Matt Volz / Kaiser Health News
The four states bordering Montana have “trigger laws” in place or pending that the U.S. Supreme Court has ended federal protection for abortion, making the conservative Big Sky Country an unlikely haven for women seeking to terminate their pregnancies.
But Montana’s chances of becoming an abortion shelter have dwindled – not by lawmakers and governors whose efforts to restrict abortions have been hampered by the state’s constitutional right to privacy, but by operators of at least four of the state’s five clinics who can already take abortion pills. To do.
Officials at the Planned Parenthood of Montana, which operates three of the four clinics, say the goal is to ensure that they and their patients from the state, including trigger bans – are prohibited or restricted by abortion laws that were designed to take effect. Rowe vs. Wade Has been injured – protected from criminal charges and lawsuits. But the change in policy is another complication for women in neighboring states, such as South Dakota, who want to end the pregnancy and face the rapidly narrowing field of alternatives.
“It was a state we hoped it would be found,” said Kim Floren, director of the Justice Through Empowerment Network, a South Dakota abortion fund that provides financial assistance to people who need the procedure. “Right now, it’s worse news on top of worse news.”
Patients often prefer drug abortions over surgical abortions because they are cheaper, take less time to the clinic and offer them more privacy and more control. The most common type of drug abortion is a two-part pill procedure: the first is taken at the clinic if a personal visit is required; The second is usually taken at home. In many states, medications may be sent to the patient after a telemedicine appointment.
In 2020, drug abortions accounted for more than half of all abortions in the United States for the first time, according to the Gutmachar Institute, a research organization that supports the right to abortion. Advocates hope that drug abortion will become the goal of the new state law. In South Dakota, a law banning abortion through telemedicine went into effect July 1.
A transferred legal landscape
The change in Planned Parenthood policy in Montana is a response to changes in the legal landscape, said Jennifer Sandman, public policy lawsuit for the National Agency for Planned Parenthood and senior director of law. “People are working in a state of extraordinary chaos and fear that the Supreme Court has abandoned us and in some states has been aroused by threats from anti-abortion politicians,” Sandman said.
Montana’s Planned Parenthood decided June 30 that it would not provide abortion pills to patients in their clinics in Billings, Great Falls and Helena in states where the Trigger Act has been enacted. At the time, bans were in place in South Dakota, Arkansas, Missouri and Oklahoma, but Planned Parenthood officials said they saw a significant number of patients from South Dakota. Officials did not respond when asked how many South Dakota patients would be infected.
Montana’s other neighbors – Idaho, Wyoming and North Dakota – also have trigger laws, but they have not yet been enacted.
Martha Fuller, president of Montana Planned Parenthood, wrote in an internal memo that the risks of cross-state provision of services were unclear, citing concerns about the potential for civil and criminal action against drug suppliers that terminate human pregnancies. From states with effective sanctions. The memo was posted on Twitter by a freelance journalist and was later deleted. Planned Parenthood officials have confirmed the policy change.
Montana’s three planned parenthood clinics will continue to provide abortion procedures to residents outside the state. “At this point, we believe this is the best way to ensure that out-of-state patients are not afraid to access their necessary follow-up care because of intimidation and intimidation by extreme anti-abortion politicians,” said Laura Terrell, a spokeswoman for Montana Planned Parenthood.
The planned parenthood decision came just days after Missoulian reported that Missoula’s Blue Mountain Clinic would only offer drug abortions to people with Montana addresses. Clinic officials did not answer questions by phone or email.
The fifth clinic to provide abortions in Montana, Whitefish’s All Family Healthcare, declined to answer questions about its policy for out-of-state patients.
Fuller said in his memo that the planned parental policy may change as the legal risks have become clear. The memo did not mention that Montana’s status as a state with legal access to abortion could change soon.
Montana’s Republican-majority legislature and Republican governor passed four state laws in 2021 to limit abortion, but three were blocked by a judge who quoted a 1999 state Supreme Court ruling as saying abortion was a right under the Montana constitution. State Attorney General Montana is urging the Supreme Court to reverse that precedent and enforce the laws. There is a pending decision.
The Montana Chapter is not the only planned parent network that is temporarily changing its policy on abortion pills due to the chaotic consequences of the US Supreme Court’s action. Planned Parenthood North Central States, which arranges drug abortions in Minnesota, Iowa and Nebraska, says patients must take the pill in states where abortion is legal.
The South Dakota Trigger Act makes it a crime to prescribe or administer a substance that causes abortion, but it does not target aborted people. Floren, of the Justice Through Empowerment Network, said there were still fears that South Dakotans could be investigated or charged if they were caught with pills in the state or had to go to their medical provider because of a complication. “A lot of people really like that method and now it’s taking people’s choices again,” he said.
Providers in other states that have become islands for legal abortion do not agree with policies restricting access to out-of-state patients. In Colorado, Dr. Nancy Fang, an OB-GYN at Denver’s Comprehensive Women’s Health Center, said she understands caution in the face of the uncertainty surrounding the state’s abortion ban. But, he said, restricting access would hurt patients and increase pressure on other clinics that continue to provide drug abortions.
“I think it’s really influential on the patient because it further limits their autonomy for access to healthcare, not being able to access a safe alternative based on where they are coming from,” Fang says.
Parenthood of the Rocky Mountain, planned in parts of Colorado, New Mexico, Wyoming and Nevada, does not plan to change its policies, although spokesman leader Meltzer said his organization supports other partners such as Montana to make “heartbreaking decisions.”
“We serve all patients equally, those who live in our own community and those who escape from the abominable restrictions in their own state,” Meltzer said.
Abortion methods are considered to be more effective than abortion pills, although they are more aggressive by their nature. The procedure requires the patient’s cervix to be dilated using surgical equipment, and patients often take anti-anxiety medications or intravenous sedatives. With pills, those who have been abused by their partners can say that they have had an abortion, since the amount of bleeding and other symptoms are similar.
Planned Parenthood plans to expand an organization called Just the Pill, limiting the distribution of abortion pills in Montana. Patients can make telehealth appointments with medical providers from Just the Peel and then take the pills in Montana, Minnesota, Wyoming or Colorado.
Following the Supreme Court decision, the agency said it would send a fleet of mobile clinics to state lines to provide services to women in the states, including abortion restrictions. “By working at state borders, we will reduce the travel burden for patients in states with restrictions or severe limits,” the company said in a statement.
Floren said he hopes Just the Peel will continue to provide services for South Dakotans. The Justice Through Empowerment Network has seen an influx of grants and volunteers, and Floren says the abortion fund is preparing to organize people to attend the upcoming special legislature session where she hopes lawmakers will target abortion aid donors or distributors.
KHN correspondents Rai Ellen Beechel and Erica Zurek contributed to this report.