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How some providers work around abortion bans since Roe v. Wade was overturned

(NEW YORK) — Some state officials as well as abortion providers are trying to find workarounds to help patients who want to end their pregnancies after the Supreme Court overturned Roe v. Wade.

Since the late June ruling, at least 12 states have ended nearly all abortion services, according to the Center for Reproductive Rights.

Some states had trigger laws banning abortion immediately after Roe v. Wade’s reversal. Others had laws written before the court’s decision that could then be enacted.

Penalties for performing abortions in states with bans vary and can include paying a significant fine, loss of a medical license or even a prison sentence.

Meanwhile, organizations and providers have come up with ways they say can help patients access reproductive care without breaking any of the new laws in place.

“What will you do if the work and the health care you provide suddenly becomes illegal?” Elisabeth Smith, director of state policy and advocacy at the Center for Reproductive Rights, told ABC News. “Do we try to muster resources and move a clinic to another state, uprooting our lives, the lives of our colleagues and employees? And how would patients get to that new clinic? So where would it be located?”

“All of those questions are incredibly difficult to answer and require a huge amount both of resources and personal determination,” Smith added.

Accessing pills in California

Legal abortions are still occurring in Arizona after a court blocked a century-old law from going into effect.

The 1901 law, which includes language dating back to 1864, provides no exceptions for rape, incest or fetal abnormalities and makes performing abortions punishable by two to five years in prison. The only exception is if the mother’s life is in danger.

Abortions can resume for at least five weeks while the case is considered by an appeals court, but one abortion clinic reportedly has a workaround — involving telemedicine appointments with doctors in California and picking up pills near the California-Arizona border — if abortions are nearly or totally banned in the state.

According to Farah Diaz-Tello, senior counsel and legal director at If/When/How, a reproductive rights organization, the arrangement is completely legal.

“If somebody receives a telehealth consultation from a provider who is legally authorized to practice in the state where [the provider] is and [the patient] actually goes into that state to receive the medications, essentially they received an abortion in that state where the telemedicine appointment happened,” she told ABC News.

She said legal questions only arise if somebody living in a state with abortion restrictions has medication abortion pills mailed to them.

“If people are in an abortion-hostile state and they’re receiving medications sent to them from other states or from outside of the country, it’s not technically legal for them to do — to obtain that medication,” Diaz-Tello said.

Anti-abortion groups have slammed the arrangement and claimed it is dangerous.

“The abortion industry’s lack of concern for women is on full display in these schemes to circumvent safety regulations in order to make a buck,” Cathi Herrod, president of the Center for Arizona Policy, a conservative lobbying group, said in a statement to ABC News.

Mobile abortion clinic

A local chapter of Planned Parenthood announced this month it is opening the organization’s first mobile abortion clinic to accommodate the number of patients who now must travel to access abortion services.

The clinic will operate in southern Illinois, where abortion remains legal, and will travel close to the borders of neighboring states, where abortion access remains restricted or gone altogether, specifically Missouri.

Dr. Colleen McNichols, chief medical officer at Planned Parenthood of the St. Louis Region & Southwest Missouri, said they’ve seen a rapid increase in the number of people seeking care outside of the bi-state area, which encompasses Illinois and Missouri.

“So before the decision, outside of our bi-state area represented just about 4% of the patients that we saw, regularly,” she told ABC News. “And now, in the three months since the decision, the proportion of folks we see from outside of that bi-state area is more than 40%. So we’ve seen a significant increase in the number of folks we’re seeing traveling really long distances to access to basic reproductive health care.”

Because of the growing demand, the mobile clinic was born. Inside the 37-foot revamped RV is two fully-functioning exam rooms, a small waiting area and a laboratory.

Diaz-Tello said it is legal for a woman to cross into Missouri to receive an abortion at the mobile clinic in Illinois.

“Essentially what those mobile abortion clinics are doing is making it easier for people to go to another state, that they don’t have to go all the way into the state, they can go to the border of their state and be able to return quickly,” said Diaz-Tello. “This is still lawful for people to leave the state to seek abortion care.”

However, some Missouri lawmakers want to close this loophole. A measure that would make it illegal to “aid or abet” an abortion, even if was performed in another state, was presented — and ultimately blocked — in the Missouri House.

Moving services across state lines

Some clinics have moved their services across state lines to areas where abortion access is largely unimpeded.

One example is the Red River Women’s Clinic, which used to be the sole abortion clinic in North Dakota and was in Fargo.

Although a judge blocked the state’s trigger law banning abortions from going into effect in August while a lawsuit plays out, Red River Women’s Clinic said it would now be performing abortions just over the border in neighboring Moorhead, Minnesota.

The right to an abortion is recognized in Minnesota’s state constitution and, in July 2022, several restrictions were permanently blocked, according to the Center for Reproductive Rights.

Tammi Kromenaker, director of the clinic, told ABC News that she’s glad the clinic can still operate but it’s “bittersweet.”

“We fought long and hard in North Dakota and, in fact, are still engaged in legal battles and so we don’t take leaving there lightly,” she said. “And it’s still very raw and it’s bittersweet. So, even though we’re very fortunate that we found a place so close and so convenient to maintain access for our patients, it’s hard to leave a place that you fought so long and so hard for..”

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