I am an Abortion Counselor, and Here’s an Inside Look at What's Really Happening Behind the Scenes after the Fall of Roe v. Wade

“Can they arrest me if they find out I traveled to another state and had an abortion? Can they try to take my children away?These are just a couple of the questions my patient asked during a recent after-hours call. 

Her fears are justified — many patients now face a chilling new reality in this post-Roe America. 

Since the conservative majority on the Supreme Court overturned Roe v. Wade, which guaranteed the right to an abortion in any state in America, on June 24th, 2022, patients in many states have been living in a real-life, dangerous dystopian nightmare.

Many Americans, nearly 60 percent, according to polling from CBS News, were outraged over Roe v. Wade being overturned. Despite this, Republican legislatures in conservative-leaning states have waged a war on personal freedom and reproductive choice, passing restrictive bans in over 20 states — with 14 states outlawing abortion entirely. Many of these bans lack clear exceptions for rape, incest and a situation in which a patient’s life in danger. And even when exceptions exist, they are nearly impossible to obtain.

I work on the frontlines of reproductive health care as an abortion counselor. Our patients come from all different backgrounds and circumstances. Some patients come into our office looking for help, but most call us for assistance from states with restrictive abortion bans.

Before Roe v. Wade was struck down, I worked in reproductive health care, and there were some challenges with patients accessing care, especially in many rural and Southern states with very few clinics, mandatory three-day waiting periods before an abortion procedure, and laws that force patients to visit clinics twice (once for a consultation and then for the procedure). But after the overturn of Roe v. Wade, things became exponentially worse, almost overnight in some states. 

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What my day-to-day is now like

Here’s what an abortion counselor’s work generally involves post-Roe v. Wade: We help patients find clinics where they can legally be seen, work through the logistics of how they will get to another state if necessary, and provide some financial assistance due to the high cost of traveling. Abortion counselors do not make medical decisions for patients or talk them into terminating — we provide practical support to patients who’ve already decided they are having the procedure.  

From the moment SCOTUS made this dangerous decision, our phones have been ringing off the hook. We sprung into action, expanding our hours, including evenings and weekends, hiring after hours on-call counselors, and expanding travel assistance. But even with these changes, phone calls poured in at all times. Patients in general were terrified, unsure if they could still be seen and never knowing what was going to happen when they showed up to their appointment. Some patients in certain states were already in the clinic waiting room and had to be turned away when the landmark case was overturned. 

Reproductive health care workers, legal experts and concerned Americans have mobilized similarly to the underground Jane operation before Roe v. Wade was passed, but this time in courtrooms, hotlines, clinics, and street protests nationwide. Volunteer pilots formed an organization that flies patients to their appointments in legal states. Lawsuits challenging bans succeeded in some cases, much to the dismay of anti-abortion lawmakers. Several democratic-leaning states passed measures further protecting reproductive choice, but despite these herculean efforts, the scope of what patients face in banned states cannot be understated. 

Patients are in grave danger

“At my sonogram today I found out there are serious fetal abnormalities. If I can’t get the procedure done immediately, I could be at great risk of serious complications — my children could lose their mother,” shared one of my patients. Throughout this past year, preventable medical emergencies have increased as patients having a miscarriage, hemorrhaging, and experiencing life threatening complications are denied abortion care, even when a fetus is not viable.

Jaci Statton, an Oklahoma mother with a partial molar (non-viable, potentially cancerous) pregnancy, was denied an abortion, despite the high risk of cancer spreading throughout her body. Statton drove three hours to Kansas to get the life-saving procedure. 

Statton’s experience was horrific, but fortunately she had the resources to travel — many patients lack transportation, gas money, or funds to fly to another state.

Patients in banned states often report concerns that getting an ultrasound could mean medical facilities will be able to track their pregnancy status. They often fear going to the emergency room during a miscarriage because they could be falsely accused of getting an abortion. Patients also worry that simply canceling an obstetrician appointment could lead to their provider assuming they terminated and potentially reporting them.

President Biden signed an executive order that protects patients traveling into a legal state, but laws like SB8 in Texas incentivize private citizens to report suspected abortions, creating terror and confusion for patients.

Crisis pregnancy centers (CPCs) have also become more emboldened during this time period. Falsely advertising as medical “clinics” but run by anti-abortion activists, these unregulated facilities often perform free ultrasounds, exploiting vulnerable patients and giving them misleading information. Early abortion bans have become a gold mine for CPCs who often tell patients they are past their state’s cutoff, even when they were still early enough to terminate the pregnancy. 

“They told me I was definitely past six weeks, but that didn’t add up at all with my last menstruation. Then, several women surrounded me and began praying,” one patient shared. Another patient told me that when she was at one of these “clinics” they began asking her invasive questions about who the father was. When she disclosed she had left an abusive relationship, they encouraged her to get back with the partner who was her abuser and raise the baby together. 

It doesn’t stop there. Even after these bans were implemented, the assault on reproductive choice continues, with anti-abortion activists and lawmakers attempting to ban the abortion pill. The Republican National Committee is calling for more bans — despite their abysmal midterm election performance based partially on this issue.

The fight isn’t over

Abortion opponents have long claimed this is a “states’ rights” issue, but conservative lawmakers in Florida, Arkansas, Idaho, North Dakota, Ohio, Missouri, Oklahoma and Mississippi are trying to stop constituents from voting on abortion ballot measures. But it is not as effective as they want it to be: Voters in conservative Kansas (and other conservative states) overwhelmingly rejected banning abortion in a 2022 ballot measure, representing the majority of Americans’ beliefs. 

As my shift was ending today, a patient from a banned state called. Her abuser, who had access to deadly weapons, violated his restraining order again and threatened her life. She just found out that she was pregnant and feared he would kill her if he knew.

“The pro-life movement is such a lie — they don’t care if I die. They just want to force me to give birth,” my patient said.

Everyone can play a role in mobilizing to end these restrictive bans by voting to elect pro-choice candidates, voting in judicial elections (judges play an integral role in bans being upheld or struck down), and supporting or volunteering with organizations fighting to get reproductive choice on the ballot. Abortion counselors will continue to fight alongside you for patients’ personal freedom for as long as it takes. We are there, working with patients who need help, connecting them to all available resources, and ensuring they are supported and they know they are not alone in the battle to access care and restore the most basic right of all: to control your own body.

If you have questions about abortion access in your state, please go to reprolegalhelpline.org

*The author’s name has been changed to protect their safety and anonymity. 

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