Last week those of us who work in reproductive health care celebrated a historic victory in Ohio: Voters overwhelmingly favored Issue 1, which enshrines a right to abortion into the state constitution and makes the six-week ban many of us feared unenforceable. As an abortion provider in Cleveland, I’m relieved that my patients’ freedom to access abortion care, miscarriage care, and contraception is protected.
But obstacles still prevent patients from receiving the care they need and make life challenging for practitioners. These obstacles disproportionately harm those already at greater risk of poor health outcomes. Now providers, activists, and everyone else who cares must take this momentum to make very necessary changes to other abortion laws in Ohio.
Even now that Issue 1 has passed, Ohio law requires us providers to give patients seeking abortion care information meant to discourage them from their choice. The informed consent requirement means we have to provide inaccurate information to patients; the booklet I’m legally obligated to hand out falsely claims that oral contraceptive pills prevent implantation of a fertilized egg — and it also provides information about Norplant, which was removed from the market in 2002. We are also required to provide a variety of alternative resources to patients, such as information about adoption agencies in the state — regardless of our patients’ desires or if there is a pregnancy complication, such as lethal fetal anomaly.
Along with my medical school education, I have a master’s in bioethics and take my duty to explain the medical procedure my patients are about to undergo seriously, and these types of requirements are not only confusing to patients but are clearly motivated by politics rather than patients’ best interest.
After their first appointment, patients are then required to wait 24 hours before coming back for the procedure. This means they must take another day off work, secure transportation, and, for patients who already have children (which is a majority of those I see), find an additional day of child care. Making it to the office for that first appointment is already difficult enough for patients, especially those with low incomes, inflexible jobs, and caretaking responsibilities. The 24-hour rule makes it doubly difficult.
The state can also still ban abortions after “fetal viability.” Regardless of the talking points and disinformation spread by anti-abortion groups, there is no hard cut-off for determining fetal viability — it must be assessed on a case-by-case basis by the patient’s physician. Even with an exception for patients to receive abortions in cases when their physician deems it necessary, this still gives leeway to lawmakers in the state to put in place arbitrary restrictions that prevent those who need an abortion from properly consulting a physician.
Further, the state’s ban on the use of taxpayer dollars on abortions prohibits Medicaid from being used to pay for abortions with very narrow exceptions. One in every five Ohioans is covered by Medicaid and is therefore excluded from having their health insurance cover the procedure. The cost of abortion without the help of insurance can be prohibitive to many families seeking care. For more than half of the women in the University of California, San Francisco Turnaway Study, abortion expenses accounted for over one-third of their monthly personal income.
The victory at the polls for Issue 1 will have many benefits that extend beyond escaping the cruel six-week ban, but there is so much more work to be done to provide truly accessible and equitable abortion care that I know my patients want and deserve. Issue 1’s passing is the perfect encouragement to keep going, and Ohioans are up for the challenge.
Emily Freeman is an abortion provider with Planned Parenthood of Greater Ohio. She currently practices in Cleveland, Ohio.