississippi’s governor threatened “action” against the state’s only clinic if it continued to perform abortions, without specifying what he meant. And dozens of anti-abortion groups sent a letter to Alex Azar, the secretary of the U.S. Department of Health and Human Services, demanding the use of the government’s “broad emergency authority” to urge abortion clinics to stop operating and prevent the expansion of abortion by telemedicine.

When abortions become harder to get, low-income women pay the heaviest price, because they have less means to travel long distances to remaining providers. And during the pandemic, it’s risky for anyone to travel.

As anxiety runs high, and the virus imposes steep costs, the government should seek to ease people’s burdens — not single out women for punishment for seeking abortions. It's their constitutional right.

Emily Bazelon is the author of “Charged: The New Movement to Transform American Prosecution. and End Mass Incarceration.”

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