By David Warmflash, MD | 18 October 2022
Today, our journey through the patchwork of different legal frameworks surrounding abortion and reproductive care across the United States takes us to Mississippi, the state where the recent overturning of the 1973 Roe v Wade decision began. One of the nicknames of Mississippi is the ‘Hospitality State’, but the state is as inhospitable to reproductive rights as a state could be. This is contrast with a plethora of pro-choice states that are offering their hospitality to travelers from anti-abortion states seeking to terminate their pregnancies, states such as New York, Connecticut, Massachusetts, Illinois, Oregon, and Washington, which are receiving numerous out-of-state women and providing them abortion care.
As of today, abortion bans have ELIMINATED access in the following states:
🔁 RT to spread the word.
— Planned Parenthood Action (@PPact) October 20, 2022
Back in June, the Supreme Court of the United States (SCOTUS) ruled on the Dobbs versus Jackson Women’s Health Organization abortion case, involving Mississippi’s Gestational Age Act. Antiabortion politicians in Mississippi wrote this act that would create a law that would prohibit all abortions subsequent to 15 weeks gestation, but that was only because of the pre-Dobbs situation, when Roe v Wade was the Law of the land. During the 20 year period from the 1992 SCOTUS decision on Planned Parenthood of Southeastern Pennsylvania versus Casey up to the Dobbs decision of this past June, the strategy of anti-abortion activists and politicians was to chip away at abortion rights. This was based on the Planned Parenthood v Casey decision replacing the trimester framework of Roe with fetal viability, which enabled antiabortion states, like Mississippi, to push back the time in pregnancy when restrictions against the right to choose could begin. Mississippi’s 15 week rule was written with the hope that it would either push back the limit further, helping a subsequent case to be decided in a way that would overturn Roe, or it would become the case that would cause Roe to be overturned. What happened was the latter. The Mississippi was upheld in the highest court of the United States based on the decision of six justices. But only one of those six justices, Chief Justice John Roberts, was willing to let the Mississippi 15-week law be the limit of restrictions, meaning that he favored continuation of the Roe framework, that idea that the Due Process Clause of the Fourteenth Amendment protects privacy in a way that should prevent all states from prohibiting abortion. But the other five justices who favored the Mississippi 15-week law signed onto a majority opinion, written by Associate Justice Samuel Alito, overturning Roe v Wade. In a minority opinion, the three liberal justices on SCOTUS opted against the Mississippi law and to uphold Roe.
Ironically, once Roe was overturned, Mississippi’s 15 week band did not go into effect, because the state already had a trigger law that took precedence, banning abortion throughout pregnancy. This means abortion is not legal in Mississippi even prior to 15 weeks. It’s illegal from the point of fertilization, which, as we have discussed, occurs before you are actually pregnant.
The state makes exceptions for rape, if you provide a police report. It also makes exceptions for cases when the mother’s life is in danger and when the mother could be severely harmed or disabled by continuing the pregnancy. However, it is expected that abortion providers will hesitate in many cases, fearing prosecution and potential loss of licensure. This is because most issues that threaten a pregnant woman’s life show up, not when she is about to die in that very moment, but earlier. While laws like the one in Mississippi would leave little doubt, that a pregnant woman’s life is in danger when she is coding (her heart is not pumping blood adequately and she needs advanced cardiac life support), such laws create legal uncertainty for clinicians when the mother’s health is deteriorating in connection with pregnancy.
It’s worth noting that, in studies performed over the past several years, Mississippi consistently has ranked highest among US states in rates of unwanted pregnancy and teen pregnancy and close to the top in rates of maternal death and neonatal death. So while anti-choice activists and politicians in the Hospitality State now rejoice in their recent success triggering the Dobbs decision overturning Roe and the enactment of a statewide prohibition against pregnancy termination, the state is doing a terrible job promoting pregnancy health and a terrible job managing the conditions that lead women and girls to seek abortion in the first place. The poor pregnancy health outcomes in Mississippi correlate with low economic status and African American race. Thus, while Mississippi prides itself as being the “Birthplace of America’s Music”, it’s not a healthy birthplace for human beings.
Jim Crow lives again: Florida and Mississippi turn back the clock on voting rights https://t.co/mM2a2AwBaj
— Salon (@Salon) September 3, 2022
If you reside in Mississippi and find yourself with an unwanted pregnancy, your best bet is to contact any of the various organizations working to assist abortion seekers in obtaining care in other states. Organizations also assist abortion seeker in obtaining help with travel and lodging costs. Normally, where abortion is legal, the option for a medication abortion is available up to a gestational age of 77 days (11 weeks), after which only procedure abortions are available. As of the writing of this post in late September, abortion is still legal in Florida up to 15 weeks. While the Floridian border is quite close to southern Mississippi, remaining abortion services are located in the eastern part of the state. Other abortion-safe states within several hours driving distance include Illinois (up to fetal viability; 24-26 weeks), North Carolina (up to 20 weeks), and Kansas (21 weeks and 6 days).
One other thing worth noting is that, if you receive telemedicine care from out-of-state providers, and receive abortion medication via the mail, or another delivery service, the new law —as horrible as it is— does not allow Mississippi authorities to search your packages. However, if you arrive at a Mississippi hospital or urgent care clinic on account of heavy bleeding, or other aspects of your abortion, or simply seeking assurance that all products of conception have been expelled, it is VERY IMPORTANT, that you do NOT reveal what you did. Nothing that the doctors and nurses will do to help you will prove that you took the medication. You will be indistinguishable from anyone experiencing a spontaneous abortion, so just go with that story. Do not say anything that can be taken to mean that you are aborting on purpose. Doing so could get both you, and those who help you at the clinic, into trouble, as Mississippi is just about the most abortion-hostile state in all ways. This is a very rare case in which the proper, ethical thing to do is to lie, although this also means that your better option, if you can do it, is to travel out-of-state for your care.
If you're in #Mississippi, in need of #abortion, best bet, travel out of state. Last resort, if prior to 77 days, telemed to get abortion medication via mail & keep it secret, even if you receive post abortion treatment. Say that you are miscarrying https://t.co/5G6V3egCqc
— Dr. David Warmflash (@CosmicEvolution) October 20, 2022
Reprinted with permission from The Pulse.
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— Dr. David Warmflash (@CosmicEvolution) March 11, 2020
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