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“We don’t do that here”

This piece in the NY Times discussing the abortion bans is depressingly predictable. Even where there are exceptions written into the law they won’t perform abortions:

Last summer, a Mississippi woman sought an abortion after, she said, a friend had raped her. Her state prohibits most abortions but allows them for rape victims. Yet she could not find a doctor to provide one.

In September, an Indiana woman learned that a fetal defect meant her baby would die shortly after birth, if not sooner. Her state’s abortion ban included an exception for such cases, but she was referred to Illinois or Michigan.

An Ohio woman carrying triplets faced a high risk of dangerous complications, including delivering too early. When she tried to get an abortion in September through Ohio’s exception for patients with a medical need, she was turned away.

The abortion bans enacted in about half the states since the Supreme Court overturned Roe v. Wade in June do not prohibit abortion entirely. Most make exceptions in certain circumstances, commonly to protect the health or life of the patient, or in the case of rape or incest. And as conservative state lawmakers prepare to take up new restrictions on abortion in upcoming legislative sessions, exceptions will be at the heart of the debate.

But in the months since the court’s decision, very few exceptions to these new abortion bans have been granted, a New York Times review of available state data and interviews with dozens of physicians, advocates and lawmakers revealed.

Instead, those with means are traveling to states where abortion is still broadly legal or are obtaining abortion pills at home because the requirements to qualify for exceptions are too steep. Doctors and hospitals are turning away patients, saying that ambiguous laws and the threat of criminal penalties make them unwilling to test the rules.

“Having the legal right on the books to get an abortion and getting one in practice are two distinctly different things,” said Laurie Bertram Roberts, the executive director of the Mississippi Reproductive Freedom Fund, a group that supports abortion rights.

Stephanie Piper, an advocate for sexual assault victims at the Gulf Coast Center for Nonviolence in Biloxi, Miss., said that she has helped several women who became pregnant as a result of rape to connect with abortion providers outside Mississippi. Emily Kask for The New York Times

An example of that disconnect is in Louisiana, which has exceptions for protecting the life or health of the patient and for deadly birth defects, and has reported zero abortions since its ban took effect. Mississippi, with exceptions for rape and protecting the life of the patient, has reported no more than two. Alabama, Kentucky, Missouri and Texas have exceptions for protecting a patient’s life or health and have reported similarly low abortion figures.

There is no reliable estimate for the number of patients who seek abortions because of sexual assault or pregnancy complications, yet experts say the number is undoubtedly much more than zero. Thousands of women have most likely qualified for exceptions to state abortion bans in the months since Roe was overturned, they say.

majority of Americans think abortion should be legal in most circumstances, and even those who otherwise oppose abortion generally support exceptions for rape and for health complications. But abortion-rights advocates say legal exceptions do nothing but make abortion bans appear more reasonable than they really are.

Abortion opponents, including those who designed the bans, say the laws are working as intended: Exceptions should be rare. If doctors are not treating patients who qualify, they say, those doctors are to blame for overinterpreting the law.

“We’re not convinced there is a problem,” said James Bopp, the general counsel for the National Right to Life Committee, who writes model legislation for states. “They are just trying to undermine the law in order to have it repealed.”

How about this?

Birth defects kill at least 6,200 babies each year between 20 weeks of pregnancy and early infancy, according to the C.D.C., though this figure does not include pregnancies that end in abortions or miscarriages.

Studies have shown that a majority of patients who discover a deadly birth defect seek an abortion. Physicians say that patients often make this choice to spare the fetus from suffering or their families from drawn-out grief.

The lawyers at Dr. Day’s hospital felt that Indiana’s new law prohibited the methods for the procedure and decided that they could not offer abortions because of the ban’s confusing wording.

“It was messy enough that everyone was appropriately nervous,” Dr. Day said.

A pair of U.S. maps. One shows states with abortion bans with exceptions for fatal birth defects and the other shows states without those exceptions.

Exceptions for fatal birth defects exist in only about a third of abortion bans. Utah, for example, allows exceptions for these abnormalities under its ban, but only if they are “universally lethal.” Physicians say they rarely have such consensus.

In Louisiana, lawmakers attached a list of about two dozen conditions to their exception for fatal defects. But this summer they said they would add at least one more condition, after a woman was denied an abortion because her diagnosis was not listed.

That’s horrifying. So is this:

Most states that prohibit abortion also include an exception for patients facing severe complications, which are estimated to occur in 14 percent of pregnancies. This exception, too, is carefully narrow, and every state law that has it uses almost identical language: “to prevent a serious risk of the substantial and irreversible impairment of a major bodily function of the pregnant woman.”

Physicians say that they cannot anticipate all of the ways in which pregnancy can go awry and that lawmakers were wrong to assume they could. Requiring doctors to pause their care to seek legal counsel puts patients’ lives at risk, they say.

In September, an Ohio woman carrying triplets faced a complicated pregnancy and delivery. Her doctors worried her health would decline and that none of the three fetuses would survive. She sought what specialists call a multifetal reduction to terminate two of them.

Multifetal reductions are typically recommended for patients carrying triplets or more, because these pregnancies are always at higher risk. The woman’s maternal-fetal medicine specialist, Dr. Ellie Ragsdale, had offered these procedures regularly.

When Ohio’s abortion ban was in effect last fall, Dr. Ellie Ragsdale sought to perform abortion procedures for patients with complicated pregnancies but was advised not to. Amber N. Ford for The New York Times

Dr. Ragsdale thought the Ohio woman was a clearcut case for the state’s health exception, but her hospital’s lawyers thought the threats to the patient’s health were not immediate enough. (The ban has since been blocked in court.)

Dr. Ragsdale’s patient traveled to Michigan for the multifetal reduction. In Indiana, Dr. Day also thought it would be simpler to refer her patient to Michigan or Illinois, rather than try to track down a willing doctor in the state.

Dr. Day said the patient told her she could not afford the travel or medical fees not covered by insurance. She did not hear from the patient again.

“What gets put out to the press is: ‘We have exceptions for fetal abnormalities and we have exceptions for maternal life,’ ” Dr. Day said. “When you get into the nitty-gritty details of it, you actually don’t.”

For all their love of babies they sure don’t care if they suffer, so they. I mean, we know they don’t care about women and their families suffering …

Almost every state ban makes an exception when the pregnancy endangers the patient’s life, but three states — Idaho, North Dakota and Tennessee — have a stricter provision. In those states, the burden is on doctors to prove the patient’s life was in peril. In the other states, the burden would be on prosecutors to prove that it was not.

Tennessee’s ban is the only one of the three not currently blocked by a judge, and anti-abortion advocates have held it up as a model because it is not weakened by exceptions. Now, confused and frightened doctors are asking legislators to change the law.

They knew what they were doing. They want to frighten doctors into not doing abortions under any circumstances because they do not believe there should be exceptions at all. They think women should be forced to give birth under all circumstances even if they will die doing it. That’s obvious. They are no doubt getting their wish.

At the “March for Life” (March for Death?) yesterday the common refrain from the zealots in attendance was that they have to ban medical abortions and ensure that no one can get access to the pills. They also want to ban Plan B because they say they believe it also causes abortion, which isn’t true.

They’re not stopping. But we knew they wouldn’t. They seek a national ban with no exceptions for anything. Let’s not kid ourselves about this.

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