Q&A: How Did Legal Restrictions Affect Your Experience?

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QUESTION

How Did Legal Restrictions Affect You?
I feel so much anger and sadness—a rage inside me—when I read of these difficult experiences.

Were there legal and insurance restrictions on pregnancy termination that affected your procedure or made it harder to obtain or afford? If so, which restrictions and how did they affect your experience? Please include your state, province or geographic region.

All answers were provided by members of Ending a Wanted Pregnancy’s  private grief support group.

Note: To find out more about abortion restrictions where you live, check out NARAL’s interactive map detailing abortion restrictions state-by-state.

ANSWERS

Florida—No one would touch me with a ten-foot pole here. I was told (which I later found out was false) that the only doctor who would perform a termination at 22 weeks was in Sarasota (2 hour drive south). The next closest option for me would be Atlanta. We had to borrow money from my in laws to pay for the procedure not covered by insurance, and for the two day hotel expense, and then for burial/funeral costs.

The clinic I went to was very “basic.” My husband, who is a surgeon, later said that he felt like he was leaving me in somebody’s garage. Biggest thing that surprised him was the lack of equipment present to resuscitate a patient if there was a problem, and that I was at least a 15 minute drive to the nearest hospital. All of the equipment was outdated. We were also directed to park in the back of the building, as there were usually protesters out front. I’m thankful that none were there that day.


Michigan—I was unable to get an L&D locally. I had to travel to a hospital in Detroit, two hours away. Michigan has a mandatory “counseling” followed by a 24-hour waiting period, so we had to make the drive to Detroit, get the “counseling” which consisted of a completely irrelevant lecture about birth control and a packet of “information” on healthy fetal development, including fetal pictures we were required by law to view and sign off on.

We were also required by law to submit to an additional ultrasound to verify gestational age even though I’d had several very recent, very high level ultrasounds diagnosing fetal defects in two weeks leading up to this. I was at 20 weeks, just as we already knew.

This appointment was on a Friday, so the 24-hour waiting period ended up taking us through a weekend. We drove home from Detroit, then made the two-hour trip back again on Sunday night—this time in a snowstorm—to stay in a hotel and be on time for our early morning appointment on Monday.

Insurance covered nothing of the $4,000+ hospital expenses because my husband is a state employee. Michigan denies all abortion insurance coverage to all state employees, regardless of reason and with no consideration for situations like fetal anomaly.

The KCL injection was technically considered the abortion (according to my hospital paperwork). Because the hospital’s newer ultrasound labs were partially federally funded, the Hyde Amendment forbids them to be used for the KCL. For that, we were led to a far corner of the hospital in what was essentially a grim and cluttered storage room—rolling laundry hampers, stacks of hospital gowns, pink barf bowls and a window view of a brick wall—where there was some yellowing old-school ultrasound equipment saved just for the purpose of circumventing the Hyde Amendment. Thanks to Hyde, we were treated like a dirty little secret.


Illinois—My fetal reduction was at 25 weeks. The director of the MFM department at the hospital called a handful of local doctors who he said specialized in late term abortions, but none of them would do mine because Illinois doesn’t allow abortions past 24 weeks except in cases affecting mother’s health. He found a doctor in New York who would do it. I caught a flight to New York the next day (because it was the only day he was free). If I couldn’t afford a last minute flight, or the $4,000 out if pocket expense for the procedure (which my insurance wouldn’t cover because the doctor was out of network) I’d have a totally different life right now. I hate how laws take away these options from those who don’t have the means to pay for them. It’s beyond unfair.


Florida—I was “lucky” in that our termination happened before 20 weeks gestation. One of the local abortion clinics did it (something similar to the “garage” another member described earlier). There was only one clinic that would provide services at 17 weeks. It’s pretty discouraging to be in a situation that is (in my opinion) medically necessary for the baby and mother, and be desperate for service, yet no doctor will touch you in a hospital setting. My OBGYN did offer to do a delivery (L&D) in the hospital, but told me up front that my insurance would reject the claim and it would be $5,000 to $6,000 rather than $750 at the abortion clinic. Even with all that said, I know I am lucky that I could terminate locally.


Quebec, Canada—No restrictions. I had my D&E at 18 weeks. My province is quite progressive in terms of access to abortion and women’s rights in general. The entire procedure was covered by public medicare. I feel so much anger and sadness—a rage inside me—when I read of these difficult experiences. It was devastating and painful enough to make this decision, to go through the procedure, but to then have anyone sit and judge, to have to change location, to have to run out the back door in fear of protestors, to not have free, easy access to complete proper care and compassion, this utterly baffles and shocks me.


Alberta, Canada—Pretty much everything “Quebec” just said even down to having the same rage and sadness of behalf of you ladies elsewhere.

We had a D&E at 18 weeks. The only restriction was personal. I would have had to have a L&D if we’d gone past 20 weeks, which I wasn’t up for. The entire cost was covered by public Medicare.


Colorado—Reading everyone’s comments and posts, I am reminded of how lucky I am to live here. I didn’t realize it at the time, but the only legal issues were regarding how far along I was. I had a D&E at 21 weeks 5 days. Had I gone to 22 weeks, a D&E would not have been an option. That being said, I was in a fantastic hospital with amazing doctors and staff. Had I opted for the L&D, I would have had more time and once again, would have had the option of a good hospital for at least a couple weeks past the 22 weeks.

The only really major hurdle was with insurance. We were denied at pre-approval and did ask for a review and reconsideration. With the time constraints for D&E, we had to borrow $5,000 to cover the discounted rate the hospital gave us. We were later told that insurance would cover it and we were reimbursed.


Maryland—We were undergoing testing from 15 weeks to 20 weeks when our decision was made final. I was told I might have to go out of state, but then my wonderful MFM doctor identified a doctor at the university hospital who would do a D&E. It turns out she was away at a conference though and I had to wait another full week. The hospital may have had to sign off on the procedure as it was after 20 weeks. I’m not sure. I just know they took care of it and my insurance covered it.


Missouri—Just this past week I learned that in this state I had to sign consent forms for the L&D, then the procedure couldn’t begin until 72 hours post signing consent! The doctor said its designed to be another hoop for women to jump through and to make it harder to have a termination. I was very disappointed in my state laws.


Iowa—There were no legal restrictions in my case, however, I was far enough along that I had to go with L&D versus D&E. My doctor was Catholic and as such, apologized for not being able to be a part of the procedure, but he found an amazing doctor for me. My insurance paid all of the costs. That was 20 years ago.


Georgia—I was active duty for our first, so because of the Hyde Amendment we had to pay for it all ourselves. That was for L&D, at our hospital. I was 18 weeks. I wrote the hospital and providers letters and got reductions to the in-network negotiated rate we’d have had if I had been on my husband’s insurance. The doctor, midwife, and nurses were all wonderful. They have a really good perinatal loss program at the hospital.


Connecticut—24 weeks is the cut off. I believe I was 20 wks when diagnosed. However I went on a few weeks to have more testing to be sure. Genetics did keep reminding me of my cut off date. I made my final decision after discussing the MRI results with the neurosurgeon. I had a fetal echogram scheduled because their were questions about heart defects. I skipped that appointment after learning how severe his brain malformations were.

I believe they then called me and had to ask me what felt like ten times “You are aware you are consenting to terminate your pregnancy?” I’m not sure when paperwork had to be signed. I did have to meet with a doctor a few days before just to go over what to expect and to make a choice about D&E or L&D. I chose delivery (L&D).

I had to go to an office owned by hospital for the fetal injection, then I was induced at the hospital. I don’t believe any of my state’s restrictions affected me other being scared shitless in my second pregnancy because they scheduled my anatomy scan so late. I was scared I would be rushed to choose if something was wrong. For years after I felt I didn’t belong in other support groups because the pregnancy was ultimately interrupted with my consent—as if I consented for him to have such a horrible diagnosis.

My amniocentesis wasn’t back in time. I got results after. They’d been positive it was a trisomy. Turns out is wasn’t. I think I was sort of relieved to get that information afterwards though. It would have put more doubt in me if I’d got it before.


South Carolina—Mandatory counseling and a 24-hour delay. I had to be offered materials describing fetal development, prenatal care, other options, etc.

It was insulting. It was infuriating.

I had to sit across from my doctor while she read a mandatory statement to me and slid a stack of state prepared materials across the desk. She kindly apologized for having to do this and reminded me I didn’t need to look at anything I didn’t want to. Through my tears of anger I scribbled my signature and the date on a form to serve as proof that she’d offered me these materials.

I had taken off work without pay, found a caregiver for my child with severe disabilities and driven two hours one way to hear that printed statement be read to me while being offered the materials.

I then waited 24 hours to again drive two hours back to the hospital. We had to travel not because my local doctor was against my choice or because he wasn’t trained in abortion services. My doctor couldn’t take care of me locally because the local hospitals will not allow it. Interestingly enough, he had previously performed a D&C on me at approximately 10 wks for a “missed abortion” (aka miscarriage). Yet they do not allow this same procedure or any other abortion procedure when it’s a “therapeutic” and/or “induced abortion.” Clearly their policies have nothing to do with the actual medical services, safety, ability or willingness of the doctors.

My other options would have been to travel out of state to Atlanta, GA or Charlotte, NC.

I was fortunate enough to have very caring and supportive medical professionals. There were a few I knew were not, but the immense compassion from those who were overcame them.

I was also fortunate enough to have insurance coverage. My insurance would only cover an abortion if it was done in a hospital setting. I was again fortunate to be able to have a hospital in my state that performed abortions. However, the costs involved to perform my abortion in Labor & Delivery was extremely high in comparison to the costs I would have incurred in a clinic.


Michigan—Michigan has has a 24 week cut off, and we got the diagnosis at 28 weeks. We were referred to a clinic in another state and had to pay $12,500 for the procedure plus airfare and a week in a hotel. I filed a claim with my insurance seeking reimbursement for the procedure, and it was denied because the referral came from the high-risk obstetrician who diagnosed my baby instead of my primary care provider of record. We’re still waiting on their response to our first appeal.


Colorado—I had to terminate before 24 weeks. They had the final test results to me at 22 weeks. It wasn’t much time to decide, they had to book my appointment the same day they gave me my genetic results, or I might not have gotten in before 24 weeks. After that, if I had missed it, my only recourse after giving birth (if that even happened) would have been to refuse medical services for her after she was born in the hopes she might pass quietly.

It sickens me that we can euthanize our pets if they are in agony, but not loved family members, people have to suffer. I wish I had more time to decide and think about the options—D&E vs. induced labor, burial or not, ultrasounds, pictures, baby blankets—who knows. I had no time.


Saskatchewan, Canada—My L&D was performed at a hospital. I was 20 weeks, 6 days. D&E is only done here up to 16 weeks. Not for legal reasons, simply because there are no doctors who perform it after that point here. I was told L&D could legally be done any time up to 40 weeks for non-viable pregnancies. However, the doctors recommend having it done prior to the 24 week mark. Like the other Canadians, there were no costs at all because of Universal Healthcare. And, like them, I feel the rage, sadness, and bewilderment when we read what so many of you in the States go through.


Massachusetts—I was told that there was a hard limit of 24 weeks, 6 days and because I was past that limit I would have to go elsewhere.

I was 35 weeks 0 days on the day of my full diagnosis. There are three clinics in the country that are known for late third trimester abortions. One does not like to give care quite this far along. Another was closed for the week. I was left with exactly one doctor in exactly one clinic in the entire country, and possibly the world. (I hear that you can access this care in The Netherlands, but the chances that I could have figured this out in time are slim.)

In any case, the procedure cost me $25,000 out of pocket plus $3,000 in travel expenses. My insurance said they cover the procedure, but they weaseled out of it on a technicality—out of network provider—and only reimbursed me only about 10%.


California—No restrictions. My insurance paid for the entire procedure, no questions asked.


 

 

 

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