This op-ed was written by Dr. Rathika Nimalendran, a Fellow with Physicians for Reproductive Health, and supporter of NARAL Pro-Choice North Carolina, and appeared in the Asheville Citizen Times.
On March 25, District Court Judge William Osteen declared the arbitrary North Carolina 20-week abortion ban unconstitutional. Yet members of the North Carolina General Assembly continued to focus on introducing restrictive anti-abortion legislation, using alarmingly inflammatory rhetoric and inaccurate medical knowledge to shame patients and incite fear. Even though Judge Osteen clearly determined that access to abortion care is safe, legal, and necessary in our state, just as in the rest of the country, North Carolinians are continually threatened by these medically unnecessary pieces of legislation designed to limit access to abortion.
As a family medicine physician in rural North Carolina, I frequently see patients who are unable to receive timely, straightforward medical care because the medical care they need is an abortion. There are many reasons a pregnant person will obtain an abortion, but in North Carolina, patients face multiple hurdles –logistical, economic, and legal.
Unlike other medical procedures, where a patient may come to my office, discuss the procedure, consent for the procedure, and obtain the procedure all in the same visit, pregnant patients are forced to wait 72-hours after providing medical consent for an abortion. If they are under 18, they will have to receive either parental consent or go before a judge to try and obtain consent. Most private insurance and no state or federal health insurance plans such as Medicaid will cover any medical costs, so now they must find a way to pay hundreds to thousands of dollars for an abortion.
As if those hurdles aren’t enough, there are only a handful of clinics that provide abortions in North Carolina, so many patients have to find a way to travel, find childcare, and take time off work. These barriers lead to patients having to wait longer and longer times to obtain an abortion, potentially coming up and over arbitrary abortion bans like the one Judge Osteen recently struck down.
These barriers are not the only reason why pregnant people need abortions later in pregnancy. Pregnant people receive a regular ultrasound around 20-weeks which is often their first opportunity to learn of certain fetal anomalies. These anomalies may lead to a fetus dying before birth. This is devastating for my patients. But their devastation is only compounded when they learn that the state would force them to continue their pregnancy, and that they must leave the state and their own doctors to obtain the health care they need, all while continuing to incur more costs and delays in the midst of their grief.
These patients are not hypotheticals. They are parents, siblings, spouses, children, and friends. They are my adolescent patient who first visited her primary care physician with her mom on one arm and a positive pregnancy test in hand. She knew she wanted an abortion, and her mother supported her decision, but the doctor had no idea where the patient could go to receive care or how much it might cost, given the countless restrictions in our state. They are the mother, excited about a sibling for her children, whose pregnancy was diagnosed with lethal fetal anomalies during a routine ultrasound. She came to see her primary care doctor desperate for support and to help guide her through this process in the midst of her grief. But the costs of the procedure at the hospital where she receives much of her care was exorbitant – over $6,000 — with no insurance coverage or financial assistance available, because this termination is considered an elective procedure. Why is our state creating so many hurdles for her to leap as she suffers through her loss of a healthy pregnancy and the future she envisioned?
I am hopeful that the ruling of the 20-week abortion ban as unconstitutional and arbitrary will be upheld. It is dangerous for politicians to insert their ideologies into the unique patient-provider relationship.
North Carolinians already face too many unnecessary restrictions when seeking abortion. Judge Osteen’s ruling is a step in the right direction and will enable patients to obtain the care they need and deserve. It is time that the legislature began protecting our rights instead of limiting them.