This week, Gov. Matt Bevin signed into law a bill that bans abortion at 20 weeks. While this law may seem to be benign, it will have life-altering consequences for Kentucky families and women, some of whom are seeking abortion for serious health threats to themselves or their babies. The bill has no exceptions for rape, incest or mental health problems.
Since 2011, there has been a dramatic increase in the number of restrictions passed by states to restrict abortion. I lead a research team that evaluates the effects of these state-level abortion restrictions on women’s lives throughout the United States. As a public-health social scientist I have observed that every woman’s pregnancy is unique — each will have a different set of circumstances around that pregnancy.
For women who make the personal decision to seek an abortion, state restrictions lead to multiple financial and logistical challenges. While most women are able to overcome them, some are not. Kentucky’s 20-week ban will make it more challenging for women to obtain a wanted abortion and will likely increase the number of women carrying unwanted pregnancies to term.
Using data from the Turnaway study which followed nearly 1,000 women who received or were denied a wanted abortion at one of 30 abortion facilities throughout the U.S., we investigated the impact of gestational limits. We estimated that in 2008 U.S. abortion clinics were already turning away over 4,000 women seeking wanted abortions each year because they had surpassed state or provider gestational limits, like Kentucky’s 20-week ban.
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Among a sample of women turned away, the most common reasons for showing up at an abortion facility beyond the gestational limit were delay in recognizing pregnancy, and time needed to raise money to pay for travel and the procedure. At the time we published the study in 2012, eight states limited abortion at about 20 weeks, and today 17 states do, including Kentucky.
The costs of an abortion in the U.S. go up later in the pregnancy. As one woman in our study explained, “By the time I was able to raise the $650 (for an abortion) … the price jumped to $1,840.”
Once a woman is beyond the first trimester, raising the funds to pay for an abortion can create obstacles and lead to further delays, creating a cycle of increasing cost and delay. As a result, gestational limits not only impose obstacles to women seeking abortions, but also completely eliminate abortion as a real option to many of those women.
Women seeking abortions are more likely to be low-income. Currently in Kentucky and 32 other states, poor women have no access to publicly funded abortions, with few exceptions. Laws that impose lower and lower gestational limits will disproportionately affect women already facing complicated financial circumstances.
Kentucky’s legislators are out to stop women from having the abortions they seek, closing down one of the two abortion providers in the state just last summer. The state of Kentucky now has only one abortion provider. For women in Eastern Kentucky, this could mean up to a four hour journey each way.
It is not always possible for a woman to get an abortion as soon as she needs one because of the many barriers that exist. When gestation bans are passed, it is usually low-income women who bear the burden, perpetuating inequalities in access to health care. Science and medicine should be guiding laws that regulate abortion. Throughout a woman’s life, her health — not politics — should drive important medical decisions like abortion.
Ushma Upadhyay is an associate professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Francisco. Reach her at firstname.lastname@example.org.