HARTFORD, Conn. — As the Supreme Court overturned Roe v. Wade national protections for abortion on Friday, Connecticut has become a “safe harbor” for women seeking an abortion.
Gov. Ned Lamont signed a new law this year offering legal protection for both patients and providers. The law, which takes effect on July 1, also expands who is eligible to offer abortion care.
As other states wait for laws to take effect banning it, Gov. Ned Lamont has promised the state will keep abortion safe, legal and accessible. But how accessible is it in Connecticut? What do people experience when seeking to terminate a pregnancy?
Medication
Two types of abortions are offered to patients in Connecticut. One is done at home, with two pills, mifepristone and misoprostol. They are prescribed, in person or by telehealth, by a physician or a nurse midwife, advance practice registered nurse or physician assistant. The pills can be picked up at a pharmacy or a doctor’s office or mailed to the patient.
This procedure can be done up to 11 weeks into the pregnancy, said Roxanne Sutocky of The Women’s Centers, a multistate consortium of women’s health providers with an office in Bloomfield.
“Mifepristone stops the production of progesterone. Progesterone is necessary to continue the pregnancy. Then she waits 24 to 48 hours and takes the second medication, which helps the uterus to expel the tissue,” Sutocky said.
Sutocky said this procedure is 99% effective, but there are side effects: cramping, bleeding, possibly nausea, fever and diarrhea. The process is similar to a miscarriage.
According to the website of Planned Parenthood of Southern New England’s New Haven office, a medication abortion costs $576 to $662 and may be covered by insurance.
Aspiration
The pill method is the most widely available, but Sutocky said many women prefer a quicker procedure.
“The medication does take place over several days and you do need a follow-up. But some people want to go in for appointment and leave that day and know that they are no longer pregnant. Maybe they don’t have the time. Maybe they are home taking care of three or four other children. Maybe they don’t have private personal space,” she said.
The outpatient medical procedure, called aspiration, can be done for pregnancies that are up to and beyond 11 weeks, pre-viability. The procedure requires an appointment lasting two to six hours. The procedure itself takes from three to 20 minutes, depending on how far along the patient is in her pregnancy. But a lot leads up to the procedure.
“They may need an ultrasound and lab work, a health checkup and a physical to make sure they are healthy enough to proceed. They might meet with financial intake coordinator and a patient advocate who would talk to them about informed consent, about their decision, their support system, their resources,” Sutocky said.
The procedure is finished in those few hours, a fraction of the time of the medication procedure.
According to the website of Planned Parenthood of Southern New England’s New Haven office, an aspiration abortion costs $613 to $996, depending on the gestation period, and may be covered by insurance.
Availability
The new law has its most profound effect on the availability of the aspiration procedure. Since 2001, nurse midwives, advance practice registered nurses and physician assistants have been able to prescribe the pill regimen. But only physicians have been allowed to perform aspirations.
When the law takes effect, people in those three professions, which are collectively referred to as advanced practice clinicians, can legally perform aspirations.
Liz Gustafson, state director of Pro-Choice Connecticut, said Connecticut is now the 16th state to allow this modernization of accessibility. “We are essentially catching up to the standard of care,” she said. Gustafson said it was necessary because nationwide, and in Connecticut, a critical shortage of doctors is looming.
“Currently in Connecticut, patients seeking abortion by aspiration have been facing around a two-week waiting period just for their appointments due to a lack of providers. And it will get worse,” Gustafson said. “It’s not even just in abortion care, but the outlook is that there will be a physician shortage overall. This shortage outlook is expected to be especially severe with ob-gyns. Connecticut could no longer rely solely on physicians to provide these procedural abortions.”
According to 2019 projections by The American Congress of Obstetricians and Gynecologists, there is a shortage of 9,000 ob-gyns nationwide and by 2050 that shortage will grow to 22,000. Those projections stated that at the time, 35% of ob-gyns were 55 or older, closing in on retirement age, and only 19% are younger than 40.
Sources
Those who want to get an abortion can refer to a variety of sources. Some doctors won’t perform them or refer to anyone who will, because they are associated with a faith-based medical group or for other reasons.
“This new law won’t work in a way that will force anyone to provide care. But it will open up the doors for providers who are willing and ready,” Gustafson said. “Nothing changes for the individual in terms of steps they would take to get care. But once there are more trained providers, there would be less of a waiting period.”
Sources for abortion information include Planned Parenthood (plannedparenthood.org), which provides a wide range of reproductive health services; Sutocky’s organization, The Women’s Centers (thewomenscenters.com), which will refer to the Hartford GYN Center in Bloomfield; the national website ineedana.com; prochoice.org; and the referral hotline 877-257-0012.
Sutocky said some organizations, like crisis pregnancy centers, use vague wording to disguise their intent.
“These organizations are an extension of the anti-abortion movement. They sometimes advertise ‘pregnant, need support?’ or ‘are you looking for options?’” she said. “They will meet with people to encourage them to continue their pregnancy, but they will not provide [abortion] information or referrals.”
Protections
Another element of the new law protects patients who come to Connecticut from states where the care they seek is illegal, and protects Connecticut providers, too. Connecticut courts will not cooperate with out-of-state investigation of this sort, and patients and providers can fight back against investigations begun in other states.
“Texas passed a law last year, where an abortion is outlawed if the pregnancy is past six weeks. The state shifted the enforcement mechanism from the state to private citizens, basically deputizing them to launch civil lawsuits against people they determine to be in violation of the law. Bills like this have been introduced in other states, too,” Sutocky said.
“In Connecticut, we have already seen patients travel from Texas to access care. Our providers are happy to take care of patients. This [new Connecticut law] creates a protection. If someone from out of state sues you, you can get that money back by launching a claw-back lawsuit. Hopefully that will serve as a deterrent.”
Gretchen Raffa, vice president of public policy, advocacy and organizing at Planned Parenthood of Southern New England, said the fight for abortion rights is not over.
“We’ll continue fighting to make health care affordable and accessible, ensure health insurance coverage for residents of our state regardless of immigration status and eliminate any barrier, including abortion shame and stigma, that keeps abortion care out of reach,” Raffa said.
Barriers
Sarah Gordon-Brilla, senior director of communications and brand experience at Planned Parenthood of Southern New England, said despite the expanded access to services, some people might hesitate anyway because of invisible psychological barriers. The most powerful of these is stigma.
“There is a massive amount of abortion stigma. It’s reinforced in a lot of pop culture narratives we see and in people’s conversations. That’s a huge barrier. It causes negative emotion, negative impacts. There is a psychological impact from the shame society puts on you,” Gordon-Brilla said.
One fear some may face is worry that a patient may come in contact with protesters. But Gordon-Brilla said laws are in place to prevent protestors from entering the property.
“There is a law about how close protesters can come to the health center,” she said. “We have a welcome crew.”
Raffa said other barriers include transportation, child care, time off from work and cost.
“Even with these important advancements, we know some Connecticut residents won’t be able to access the abortion care they need and deserve,” she said. “We’ll continue fighting to make health care affordable and accessible, ensure health insurance coverage for residents of our state regardless of immigration status, and eliminate any barrier — including abortion shame and stigma — that keeps abortion care out of reach.”
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