Montana clinics restrict abortion access for out-of-state patients

There are four trigger laws in Montana that are in effect or pending.

08 July 2022 Friday 01:19
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Montana clinics restrict abortion access for out-of-state patients

There are four trigger laws in Montana that are in effect or pending. The U.S. Supreme Court recently ended federal protections against abortion. This makes Big Sky Country conservative and a safe haven for women who want to end their pregnancies.

However, Montana's potential as an abortion refuge was diminished aEUR" by its lawmakers and governor, whose attempts at restricting abortions were thwarted by the state constitution's privacy right, but rather by the operators of at most four of five state clinics that preemptively limit who can get abortion pills.

Officials of Planned Parenthood of Montana (which operates three of the clinics) stated that the intention was to protect them and their patients from other states that have trigger bans aEUR "laws to ban or restrict abortion which were intended to take effect if Roe v. Wade is overturned aEUR". The policy change presents a problem for women from South Dakota and other states that want to end their pregnancy.

Kim Floren, director at the Justice Through Empowerment Network in South Dakota, said that "that was a state we were hoping would be available." She also provided financial assistance to those who needed the procedure. "It's just more bad and worse news than it is at this point."

Medication abortions are preferred by patients over surgical ones. They are more affordable, take less time in a clinic, offer greater privacy, and allow for greater control. A two-part medication abortion is the most popular. The first is usually taken at the clinic if it is necessary; the second is typically taken at home. The medications can be sent to patients in many states after a telemedicine appointment.

According to the Guttmacher Institute (a research organization that supports abortion rights), medication abortions accounted for more than half of all abortions in 2020. Advocates believe that medication abortions will be a target for new state laws. South Dakota's July 1st law bans telemedicine for abortions.

According to Jennifer Sandman (senior director of public policy litigation for Planned Parenthood), the Montana Planned Parenthood policy changes are a response in part to the changing legal landscape. Sandman stated that people are acting in extraordinary chaos and fear because of the Supreme Court's decision and threats from anti-abortion politicians.

Planned Parenthood of Montana voted June 30 not to offer abortion pills at its clinics in Billings and Great Falls to patients from other states that have trigger laws. Although bans were in effect in South Dakota, Arkansas and Missouri at the time, Planned Parenthood officials stated that they still see many patients from South Dakota. When asked how many South Dakotan patients might be affected, the officials didn't respond.

Montana's neighbors Idaho, Wyoming, and North Dakota also have trigger laws but they are not yet in effect.

Martha Fuller, president of Planned Parenthood of Montana wrote in an internal memo, that the risks of cross state provision of services were not clear. She also expressed concerns about civil and criminal actions against people who provide medicine to end a pregnancy in states that have bans. A freelance journalist posted the memo on Twitter and it was later deleted. Officials at Planned Parenthood confirmed the policy change.

Out-of-state residents will still be able to access abortion services at the three Montana Planned Parenthood Clinics. Laura Terrill, spokesperson for Planned Parenthood of Montana, stated that they believe this is the best way to ensure that patients out of state are not intimidated and afraid to access essential follow-up care.

After the Missoulian reported in March that Blue Mountain Clinic in Missoula would only offer medication abortions to Montana residents, Planned Parenthood's decision was made. The clinic officials did not respond to emails and phone queries.

All Families Healthcare in Whitefish is the fifth Montana abortion clinic. It declined to answer questions regarding its policies for patients from outside of Montana.

Fuller stated in her memo that Planned Parenthood's policy could be changed as legal risks become more clear. The memo does not mention that Montana could soon lose its status as a state offering legal abortion access.

In 2021, Montana's Republican-majority legislature passed four state laws to limit abortions. However, three of them were blocked by a judge who cited a 1999 Montana Supreme Court ruling that abortion was a right under the Montana Constitution. The attorney general of Montana is asking for the Montana Supreme Court's approval to allow the laws to go into effect. The decision is still pending.

Because of the chaos that followed the U.S. Supreme Court decision, the Montana chapter of Planned Parenthood isn't the only one temporarily changing its abortion pill policies. Planned Parenthood North Central States provides medication abortions in Minnesota and Iowa. It also says that its patients must only take the pills in states that allow abortion.

The South Dakota trigger law makes it a felony to prescribe or administer a substance that causes abortion. However, it doesn't target those who have had abortions. Floren of Justice Through Empowerment Network said that there is still fear that South Dakotans could be charged or investigated if they are caught with pills in the state, or if they have to seek medical assistance due to a complication. She said that many people prefer this method, and that it is now up to the people to choose.

Other states have become legal abortion islands. However, providers in these other states disagree with policies that restrict access to out-of-state patients. Colorado's Dr. Nancy Fang is an OB/GYN at the Comprehensive Women's Health Center. She said that she understands the need to be cautious in light of the uncertainty surrounding state abortion bans. She said that limiting access to abortions will not only harm patients but also add stress to other clinics who continue to offer medication abortions.

Fang stated that he believes it has a significant impact on patients because it restricts their ability to access health care.

Planned Parenthood of the Rocky Mountains serves Colorado, New Mexico and Wyoming. However, spokesperson Neta Meltzer stated that her organization supports other affiliates such as the one in Montana who make "heartbreaking decisions".

Meltzer stated that all patients are treated equally.

This story was created in partnership with Kaiser Health News.

Although abortion pills are more effective than abortion procedures, they are still considered to be more efficient. This procedure involves the dilation of the patient's cervix using surgical tools. Patients may also be prescribed anti-anxiety medications or intravenous sedates. People who are abused by their partners may be able to claim they had a miscarriage with pills. The amount of bleeding and other symptoms can be similar.

Just the Pill, an organization that is opposed to Planned Parenthood's ban on abortion pills distribution in Montana, plans to grow. Telehealth visits can be made with Just the Pill doctors and patients can then pick up the pills in Montana or Minnesota, Wyoming, Colorado.

The Supreme Court decision led to the company announcing that it would send a fleet to state lines with mobile clinics in order to provide services to women in states that have restrictions on abortion. The company stated in a statement that it will operate on state borders to reduce travel costs for patients from states that have strict restrictions or bans.

Floren stated that she hopes Just the Pill will continue to offer services to South Dakotans. Justice Through Empowerment Network has experienced an influx in donations and volunteers. Floren stated that the abortion fund is planning to organize people to attend a special legislative session where she expects legislators to target those who distribute or donate abortion aid.

This report was contributed by Erica Zurek and Rae Ellen Bichell, KHN reporters.



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