Mississippi is trying to stop abortions with threats of prison

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A new Mississippi abortion law seems designed to intimidate patients and threaten doctors.

The Mississippi state House and Senate have just passed a bill that seeks to restrict the reasons for which a person can seek an abortion, also known as a "reason ban." The state's anti-abortion Republican governor, Tate Reeves, is expected to sign it. If the bill becomes law, it could discourage people from seeking abortion care in the state. And that could mean people in Mississippi could be be forced to wait for the care they seek, travel out of state, and obtain abortions later in pregnancy, when they are more expensive and even more burdensome.

The Mississippi bill would impose penalties of at least one year in prison for a felony in the case of conviction on a doctor who "intentionally or knowingly" performed an abortion "because of the actual or presumed race or sex of the unborn human being or because of the presence or presumed presence of a genetic abnormality."

Such bans require an abortion provider to unearth the reason someone wants an abortion. Doctors essentially either have to make unfounded assumptions about their patients' reasons, or they have to actively ask about them. 

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The American Congress of Obstetricians and Gynecologists has said these types of bans "represent gross interference in the patient-physician relationship, creating a system in which patients and physicians are forced to withhold information or outright lie in order to ensure access to care."

"By forcing physicians to interrogate women about their motives for obtaining a medical service — in this case safe, legal abortion — this bill would turn doctors into investigators and women into suspects," Mary Nolan, executive director of Planned Parenthood Advocates of Oregon, said when that state was considering a similar ban in 2017.

A reason ban is already on the books in Tennessee, though it was immediately challenged in court by abortion providers in that state.

According to both the Tennessee law and the Mississippi bill, doctors are prohibited from performing abortions when they know the procedure is being chosen for a particular reason. The legal filing in the Tennessee case explains the problem with the language in these sorts of bills, noting the bans "do not make clear whether the law targets abortions where the prohibited reason is the patient's sole reason, a primary reason, or one motivating factor among many." 

Given that the Mississippi bill imposes criminal penalties, doctors may become wary of performing abortions in any situation where they might be aware that one of the forbidden reasons may be a factor. Megan Donovan, a senior policy manager at the Guttmacher Institute, which tracks abortion laws and policies, says these penalties can deter doctors who would face criminal charges or the loss of their medical licenses.

Reason bans such as the one proposed by Mississippi are also flat-out racist. The Guttmacher Institute says the bans are "based on the idea that women of color are coerced into abortions or are complicit in a 'genocide' against their own community." Further, race-based bans, which bar someone from having an abortion because of the race of the fetus, "send the message that women, and especially women of color, cannot be trusted to make their own medical decisions." 

If Mississippi's bill becomes law, it will join a host of other restrictions on abortion in the state. Mississippi already mandates both counseling and an ultrasound for people seeking to obtain an abortion, and it imposes a 24-hour waiting period between such counseling and the procedure, which means patients must make two separate trips to a provider. The state also bars the use of telemedicine for medication abortions, has a mandatory parental consent notification law, and bans one of the most common methods of abortion. 

Further, Mississippi bars most abortions later in pregnancy, with an 18-week ban that has very few exceptions. A total of 99% of counties in the state have no abortion clinic, and there is currently only one stand-alone clinic left in Mississippi of three providers that remain.

With all of those restrictions in place, combined with possible wariness on the part of providers of running afoul of the reason ban, abortion in Mississippi may become close to impossible to obtain.

Guttmacher points out that these bans "discourage honest, confidential conversations and interfere in the provider-patient relationship." Because of that, "patients may withhold information or be dissuaded from seeking care from providers altogether."

As a result, patients may attempt to get an abortion within the state and be turned away, or they may choose to travel outside the state to avoid being interrogated about their reasons.

Raising money to travel out of state is difficult for many patients and can take a considerable amount of time. Traveling out of state also incurs secondary costs, such as for hotel room stays, lost wages for missing multiple days of work, and child care.

If a patient is denied abortion care in Mississippi and needs to travel out of state, their driving distance to the nearest clinic increases by nearly 50%.

Additionally, abortions performed later in pregnancy are simply more expensive

One study that examined women who were seeking abortions at or after the 20-week mark found that many "attributed their delay in seeking care to logistical issues, such as difficulty finding a provider or raising the funds for the abortion." That same study concluded that when people encounter a delay due to financial difficulty, they may experience a "negative feedback loop": As the cost of abortion rises later in pregnancy, "that, in turn, could lead to further delay if a woman needs to then raise additional funds."

If that feedback loop goes on long enough, people may end up having abortions much later in pregnancy, or being unable to get one at all.  

Published with permission of The American Independent Foundation.