Abortion in Georgia: Here is what’s currently legal — and not

The U.S. Supreme Court ruling Friday that struck down Roe v. Wade will have drastic implications for what is — and isn’t — legal in Georgia regarding abortion.

Georgia is not among the 13 states that had so-called “trigger laws” that effectively would ban abortion the moment Roe v. Wade is overridden. However, today’s ruling could still bring quick changes here.

For now, abortion is still legal in Georgia and here’s how abortions work.

What is a legal abortion?

There are two methods of abortion allowed in Georgia: surgical and medical.

Surgical abortions, which were the only type of abortion offered at the time of the Roe v. Wade ruling, involve an in-clinic visit. Despite the name, they are classified as medical procedures, not surgeries, and the process involves a doctor using suction to empty the patient’s uterus.

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Medical abortions are a much more recent method, with the first abortion pill getting U.S. Food and Drug Administration approval in 2000. According to the Kaiser Family Foundation, roughly half of abortions at eight weeks gestation or less are medical abortions.

The medical abortion involves two medications: mifepristone and misoprostol. Mifepristone is sold under the brand name Mifeprex and is also known as RU-486. It blocks progesterone, a hormone essential to the development of a pregnancy, stopping it from progressing. Misoprostol is then taken 24 to 48 hours later to empty the uterus through methods similar to an early miscarriage.

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When in pregnancy is an abortion allowed?

Georgia law allows abortions within 20 weeks of gestation or about 22 weeks since the patient’s last menstrual period. This means abortions are legal during the entirety of the first trimester (12 weeks) and partway through the second trimester, which ends after 26 weeks.

Medical abortions can take place within the first 10 weeks of pregnancy, while surgical abortions are the primary method for more advanced pregnancies.

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An anti-abortion bill, commonly known as the “heartbeat bill” was approved by the Georgia Legislature in 2019 to outlaw most abortions once a doctor can detect fetal cardiac activity — typically six weeks into a pregnancy. A federal judge later struck it down on the grounds that it violated Roe v. Wade.

Now that Roe v. Wade was struck down, what about the ‘heartbeat bill’?

With Roe v. Wade no longer standing as the law of the land, the 2019 bill is expected to go into effect in Georgia. While it isn’t a “trigger law” that’s tied to Roe v. Wade, the Supreme Court case was the primary legal argument that prevented the law from immediately going into effect.

Under the state’s heartbeat bill, abortion providers would no longer be able to proceed with surgical or medical abortions once fetal cardiac activity is detected, which is typically about six weeks into a pregnancy.

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How the heartbeat bill might be enforced is a different story. Earlier this month, the Atlanta City Council passed a resolution that asked for no city funds to be used to record or track where abortions are occurring in the city, or to provide such information to another government agency. The Council also asked Atlanta police to make investigating abortions their “lowest possible priority.” It’s unclear if other jurisdictions could take similar actions.

How many abortions take place?

State records show 31,248 abortions were performed in 2020, a rate of 9.3 abortions per 1,000 women between the ages of 10 and 55.

Who can prescribe abortion pills?

Medical abortions must be prescribed by a doctor. Georgia law prohibits physician assistants, registered nurses or pharmacists from prescribing abortion pills. Medical abortions can be prescribed using telehealth.

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Pharmacists are allowed to refuse to fill or refill abortion pill prescriptions based on their moral beliefs. Abortion pill prescriptions can be fulfilled through the mail, and a bill that would have banned the practice in Georgia never came up for a final vote earlier this year.

Are abortion pills and morning after pills the same thing?

No, they are not the same. Abortion pills terminate an existing pregnancy, while the so called “morning after” pills — there are several different brand names — prevent pregnancy. Morning after pills are available without a prescription at most retail pharmacy stores in Georgia to anyone 17 or older.

Where are abortions available in Georgia?

There are 28 facilities in Georgia that provide abortions, with 17 of those being dedicated clinics, according to the abortion rights activist organization NARAL Pro-Choice Georgia.

A recent report by Jezebel said Planned Parenthood, the largest provider of reproductive health services and abortions in the United States, stopped scheduling abortions in Georgia due to staffing issues. Planned Parenthood operates at least three clinics in Georgia.

A spokeswoman for Planned Parenthood South East told The Atlanta Journal-Constitution that the staffing issues were at the executive level, not clinicians, and that new staffers had been hired and abortions would resume “very soon.”

What is required during an abortion consultation?

Georgia law includes a mandated counseling session by a physician, where certain information must be presented to the patient. The patient must then wait 24 hours before they can move forward with an abortion procedure, either surgical or medical.

If the patient is a minor, their parent or guardian must be provided 24 hours notice before an abortion is performed. Georgia minors can seek a judge’s order to forgo this requirement, a process called judicial bypass.

Are abortions covered by insurance?

Private insurance plans may cover abortion. Georgia law prohibits abortion coverage in all health plans made available through the Affordable Care Act’s insurance marketplace. The health insurance packages for state employees also can’t include abortion coverage. The only exception is when the abortion would save a woman’s life or avert substantial and irreversible impairment to a major bodily function.

Federal law also prohibits Medicaid recipients and those with military health insurance from receiving abortion coverage.

How much does an abortion cost?

The price varies based on the clinic and the patient’s insurance provider. The Feminist Women’s Health Center, an abortion clinic in Atlanta, provides price estimates online. It estimates a medical abortion would cost between $518 and $575, while surgical abortions vary from $518 to $1,850 depending on how advanced the pregnancy is.

— AJC staff reporter Ariel Hart contributed to this article.