Lilith Fund
In the early days of the coronavirus pandemic, as the virus began to spread, Republican Governor Greg Abbott of Texas, like the governors of most other states, issued an executive order barring elective medical procedures to preserve vital personal protective equipment (PPE) and hospital bed capacity.
In early 2019, a wave of abortion bans spread across the South and Midwest, aiming to outlaw abortion after as little as six weeks of gestation—before many women know they are pregnant.
Unlike most states, Texas quickly clarified that the order included abortions. Overnight, the state had done what anti-choice activists have worked toward for decades: It banned abortion.
Restrictions have long been a part of the abortion landscape in Texas. A 2013 law requiring abortion providers to have admitting privileges at local hospitals forced half of the state’s abortion clinics to close before it was struck down in 2016 by the U.S. Supreme Court.
Still, an abortion ban in the midst of a global pandemic was “a complete nightmare,” says Amanda Beatriz Williams, executive director of the Lilith Fund, an Austin-based group that assists people with paying for their abortions. There was no way for advocates to prepare, and Abbott’s order created an environment of confusion where activists went back-and-forth in the courts about what—if any—abortion care was allowed.
Medication-induced abortion was also caught up in litigation, though the pills are safe to take at home, via telemedicine, in the first ten weeks of pregnancy and do not require the use of PPE.
Dr. Ghazaleh Moayedi at work
The day after Abbott released the order, but before it was clarified to include abortion, Dr. Ghazaleh Moayedi, an ob-gyn in Texas and board member with Physicians for Reproductive Health, had performed the state-mandated ultrasounds and counseling, twenty-four hours before she could provide abortion care. Moayedi had to tell these clients that those follow-up appointments could not be kept; she spent the next several days and weeks helping refer them to out-of-state providers.
Meanwhile, the Lilith Fund was “hearing from our callers [seeking abortions that] they lost jobs, they’re sick, they’re scared to travel,” says Williams, noting that more than half reported being negatively affected by the pandemic.
Many of these clients were forced to drive hours across Texas to surrounding states where abortion remained available, missing work and incurring additional costs. Moayedi had clients travel to clinics in Illinois, Kansas, Colorado, and New Mexico. Williams says that, among nearly half of the Lilith Fund’s clients, each drove an average of 600 miles for their abortions during the month abortion was banned.
Texas’s abortion ban only expired when elective surgeries were allowed to take place, a full month after the order was issued. Many clients who could have had medication abortions before the ban ended up needing second-trimester, surgical abortions.
In all, twelve states imposed moratoriums on abortion (all of which have since ended).
It’s likely that these states would have seized this opportunity to ban abortion even if Donald Trump was not President. After all, hundreds of anti-abortion laws proliferated at the state level under the Obama Administration, ensuring that getting an abortion was dependent on race, class, sexual orientation, health insurance, and geography.
Yet there is something different about the current administration—an “added layer of hate and cruelty,” charges Williams. Indeed, Trump, with his evangelical right-hand man, Vice President Mike Pence, has exacerbated the inequities that have long-existed even after the protections promised by Roe v. Wade.
The Trump Administration has not only put forward its own anti-abortion attacks but has legitimized—and inspired—severe restrictions and attacks on abortion. And, in doing so, it has emboldened a movement and invited extremists to the highest ranks of power.
On November 9, 2016, anti-abortion activists across the country rejoiced.
Trump’s victory reflected the results of “a national referendum on abortion,” wrote Ernest Ohlhoff of Maryland Right to Life, a state partner of National Right to Life. “Now,” he reminded supporters, “our real work begins.”
The election was a “historic moment for the pro-life movement,” Marjorie Dannenfelser, president of the anti-choice Susan B. Anthony List, said in a statement. “We are poised to make the biggest legislative advances for the protection of unborn children and their mothers since Roe v. Wade was decided.”
Dannenfelser went on to list some of the group’s goals under the new administration, including codifying the Hyde Amendment (which restricts federal funds from being used for abortion), defunding Planned Parenthood, and ensuring the appointment of anti-abortion justices to the U.S. Supreme Court—a prospect made immediate by the death of Justice Ruth Bader Ginsburg.
The Trump Administration has hammered Planned Parenthood, limited access to birth control, and instituted a “global gag rule” that bars international organizations from receiving U.S. funding if they so much as refer clients to abortion providers.
Trump has succeeded in appointing two anti-choice Supreme Court Justices, Neil Gorsuch and Brett Kavanaugh, and nominated nearly 200 federal judges (almost a quarter of the whole), with most being extremely conservative and anti-choice.
In January, Trump became the first U.S. President to address anti-abortion activists at the annual March for Life rally in Washington, D.C., telling attendees that “unborn children have never had a stronger defender in the White House.”
Perhaps most significantly, Trump has created a climate of fear that affects people seeking abortions almost as much as de jure law. What we’ve seen, says Megan Donovan, senior policy manager at the pro-choice Guttmacher Institute, is a “weaponization of abortion stigma to undermine reproductive health care more broadly.” The President has emboldened anti-abortion activists to use harsher, more nakedly brutal tactics.
In early 2019, a wave of abortion bans spread across the South and Midwest, aiming to outlaw abortion after as little as six weeks of gestation—before many women know they are pregnant. These bills were known as “heartbeat bills” because they sought to ban abortion when a “fetal heartbeat” can be heard. (This is misleading, because what can actually be heard is the pulsation of a cluster of cells that will later become the heart.)
Tennessee was one of the first states to introduce such a law, though it initially failed to pass the state senate. Shannon Hardaway, a reproductive rights activist with the Chattanooga Health Advocacy Team, attended hearings for the bill. Some state senators, she says, “pretty much said that because Trump is President, they [were] going to get Roe v. Wade overturned,” by passing a heartbeat bill and hoping it would withstand legal challenge.
Chattanooga, Tennessee, where Hardaway lives, is one of the biggest cities in the country without an abortion provider. When Hardaway needed an abortion, she had to travel two hours to Knoxville.
This summer, Tennessee made a fresh run at undermining access to abortion statewide. In July, Republican Governor Bill Lee signed into law a bill banning abortions after the point a fetal heartbeat can be detected, among other restrictions. It includes creative “ladder” provisions, modeled after a Missouri bill, banning abortion at eight, ten, twelve, fifteen, eighteen, twenty, twenty-one, twenty-two, and twenty-three weeks—each less-restrictive time limit becoming law if the previous is overturned. The law is currently blocked, by order of a federal court.
The influence of intense anti-abortion activism is even expanding at the local level. In Texas, about a dozen small towns have passed ordinances attempting to ban abortion. While the bans can’t become law unless Roe or Planned Parenthood v. Casey (which upheld Roe but allowed state restrictions that did not impose a fuzzily defined “undue burden”) were overturned, they represent a shift toward the normalization of extreme anti-abortion fervor.
In June, abortion rights activists celebrated when the Supreme Court handed down its decision in June Medical Services LLC v. Russo, regarding a Louisiana admitting-privileges law nearly identical to a Texas restriction that was struck down in 2016. Chief Justice John Roberts joined the liberal justices in ruling that the Louisiana law was unconstitutional.
Unfortunately, Roberts penned his own opinion suggesting that he remains open to future challenges to abortion. Indeed, the Eighth Circuit Court of Appeals recently cited Roberts’s opinion when it validated Arkansas laws that, among other restrictions, banned a common second-trimester abortion procedure and regulated the disposal of fetal tissue.
The Trump Administration has also restricted reproductive rights through the actions of federal agencies. His Department of Health and Human Services (HHS), which declares its commitment to “protecting Americans at every stage of life, from conception,” in January issued a press release listing two dozen actions it had taken to “protect life and conscience.”
Among these was an HHS policy to allow employers to refuse to cover birth control for their employees (which was greenlighted by the Supreme Court), as well as one that would complicate abortion coverage billing through Affordable Care Act health plans that offer it (which was blocked by a federal judge).
Last year, the Trump Administration finalized a “domestic gag rule” on clinics that receive Title X funding. It bars clinics from referring clients for abortions and requires clinics that provide abortions with non-Title X funds to physically separate their abortion services. The changes were a blatant attack on Planned Parenthood, which, unwilling to comply, withdrew from the program.
In Michigan, Planned Parenthood was one of thirty-two Title X providers, but accounted for 70 percent of the program’s patients, Lori Carpentier, president and chief executive officer of Planned Parenthood Advocates of Michigan, tells The Progressive. In a typical year, Planned Parenthood would see about 43,000 patients, using approximately $4.3 million Title X funds. Since leaving the program, the group has had to use philanthropy to fill in the holes in their funding streams.
As a result of Trump’s gag rule, six states (Washington, Oregon, Utah, Maine, Vermont, and Hawaii) now have no Title X provider at all.
Carpentier has been working in abortion advocacy for years; she was around when anti-abortion activists would use extreme tactics like blocking doors at abortion clinics in the 1980s and 1990s. While the number of protesters at clinics is not as great as it was then, she says those who remain “are more likely to trespass, more likely to get in our patients’ faces.”
According to the National Abortion Federation, acts of violence and disruption by protesters are indeed increasing. In 2019, clinic invasions more than doubled from the year before, from eight to nineteen. And the group identified more than 1,507 incidents of trespassing, the most since it began tracking this metric in 1999.
Under the Trump Administration, Carpentier says, anti-abortion activists “think they’re untouchable.”
If Joe Biden is elected on November 3, he will likely do what he can to reverse his predecessor’s harmful actions. But even a President heartily committed to reproductive justice can’t force states, led by anti-abortion lawmakers and often heavily gerrymandered, to liberalize their abortion laws. It would take action by Congress to do away with the Hyde Amendment and establish federal standards for abortion access.
As Trump has demonstrated, rhetoric itself is a powerful tool. Democrats, too, often reinforce abortion stigma by claiming abortion should be legal but rare. Why should the ability to obtain vital health care be rare?
Biden should do away with his wishy-washy views of abortion—he only reversed his support for the Hyde Amendment last year—and reiterate that abortion care is health care, as Americans increasingly believe. Only bold and concerted action can undo the damage to reproductive rights that Donald Trump has done.