State by State, Chipping Away at Reproductive Rights

by Georgana Hanson

January 22 marked the 30th anniversary of the Supreme Court's groundbreaking ruling that women have a fundamental and constitutional right to assert control over their reproductive health. "Motherhood by choice, not chance" was the cry of women in 1973, and unfortunately the fears behind that cry remain valid 30 years later. The past decade has seen the steady erosion of women's reproductive rights as anti-choice advocates and lawmakers at the state and federal levels continue to create and enact legislation impeding women's access to abortion services.

Public focus has centered on federal judicial nominees and the prospect of the retirement of a Supreme Court justice, paving the way for the repeal of Roe v. Wade. But pro-choice advocates and groups are more concerned about activities at the state level. Since 1995, states have enacted 335 anti-choice measures, creating a patchwork of restrictions affecting women throughout the U.S.1 The following is a snapshot of a few types of anti-choice legislation being enacted at the state level. Our hope is that after reading this article, you become as concerned and outraged as we are, and that you use that energy to battle anti-choice forces in your state.

Mandatory Delays and Biased Counseling: 20 States

Anti-choice lawmakers in 20 states have enacted laws that force women to delay abortions as long as 48 hours after receiving state-mandated counseling. 2 Erroneously entitled "informed consent" or "women's right to know" laws, these often give women medically inaccurate and misleading information in the hopes that they will reverse their decision to terminate the pregnancy. 3 The majority of the states that have enacted and now enforce such laws require women to visit their provider or two separate occasions, one to receive the mandated counseling and again for the procedure. The extra visit creates a substantial burden for young women, low-income women and women who live in rural areas by subjecting them to increased travel time and costs, the need to take additional time off from work or school, and/or the necessity of arranging for child care. These laws not only obstruct women from getting the care they need, but they also insinuate that women are unable to make informed and responsible decisions for themselves.

On June 20, Governor Rick Perry of Texas signed into law a bill that would require women to wait 24 hours before obtaining an abortion. The law also requires physicians to explore alternatives to having an abortion, discuss with the women the medical risks associated with the procedure, and show the patients color pictures of the developing fetus."4 In a state where 93 percent of counties lack an abortion provider, this law only hurts women by forcing them to surpass considerable barriers to receive the care they need and deserve.1

Parental Consent/Notification Laws: 33 States

In an effort to "protect our youth," state lawmakers have enacted legislation requiring minor women to involve their families in decisions regarding the women's reproductive health. Some require the minor to obtain consent from a parent; others require physicians to notify minors' parents of the women's intent to terminate a pregnancy.⁵ While we all aspire to live in a world where families are caring, understanding and supportive of one another, the reality is often far bleaker. Some young women live in abusive homes, some parents are anti-choice and the list continues. In a supposed effort to amend this issue, lawmakers have created a judicial bypass system that lets minors who cannot notify or receive the consent of their parents seek permission to terminate through a judge. ⁵ Clearly, revealing personal information to a powerful stranger is a potentially terrifying experience that could deter young women from using the judicial bypass system. Also, many judges themselves are antichoice and will deny women their right to a legal procedure regardless of the circumstances. As of late July, 19 states require parental consent, and 14 require parental notification.⁶ 

In June, Governor Craig Benson signed into law New Hampshire's first abortion regulation requiring physicians to notify the parents of minors wishing to terminate a pregnancy. Young women in the state will be able to seek judicial bypass if they do not wish to have their parent(s) involved. The law goes into effect on December 31.⁷

Refusal Clauses: 45 States

Another means of restricting access to abortion services involves letting providers refuse to offer certain services that conflict with their moral or religious views. Such laws are usually termed "refusal" or "conscience clauses" and pertain to hospitals, physicians, pharmacists and insurers. These clauses allow individuals or institutions to deny women counseling services, medical procedures, referrals and insurance coverage if the care the woman is seeking conflicts; with the provider's personal views.8 Refusal clauses can prevent women from receiving medically appropriate care, further endangering their health and well-being. Forty-five states allow individuals and institutions to refuse to provide abortion-related services. Of these, 12 allow refusal of contraceptive services, and 16 allow refusal of sterilization procedures (as does West Virginia, which doesn't allow the broader refusal clauses).⁹

Aiming to make Wisconsin the 46th state in this category, state legislators there hope to pass a bill that will allow "health care workers" to refuse certain services if they conflict with personal moral and religious beliefs. Such services could include providing abortions and in vitro fertilization. Pharmacists could also refuse to dispense any medication they believed would be used as an abortifacient or for euthanasia, even when prescribed by a doctor for other purposes.¹⁰

Targeted Regulation of Abortion Providers (TRAP) Laws: 24 States

TRAP laws are yet another example of how anti-choice lawmakers single out abortion providers by requiring them to comply with outrageous additional requirements. Disguised as promoting maternal health and safety, TRAP laws often impose various health requirements exclusively upon physicians and facilities that provide abortions, and not upon facilities that do not.¹¹ Physicians often find that such requirements impose unnecessary financial and regulatory burdens that make it increasingly difficult to offer services. Twenty-four states have TRAP laws that are enforceable and apply to providers of abortion services during the first and/or second trimester. ¹² Examples:

• "Health Department inspectors shall have access to all properties and areas, objects, records and reports [of the abortion facility] and shall have the authority to make photocopies of those documents required in the course of inspections or investigations." South Carolina Regulation 61-12 Section 102-F. ¹² 
• "Abortion procedure and recovery rooms shall have a minimum of six air changes per hour. All air supplied to procedure rooms shall be delivered at or near the ceiling and must pass through a minimum of one filter bed with a minimum filter efficiency of 80 percent." North Carolina Admin. Code 3E.0206. ¹²
• "All outside areas, grounds and/or adjacent buildings shall be kept free of rubbish, grass and weeds that may serve as a fire hazard or as a haven for insects, rodents and other pests." South Carolina Regulation 61-12 Section 606. ¹²

Fetal Rights: 23 States

Undoubtedly one of the most frightening attacks on women's reproductive rights involves the provision of rights to the fetus, in essence providing legal protection upon conception. Anti-choice lawmakers have capitalized on the public outcry over the Laci Peterson case to push legislation that places the rights of the fetus on a par with those of the woman, with the covert intention of dismantling Roe v. Wade. Twenty-three states have introduced legislation that seeks to redefine the fetus as a person by criminalizing harm to an embryo or fetus, allowing the fetus to be eligible forSCHIP (State Children's Health Insurance Program), or including embryos and fetuses in wrongful death cairns. ¹³

In June, Texas Governor Rick Perry signed into law a bill that defines a fetus as a person, and thus allows charges to be filed on behalf of the fetus if it is terminated via accident or crime. Additionally, families of the fetus can bring civil charges against the person responsible for the death of the fetus^.4

Stand Up and Speak Out: Voicing Our Support for Reproductive Rights

Attacks on women's reproductive rights are occurring daily. State governments are all too eager to infringe upon women's rights by creating insurmountable barriers, leaving women unable to access the appropriate care they need and deserve. We must not remain silent. Keep abreast of what state legislators are proposing and let them know that as a pro-choice constituent, you will not continue to support any lawmaker that proposes or supports anti-choice legislation. As election time draws near, campaign for pro-choice legislators and ask that they ensure that your state respects and promotes the reproductive rights of its female constituents. Lastly, support pro-choice organizations that are dedicated to ensuring women's reproductive freedom. Without their constant vigilance, we face an almost certain return to the days of more unintended pregnancies, illegal abortions and women's deaths.

'Choose Life' License Plates: the Art of Anti-Choice Fundraising

Over the past couple of years, anti-choice activists have taken fundraising to a whole new level with the development of 'choose life' license plates. Currently, residents in eight states can purchase these specialty plates at $25 to $70 above the price of standard plates. The excess funds are distributed to crisis pregnancy centers that often give women biased and medically inaccurate counseling. Prochoice organizations have argued that the plates are unconstitutional, saying the government is choosing political sides (many of the states have refused to allow the sale of pro-choice license plates). Support women's right to choose by urging your state representatives to oppose any legislation that supports 'choose life' license plates. You can also voice your opinions by placing a pro-choice bumper sticker on your vehicle, or by purchasing pro-choice license plate holders (available by visiting www.NARAL org).

Georgana Hanson is the Network's clearinghouse coordinator. Her last article for this publication explored state and federal efforts to undermine the Medicaid program (July/August 2003).

REFERENCES

1 NARAL Pro-Choice America. Who Decides? A State-by State Review of Abortion and Reproductive Rights. 12th Edition 2003.

2 Alan Guttmacher Institute. Mandatory Waiting Periods for Abortion. State Polices In Brief. July 1, 2003.

3 Center for Reproductive Rights. Mandatory Delays and Biased Information Requirements. May 2003.

4 Kaiser Family Foundation. "Texas Governor Signs 24-Hour Waiting Period, Fetal Homicide Bills." Kaiser Daily Reproductive Health Report. June 24, 2003.

5 NARAL Pro-Choice America. Minors' Access to Abortion Services. Available at: http://naral.org/facts/im_minors_access.cfm.

6 Alan Guttmacher Institute. Parental Inuoluement in Minors' Abortions. State Policies in Brief. July 1, 2003.

7 Kaiser Family Foundation. "New Hampshire Governor Signs Parental Notification Bill into Law." Kaiser Daily Reproductive Health Report. June 23, 2003.

8 NARAL Pro-Choice America. Refusal Clauses. Available at: http://narat.org/facts/imjrefusal.cfm.

9 Alan Guttmacher Institute: Exemptions from Providing Health Services. State Policies in Brief. July 1, 2003.

10 Kaiser Family Foundation. "Wisconsin Assembly Approves Bill to Allow Health Workers Right of Refusal for Certain Procedures, Including Abortion." Kaiser Daily Reproductive Health Update. June 6, 2003.

11 NARAL Pro-Choice America. TRAP Laws. Available at: http://naral.Org/facts/imj:rap.cfm

12 Center for Reproductive Rights. Targeted Regulation of Abortion Providers: Avoiding the TRAP. January 2003.

13 NARAL Pro-Choice America. Anti-Choice State Legislative Trends. May 2003.