In Louisiana, an abortion clinic anxiously waits for a U.S. Supreme Court ruling

Louisiana’s ‘trigger law’ could immediately ban abortion if Roe is overturned

By: and - June 23, 2022 10:49 am
Shreveport abortion clinic

Hope Medical Group for Women, an abortion services clinic in Shreveport, has filed a lawsuit challenging Louisiana’s abortion ban. (Julie O’Donoghue/Louisiana Illuminator)

SHREVEPORT – On a Thursday morning in mid-June, every parking space in the Hope Medical Group for Women parking lot was claimed by a car with either a Louisiana or Texas license plate.

A brown fence surrounding the abortion clinic provides some privacy, obscuring the faces of people going in and out of the building. There are no windows to offer a view inside the clinic. The front desk and waiting room are behind thick security glass, and everyone has to be buzzed into the facility by a staff member to enter. 

With a waitlist of 400 people, every appointment at this abortion clinic in the Bible Belt is taken and every day is busy. The parking lot emptied by Thursday evening, only to fill back up at 9 a.m. the next morning with a different set of cars. The facility sees patients six days per week, with just Sundays off. 

In spite of that demand, Hope Medical Group could be just days from closing its doors. Louisiana will immediately outlaw abortion if the U.S. Supreme Court allows it to do so later this month.

Justices are expected to overturn the historic Roe v. Wade opinion, leaving the door open for conservative states such as Louisiana to ban abortion for the first time since 1973. That decision would automatically shutter the state’s three abortion providers – Hope Medical Group in Shreveport and two other clinics in Baton Rouge and New Orleans.

For now though, Hope Medical Group is continuing to see patients as normal. The clinic isn’t preparing to close and hasn’t pared down its operations, even after a draft court opinion leaked in early May indicated an abortion ban might be coming soon. None of the clinic’s staff has left for another job. Most are preoccupied with what their patients might do if they can’t end their pregnancies.

“It’s never not in our minds,” clinic administrator Kathaleen Pittman said of the pending Supreme Court decision. “I tear up thinking of those women being denied access to care.”

Meanwhile, Louisiana anti-abortion advocates are excited but cautious about the possibility of a statewide abortion ban.

“No political victory is ever permanent nor any defeat,” said Gene Mills, president of Louisiana Family Forum, a conservative Christian advocacy group that has lobbied for abortion restrictions. 

Mills said that if an abortion ban comes to Louisiana, his organization will pivot to addressing the needs of pregnant people in distress through religiously-run crisis pregnancy centers. It will also educate people on fostering and adoption.

Louisiana abortion law now stricter

Louisiana governors and lawmakers have ratcheted up restrictions on abortion clinics over the years. They have to meet more stringent building requirements than similar medical centers. Both a doctor and a nurse must be present for a surgical abortion and staff has to read a state-mandated script that directs patients to consider alternatives to abortion, among other things.

In Louisiana, the state-mandated waiting period for most abortions also jumped in the middle of May from 24 hours to 72 hours. This means most people have to wait three days between their initial appointment at the clinic and when the abortion is administered.

“It is complicating things even more,” Pittman said of the 72-hour wait time. “There are women that are further into the pregnancy that it truly affects. They timed out on us before we could take care of them.”

Outside of an abortion clinic, physicians in Louisiana are very limited in terms of abortion services they can provide. A hospital or private practice with a doctor who performs more than five abortions annually – either through surgery or abortion medication – must register as an abortion clinic with the state and would be subjected to a clinic’s stringent  licensing process. 

Gov. John Bel Edwards this week signed into a law an updated version of Louisiana’s “trigger law” that is supposed to immediately ban abortion if the Supreme Court reverses Roe vs. Wade. The new statute, pushed by anti-abortion advocates, was intended to clarify and consolidate dozens of abortion restrictions passed over decades.

Under the trigger law, abortion would only be legal if a pregnant woman’s life is in danger from a physical illness or she could otherwise sustain “serious, permanent impairment of a life-sustaining organ.” 

It would also be permitted for pregnancies that would result in a child expected to die immediately after birth. In those cases, two physicians would have to agree that the pregnancy was futile.

Abortion services could also be used to resolve a miscarriage or to deal with a ectopic pregnancy, a dangerous condition that would not result in the birth of a child anyway.

If the ban took effect, suicidal thoughts or another mental illness could not be used to justify an abortion. A pregnancy that results from rape or incest would also not be eligible. Those who provided illegal abortions – including medication that induces abortion – could face up to 10 years in prison and a $100,000 fine. 

What happens after SCOTUS rules

In the event that the Supreme Court only partially overturns Roe v. Wade – and doesn’t fully reverse the opinion – Louisiana’s updated trigger law is designed to immediately enact the strictest provisions on abortion allowed, even if an outright ban is off the table. 

As of last week, the Hope Medical Group expects to “pause” operations once the Supreme Court decision was handed down and consult with its attorneys to figure out how to proceed, Pittman said. 

“When the Supreme Court rules, we will look at our options then,” she said. “We are certainly not going to violate the law. I mean we are not going to do that, but if there is redress, we are going to look at our options.” 

The Louisiana Department of Health is in charge of enforcing the closure of the abortion clinics if a ban goes into effect. Each abortion performed in a clinic after the court’s decision is handed down and the clinics are supposed to close would come with a fine of $10,000 to $50,000, according to state law.

Pittman’s clinic has started warning patients that it might not be able to carry out abortions they are scheduling, depending on the court’s ruling. The clinic’s long waitlist means it has to book abortion appointments at least two and a half weeks in advance. So people who call the clinic this week seeking an abortion will not be able to see a doctor before the court’s decision is out. 

Some clinic patients are also not aware that abortion could shortly become illegal in Louisiana, according to the clinic administrator.

“They don’t know that we are concerned about a Supreme Court ruling. There are still people out there that are not fully cognizant of that,” Pittman said. 

Abortion ban could lead to ‘backslide’

A Louisiana abortion ban would be the culmination of a successful, decades-long campaign that has already chipped away at abortion access in the state. In 1999, there were a little over 12,000 abortions carried out in Louisiana, according to data from the state Department of Health. Last year, there were just 7,500.

When Pittman started working at Hope Medical Group 30 years ago, it was one of 11 abortion clinics in the state. Now, there are just three clinics open. Many likely shut down, she said, because of onerous state regulations that caused a financial burden and stress.

The bulk of those who seek out abortions in Louisiana are people of color. In 2021, 64% of the state’s abortion patients were Black and 89% were unmarried, based on state health statistics

Fifty-eight percent were between 20 and 29 years old, though there are outliers in terms of age. Twenty-seven people who had abortions last year were under the age of 15, and 11 were over 45. Of the 66 people under 18 who had abortions, all but one did so with the permission of their parents, according to state statistics.

Pittman said most of the patients who receive abortions at her clinic already have children and they are terminating their pregnancy for financial reasons.

“Women simply know they cannot afford to have another child at this point,” she said. 

Angela Adkins, an abortion rights advocate with 10,000 Women Louisiana, worries about the impact of an abortion ban on women’s participation in society.

“A person cannot control their lives if they cannot control their reproduction,” Adkins said.”The backslide in women’s participation in our society will backslide in our economy, in education, in every facet of life.”

Yet abortion is still less popular in Louisiana than it is in most other parts of the country. A poll LSU conducted this year showed that less than half of Louisiana residents (46%) thought abortion should be legal in most or all cases. In nationwide polls, people who support abortion rights are consistently in the majority. 

‘This is a crisis for them’

Pittman said not everyone coming to her clinic is necessarily seeking an abortion. Some have suffered a miscarriage and find the clinic the most affordable option for necessary medical care.

Others are happily pregnant but need an ultrasound and an estimated due date provided from a medical professional to qualify for Medicaid insurance. An initial doctor’s visit is $50 at Pittman’s clinic, cheaper than most other medical providers.

Louisiana’s abortion ban also has those in the medical community outside of abortion clinics worried about the impact on women’s health. Not only is Louisiana likely to outlaw abortion, but surrounding states are expected to put bans in place as well. Louisiana residents seeking abortions may have to go as far as Florida or Illinois to reach a provider. 

Sara Lever, an OB-GYN resident based in New Orleans, called the prospect of a widespread abortion ban across the Deep South alarming for many Louisiana physicians.

“It’s important for there to be providers who are willing to help get women access to abortion in environments where it’s extremely restricted,” Lever said. “But at the same time, it is very hard to practice medicine in an environment where you feel like you actually can’t offer your patients scientifically based, safe options.”

Clinics and other providers in abortion-friendly states could also be overwhelmed with demand in the wake of the Supreme Court’s decision. Pittman’s clinic in Shreveport has seen an enormous influx of Texas residents seeking abortions since that state banned abortion after six weeks of pregnancy.

Shreveport is less than a three-hour drive from Dallas and four hours from Houston. Many who are too far along in their pregnancies to get a legal abortion in Texas have turned to Pittman’s clinic for help. It’s one of the reasons the waitlist for an appointment at Hope Medical Group has grown to hundreds of people in recent months. 

“The patients that come to us, this is a crisis for them,” Pittman said. “They are trying to get this one issue addressed.”

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Julie O'Donoghue
Julie O'Donoghue

Julie O’Donoghue is a senior reporter for the Louisiana Illuminator. She’s received awards from the Virginia Press Association and Louisiana-Mississippi Associated Press.

Piper Hutchinson
Piper Hutchinson

Piper Hutchinson is a reporter for the Louisiana Illuminator. She has covered the Legislature and state government extensively for the LSU Manship News Service and The Reveille, where she was named editor in chief for summer 2022.