In Indiana, a changing abortion landscape without clinics

INDIANAPOLIS (AP) — About nine years ago, Sarah Knowlton sought an abortion at a now-shuttered clinic in northern Indiana, where she encountered anti-abortion protesters as she approached the entrance.

Knowlton reflected on how that experience led her in 2019 to Whole Woman’s Health, another abortion clinic in South Bend, to train workers to walk patients safely through its doors, creating a resource she wishes she had years ago. .

But the program — and Knowlton’s job at the clinic — will end Sept. 15, when Indiana’s abortion ban goes into effect, effectively closing abortion clinics across the state.

Indiana’s legislature became the first in the nation to pass abortion restrictions after the U.S. Supreme Court overturned Roe v. Wade, and Republican Gov. Eric Holcomb signed the ban into law on Aug. 5.

The ban, which has exceptions, prohibits abortion clinics from providing any abortion care, leaving such services exclusively to hospitals or hospital-owned outpatient surgery centers.

“My last shift as a clinic attendant is coming up,” Knowlton said Wednesday. “And I’m not ready for that.”

At Indiana University Health, which is the state’s largest hospital system, providers are trained to continue providing abortion care in permitted settings.

According to the new law, abortions will only be allowed in cases of rape and incest before 10 weeks after fertilization. to protect the patient’s life and physical health; or if a fetus has been diagnosed with a fatal abnormality.

A doctor who performs an illegal abortion or fails to file the required reports must lose his medical license.

IU Health officials described a new 24/7 response team — which will include a clinician, an ethicist and an attorney — that providers can contact to assess nuanced emergencies.

“The law is broad,” said Dr. Caroline Rouse, medical director of maternity services at IU Health. “Patient situations are very specific and unique.”

Last year, the majority of abortions in Indiana occurred at abortion clinics. Hospitals performed 133 of the state’s 8,414 abortions, according to the state health department’s 2021 annual report, while the remaining 8,281 were performed at abortion clinics.

Indiana clinics that will not be able to provide abortion services on Sept. 15 include Whole Woman’s Health in South Bend, Women’s Med in Indianapolis and Clinic for Women in Indianapolis.

The four Planned Parenthood clinics that provide abortion care in Indiana will no longer do so, but will continue to see patients for other medical services, such as STD testing and treatment, contraception and cancer screenings, said Rebecca Gibron, CEO of Planned Parenthood. Parenthood. includes Indiana.

“Planned Parenthood has been a leading provider of reproductive health care in Indiana since 1932. And we’re not going anywhere,” Gibron told the AP in August.

Sharon Lau, Midwest Advocacy Director for Whole Woman’s Health Alliance, said that although the South Bend clinic will stop providing abortion care, patients can still access a program that directs patients to abortion appointments in other states.

“We will continue until we are forced not to,” he said.

The Women’s Clinic in Indianapolis declined to speak to The Associated Press.

Lau said her clinic’s plans could hinge on two lawsuits filed by the American Civil Liberties Union of Indiana seeking to block the abortion ban before it takes effect.

The first lawsuit, filed Aug. 31 in Monroe County, says the ban violates the Indiana Constitution, while the one filed Thursday in Marion County claims the ban runs afoul of the state’s religious freedom law, which the Republicans enacted seven years ago. The timing of the two lawsuits is unclear.

Mike Fichter, CEO of Indiana Right to Life, said in a statement that delaying the ban would mean “the indiscriminate killing of unborn children will continue in Indiana abortion clinics.”

“We are confident that the state will prevail and we pray that the implementation of the new law will not be obstructed,” he said.

Women’s Med will also stop providing abortions after the ban, but will continue to refer patients in states where abortion is legal until about a month later, said Dr. Katie McHugh, an abortion provider at the clinic.

McHugh said she has seen a change in patient behavior since Indiana’s ban was passed. While some seek abortion earlier, others choose surgical over medication abortions to avoid complications, he said.

Other patients assume that abortion is already illegal, “and yet they choose abortion anyway, if that might indicate the desperation that people feel,” McHugh said.

Knowlton said she worries about those patients who will put their health or lives at risk if they can’t get an abortion. He knows that feeling. was her mindset nine years ago.

“I was going to find a way, come hell or high water, whether there was a clinic I could access or not,” Knowlton said.

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The Associated Press Tom Davis contributed to this report. Arleigh Rodgers is a member of the Associated Press/Report for America Statehouse News Initiative corps. Report for America is a nonprofit national service program that places reporters in local newsrooms to report on undercover issues. Follow Arleigh Rodgers on Twitter at https://twitter.com/arleighrodgers

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