Reproductive rights advocates knew from the start there would be tremendous challenges for Tennessee women seeking abortion access across state lines once the procedure was banned here.
One year after the Supreme Court ended federal protections for abortion, advocates say those challenges have been far greater than anyone anticipated.
Planned Parenthood of Tennessee and Northern Mississippi expected to provide 2,000-3,000 pregnant patients with logistical and financial assistance to access out-of-state abortions in the first year of Tennessee’s ban.
Thus far, said CEO Ashley Coffield, they have served just 500.
A Tennessee abortion fund, which provides financial assistance, reports “a lot less inquiries” directly from patients, even as the number of clinics getting in touch continues to expand. Many of the calls Abortion Care Tennessee are getting come from individuals later in their pregnancies, increasing the cost — and risk — in accessing abortion, said Robyn Baldridge, the fund’s co-founder and development coordinator.
CHOICES, a Memphis healthcare provider that opened a clinic in Carbondale, Ill (where abortion remains legal) has served more than 2,000 patients since the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization.
The vast majority of its patients are from Tennessee — particularly Memphis and Nashville — along with Mississippi and Arkansas, said Jennifer Pepper, executive director. The clinic is not the only one in southern Illinois serving Tennessee patients, but it has seen far fewer than the 5,700 patients who typically seek the procedure from Middle and West Tennessee each year.
While data lags on abortion access by Tennessee patients in neighboring states, abortion advocates are seeing a clear downward trend.
“We have been shocked at how low the numbers are,” Coffield said. “The reality of abortion bans is far more devastating and inhumane than many people really understood a year ago.”
‘An ongoing war’
Tennessee is one of 14 states that has implemented a near-total ban on abortions since the Supreme Court overturned Roe v. Wade, returning to individual states the power to criminalize some or all abortion procedures.
The state’s abortion ban was enacted in 2019 in anticipation of the overturning of Roe and went into effect about a month after the court’s opinion.
Once the strict contours of the ban became widely understood — including its halt to miscarriage care, treatment for life-threatening ectopic pregnancies and criminal jeopardy for doctors providing routine care — lawmakers enacted a narrow carve-out for ectopic and molar pregnancies. The exception also allows doctors to perform abortions if in their “reasonable” medical judgment an abortion would prevent the death or “to prevent serious risk of substantial and irreversible impairment of a major bodily function of the pregnant woman.”
The exceptions were enacted by Tennessee legislators over the objections of the state’s chief anti-abortion lobbying group, Tennessee Right to Life, which on Saturday issued a celebratory message to commemorate the Supreme Court decision’s anniversary — and a warning.
“Know this is an ongoing war and the other side will not stop,” said Will Brewer, legal counsel and lobbyist for Tennessee Right to Life, in a video recorded message.
“We have to be vigilant in making sure the legislators we send to Nashville are pure pro-life conservatives who have our back and not ones that are willing to cave at the first sign of trouble,” he said.
‘We can get anybody where they need to go’
Even with narrow exceptions, advocates say Tennessee’s abortion ban poses severe burdens on women and families in a state that has among the highest rates of maternal and infant mortality.
“One year ago Tennessee faced an instant health emergency for pregnant people when we became a forced birth state,” said Coffield, the Planned Parenthood CEO.
“It is more dangerous and more deadly to be pregnant in Tennessee,” she said. “If you’re pregnant you shouldn’t travel here. If you live here you you might have to travel out of state for life saving care.”
Coffield also sees a looming battle ahead in Tennessee.
“The government seizure of bodily autonomy is bigger than abortion,” she said Thursday, noting that Tennessee has enacted a series of policies since the abortion ban took effect that include ending HIV prevention program funding and banning gender-affirming care for transgender youth. State lawmakers, she said, have already hinted they will act to limit contraceptive access, in vitro fertilization and impose restrictions on interstate travel for abortion.
At the same time, abortion rights advocates are experiencing a groundswell of support even as the patients they serve experience high hurdles to access care, Baldridge, the abortion fund development director, said.
The non-profit abortion fund, which provides stipends for clinics to give to patients that can cover medical, food and lodging costs, launched three years before the Dobbs decision, distributing a total of about $10,000.
In the two days following the leaked draft of the Supreme Court Dobbs decision — weeks before the court issued its formal ruling — the fund received about $40,000, she said. While there’s been a leveling of support since, the fund has gone from being able to provide a one-time $75 to defray the neediest patients’ costs to expansive aid to anyone in need.
The fund can now help any Tennessee patient seeking care in any state, Baldridge said. Her concern is that patients are discouraged from seeking help, or don’t know where to find it.
“At this point we can get anyone where they need to go,” she said. “My biggest fear is of someone continuing a pregnancy because they’re like, well, I’ll just continue on with my pregnancy.”
This story was originally published by The Tennessee Lookout.
