How abortion providers in Kentucky are helping patients despite the ban

On April 12, there were only two reproductive health care clinics in the state of Kentucky. Both operated in Louisville, leaving most Kentuckians hundreds of miles away from this health service. On April 13, both clinics ceased offering abortion services, leaving the 4.5 million residents of Kentucky without any way to access this form of care within their own state’s borders.

The decision was not one that the health care providers came to by choice. They were forced into ending the practice by House Bill 3, a restrictive and potentially unconstitutional law that places such broad restrictions on abortion providers that it has effectively become impossible to offer the procedure to those in need of it.

On its face, House Bill 3 appears to be a straightforward abortion ban, the kind that restricts access to abortion after 15 weeks of pregnancy. This part of the law follows similar attempts by states like Florida, West Virginia, and other red states to shrink the window of time during which pregnant people can seek out abortion care. But the Kentucky bill also included more than 60 pages of regulatory requirements that create an environment under which no abortion provider within the state can reasonably operate.

Under the law, minors have to seek parental permission to get an abortion, patients are forced to report their abortions to the state and file “birth-death” certificates, and the state will create a public database of all physicians who perform abortions. It also creates new and strict requirements for physicians offering abortion pills, requiring them to administer the pills in person and banning the practice of mailing them. Additionally, all aborted fetuses must be cremated or buried, in a transparent attempt to create excessive costs for having an abortion in Kentucky.

One of the two clinics that offered abortion services in Kentucky up until last week was Planned Parenthood. (The other, EMW Women’s Surgical Center, has also stopped providing the procedure for now.) For weeks, the Louisville clinic had been operating under tumultuous conditions. “My staff and I have been very determined to make sure that our voices are heard,” Tamarra Wieder, the Kentucky state director at Planned Parenthood Alliance Advocates, tells Mic. From the day the bill first passed the state legislature on March 29, to the day it landed on the desk of Democratic Gov. Andy Beshear (who would veto the bill, but have his veto overturned by the Republican supermajority in the statehouse), Wieder and her team managed to get hundreds of volunteers to show up in protest.

“Our supporters were with us for 10 hours,” Wieder says. “They would not leave even with a tornado warning for the area that we were in. They wanted so much to make sure that those legislators knew what they did to us.”

That included showing up in the statehouse to make sure legislators would have to look them in the eyes while on their way to cast their vote to ban abortion. “No legislator could walk past us without having to see us before they took this vote,” Wieder tells Mic. Volunteers spoke to anyone who would listen and tried to flip votes, though most politicians ignored them. State Sen. Ralph Alvarado (R), the lead sponsor for the bill, “literally ran past us with his head down so that he didn’t have to acknowledge who we were or answer for his vote,” Wieder says.

“Patients are afraid. ... They don’t know what they can do legally and what they can’t do legally.”

Back at the Planned Parenthood clinic in Louisville, doctors and nurses on staff have shifted from providing abortion care to helping patients find the care that is right from them, however they can. “We have stopped providing abortion care, because currently it is illegal based on that law,” Kara Caldwallader, the chief medical officer for Planned Parenthood Great Northwest, Hawaii, Alaska, Indiana, and Kentucky, tells Mic. “But we are reaching out to our communities and our patients to let them know that our doors are still open.”

According to Caldwallader, Planned Parenthood clinics in Kentucky, including the one in Louisville, will continue to provide the reproductive health services that they have always offered beyond abortion. That includes providing lab work and testing, as well determining how far along into their pregnancy a patient is. From there, Planned Parenthood staff can help the patient determine next steps, including where to go in order to access abortion care if they so desire.

“We are still open and encouraging patients who need abortion care to come in so that we can assist them in getting to the place that they need to be,” Caldwallader says. “Right now they can go to Indiana, and we have clinics in Indiana that can help facilitate the care that they need ... and we can help coordinate that care.”

It’s a helpful service, but it puts a high burden on patients. Wieder says some patients are already driving 250 miles just to get to the Planned Parenthood location in Louisville. Now that abortion services can no longer be performed there, patients will be looking at an even farther trek to get the care they need. “That’s going to increase the costs in days off of work, in school or child care. So many barriers get layered on the further that you have to travel,” she says.

Already, Wieder notes, there has been a lot of confusion for patients seeking abortion care — something that she believes is a purposeful side effect of the law. “Patients are afraid,” she tells Mic. “They don’t know what they can do legally and what they can’t do legally.”

Caldwallader says patients who may be experiencing bleeding or cramping and are unsure of what to do may now feel unsafe seeking out care. That can lead to much greater risks. “Some of those patients may have ectopic pregnancies, which are pregnancies outside of the uterus,” Caldwallader explains. “Those can be potentially lethal or life threatening.”

Kentucky already suffers from the worst maternal mortality rate in the entire country. Weider calls Kentucky a health care desert. “We have 120 counties in Kentucky, 73 do not have a practicing OBGYN,” she says. She fears that situation will only get worse with House Bill 3 on the books.

A recent study from the University of Colorado found that abortion bans can result in an increase to the maternal morality rate by as much as 21%. That figure jumps to 33% for Black women. Yet so far, despite legal challenges, House Bill 3 remains in place. And while those lawsuits may eventually win out, Kentucky will seek to add a constitutional amendment to make abortion illegal in the state in November. There is hope that the ballot measure won’t pass, as polling suggests a majority of Kentuckians support abortion access. But it appears that lawmakers in the state intend to exhaust every option to exert their will in the matter — forcing advocates to continue fighting for the actual will of the people.