Sara, a 25-year-old Canton, Mississippi, resident who asked that her last name be withheld, said she was suffering from postpartum depression nearly a year after giving birth to her daughter when she got pregnant again. She decided to have an abortion at Mississippi’s only abortion clinic. MELANIE THORTIS FOR THE ATLANTA JOURNAL-CONSTITUTION
Photo: Melanie Thortis for The Atlanta Journal-Constitution
Photo: Melanie Thortis for The Atlanta Journal-Constitution

Georgians closely watching Mississippi’s moves to limit abortions

Once a car turns the corner, a teenage girl wearing a pink vest signals its occupants to stop and roll down their window. If they oblige — showcasing Southern hospitality — they are handed pamphlets with titles such as “Abortion: A Modern Day Holocaust” and “Are you a Good Person?”

As a woman walks up to the Jackson Women’s Health Organization — known locally as the “pink house” and shielded from the sidewalk by black tarps — the teenage “sidewalk counselor” keeps pace on the other side of the barrier.

“Are you going to kill your baby?” the girl shouts over the music that clinic volunteers play to drown out demonstrators. “When you come out, you’re still going to be a mother. You’ll just be the mother of a dead baby.”

It’s a scene that plays out nearly every day as abortion foes focus on the last remaining clinic in the state. And it’s a situation Georgia abortion rights advocates hope to avoid in Atlanta as opponents push the state to limit, if not outlaw, the procedure.

An abortion opponent prays outside the Jackson Women’s Health Organization clinic in Jackson, Mississippi. It is the only medical facility that performs abortions in the state. The state Legislature recently passed a law that would ban most abortions after a fetal heartbeat is detected, meaning as early as six weeks. Similar legislation has also won passage in Georgia. (AP Photo/Rogelio V. Solis)
Photo: Rogelio V. Solis/AP

Mississippi, where lawmakers have made abortions increasingly difficult to get, has become a training ground of sorts for opponents to test the legal limits of the Roe v. Wade decision guaranteeing access.

Georgia this spring approved a law that bans most abortions after fetal cardiac activity can be detected — usually about six weeks into a pregnancy and before many women know they are pregnant. The state was sued in June and a federal judge will hear arguments Monday to decide whether the court should stop the state’s law from going into effect Jan. 1.

Anti-abortion activists in Mississippi have taken a two-pronged approach to tamping down abortions — placing crippling regulations on clinics and passing legislation, similar to Georgia’s “heartbeat bill,” that limits the procedure itself. As in Georgia, activists there hope the legislation will challenge the U.S. Supreme Court ruling that guaranteed a woman’s right to an abortion and reverse the 1973 decision.

Abortion rights activists in Georgia are keeping watch on states such as Mississippi.

“We often see Mississippi being used as a testing ground for regressive legislation that is eventually rolled out across the Southeast and the rest of the country,” said Planned Parenthood Southeast President and CEO Staci Fox, who oversees operations in Georgia, Mississippi and Alabama.

Terri Herring, a longtime anti-abortion lobbyist in Mississippi, said regulations such as a 24-hour waiting period and state-mandated counseling aim to deter women from having the procedure.

“What we’re trying to do through state law is give women as much information and as much time to change their mind as possible,” she said.

Abortion rights activists say women in states such as Mississippi are already living as if Roe v. Wade is no longer the law of the land.

Before the court decision, when each state regulated abortion as it saw fit, pregnant women often traveled out of state to get abortions. That’s not unlike life in many Southern and Midwestern states, said Quita Tinsley, deputy director of the Atlanta-based abortion fund Access Reproductive Care-Southeast.

Thousands of women in states such as Mississippi who have the means — or connect with organizations that offer help — already are going to other states to have the procedure done.

“The reality is many people already don’t have access to care with Roe,” Tinsley said. “The laws have made it almost inaccessible for many people, especially in the South.”

By the numbers

Women who leave the state to get abortions typically go because their home state’s laws are restrictive, they live in a place with few providers, or they live close enough to the border that it’s easier to get to a clinic in a neighboring state.

According to U.S. Centers for Disease Control and Prevention numbers for 2015, the most recent available online, 2,220 abortions were performed on Mississippi residents out of state while 2,479 occurred in the state. By contrast, all but 314 of the 26,835 abortions performed on Georgia residents in 2015 reported to the CDC took place in state.

The number of abortions reported nationally have declined over the years, which experts say is due to a combination of access to birth control and fewer pregnancies. Both Georgia and Mississippi have followed the trend.

According to the Georgia Department of Public Health, reported abortions have fallen by 14.8% since 1994. That equates to 13.1 abortions per 1,000 females between the ages of 15 and 44 in 2017. In Mississippi, reported abortions dropped by 34.2% from 1994 to 2017 — to a rate of 4.3 abortions per 1,000 reproductive-age females.

‘I’m pregnant and I do not want to be’

Sara said she was still struggling with postpartum depression when her nearly 1-year-old daughter was admitted to the children’s hospital last year for being underweight.

The lactation consultant told Sara — a 25-year-old Canton, Mississippi, resident who asked that her last name be withheld — she wasn’t producing enough breast milk and encouraged her to stop taking birth control to boost her supply.

Within two months, Sara was pregnant.

“I just immediately knew I could not have it,” the stay-at-home mom said.

Sara said she spoke with her husband and immediately told him she wanted to get an abortion. She was familiar with Jackson Women’s Health Organization, where she volunteered as an escort for a couple years before her daughter was born.

She made her appointment and the 40-minute drive to Jackson — once when she was about five weeks pregnant to receive the state-mandated in-person counseling from the doctor and again two weeks later once she’d pulled together enough money to pay for the $600 procedure.

(Mississippi, like Georgia, requires a woman to wait at least 24 hours after receiving counseling to get an abortion. Unlike Georgia, however, that counseling must be done by a doctor and in person.)

Sara photographed in Jackson, Miss., on Thursday, Sept. 19, 2019. Sara, a 25-year-old Canton, Mississippi, resident who asked that her last name be withheld, said she was suffering from postpartum depression nearly a year after giving birth to her daughter when she got pregnant again. She decided to have an abortion at Mississippi's only abortion clinic. MELANIE THORTIS FOR THE ATLANTA JOURNAL-CONSTITUTION
Photo: Melanie Thortis for The Atlanta Journal-Constitution

There were few demonstrators that May afternoon when she went for her abortion, Sara said. After more than a year volunteering as a clinic escort, she had no problem tuning them out.

“The people following me (on the other side of the tarp) playing the recording of a child crying, ‘Mama, mama, don’t kill me,’ didn’t phase me at that point,” she said.

Nearly a year and a half later, Sara says she wouldn’t have done anything differently.

“I would like to have more kids in the future,” she said. “I remember thinking, ‘I wish this would have happened to me at another point in my life.’ But that was the best decision for me. I have no regrets.”

Cracking down on abortion

Shannon Brewer, the director of Jackson Women’s Health Organization, said the recent passage of Mississippi’s anti-abortion law spurred doctors across the country to offer their services at the facility. Local doctors decline to work with the clinic for fear of harassment at their medical practices or homes, she said.

At one point, two doctors took turns performing abortion services at the “pink house.” Now there are seven who rotate, she said, offering three or four clinic days during the week. The clinic pays to fly the doctors out and put them up in hotels.

Shannon Brewer, the clinic director at the Jackson Women's Health Organization, expresses her concerns about the growing number of abortion restrictive bills being passed by state legislatures, Friday, May 17, 2019, in Jackson, Miss. (AP Photo/Rogelio V. Solis)
Photo: Rogelio V. Solis/AP

Though Mississippi law allows abortions up to 20 weeks, the Jackson clinic made an internal decision to only offer the procedure up to 16 weeks into pregnancy.

The new law outlaws most abortions once a fetal heartbeat can be detected — usually about six weeks into pregnancy. A federal judge blocked the law from going into effect, as he did the year before when Mississippi approved a 15-week ban. The decisions on both laws are being appealed in court.

Like Georgia, Mississippi’s newest law would allow later abortions if the mother’s life is at risk or would cause serious injury. Unlike Georgia, Mississippi’s law does not allow exceptions for rape and incest.

Georgia’s law requires a police report to be filed in cases of rape and incest to get a later abortion. The law here is scheduled to go into effect in Georgia on Jan. 1. The American Civil Liberties Union is challenging it.

Anti-abortion activists in Mississippi also have been successful in closing clinics by passing regulations that make it difficult for them to operate, clinic staff said.

Mississippi law says the procedure must be done by an obstetrician/gynecologist, and it requires second-trimester abortions to be performed in a hospital, ambulatory surgical facility or an abortion facility with a special license.

Abortion rights activists say since many abortions are done medicinally — using pills — a nurse or other clinic staff member could be the one to hand over the pill, not a doctor.

Other regulations govern the facilities, dictating the width of hallways (5 feet) and doors (3 feet), and height of ceilings (7 feet 8 inches). They require clinics to be located within 30 minutes of a hospital that has an emergency room and more than 1,500 feet from a church or school.

Retrofitting existing facilities to meet regulations was too expensive and finding a new space that complies with location requirements was difficult, said Laurie Bertram Roberts, a co-founder of the Mississippi Reproductive Freedom Fund.

The group provides assistance to women who need abortions, whether it’s with money to pay for the procedure or getting someone across state lines if they’re too far along to get one in Mississippi.

“We call the South an abortion desert — where abortion access is just a mirage,” Roberts said.

In 1992, there were eight abortion facilities in Mississippi. In 2006, Jackson Women’s Health Organization became the last facility in the state.

There are nearly 30 facilities that provide abortions in Georgia, but doctors can provide the procedure at their office when the woman is in her first trimester. After that, the procedure must be done at a hospital or ambulatory surgical center.

Herring, the Mississippi anti-abortion lobbyist, said facilities that provide the procedure were barely regulated when she began her career in the ’80s.

“Many of the clinics that closed at the time legislation was passed, and there were no regulations whatsoever, they did not meet the standard of care for the rest of the medical community anywhere,” Herring said.

Anti-abortion lobbyists in Mississippi lost a legal fight to force doctors who perform abortions to have admitting privileges at nearby hospitals, but Herring said she still believes it’s a necessary requirement.

For example, she said, since abortion doctors come from other parts of the country, he or she is no longer around if a woman has complications after the procedure. She said doctors who perform surgeries in other areas of health care are required to have admitting privileges.

“I think as women, and as a nation, we have to go, ‘Why do we continue to make exceptions for abortion that do not meet the standard of care and do not protect women, and break all the rules that we require of everyone else?’ ” she said.

‘Whatever they’re experimenting with here, it’s coming there’

Abortion rights activists say Mississippi’s political makeup in the heart of the Bible Belt makes it a training ground for people who want to limit or eliminate access.

Diane Derzis, who owns the “pink house” as well as abortion clinics in Columbus, Georgia, and Virginia, said people may want to believe the laws passing in Mississippi are happening in a vacuum, but that’s not the case. Her Columbus clinic is one of the providers suing Georgia over it’s new abortion law.

“Whatever they’re experimenting with here, it’s coming there,” she said.

Children of abortion opponents, sing outside Jackson Women's Health Organization clinic in Jackson, Miss., Wednesday, April 10, 2019. The singing is an effort to get a pro-life message to clinic patients, since the clinic is the only medical facility that performs abortions in the state. The state legislature recently passed a law that would ban most abortions after a fetal heartbeat is detected, meaning as early as six weeks. (AP Photo/Rogelio V. Solis)
Photo: Rogelio V. Solis/AP

Clinic escort Kim Gibson, a Jackson resident who’s volunteered at the “pink house” for about two years, said she’s amazed by some of the laws addressing abortion that win approval in Mississippi.

“You bring your boiler plate (legislative language) here and it’s easy to do, so you can tweak your bill and take it to other parts of the country,” she said. “Here, ain’t nobody looking real hard, ain’t nobody gonna push back and nobody cares.”

Anti-abortion activists in Georgia say it only makes sense for lawmakers and lobbyists with similar interests to collaborate when proposing new legislation.

“It makes sense because why reinvent the wheel?” said Virginia Galloway, a lobbyist with the conservative Georgia Faith and Freedom Coalition.

Abortion rights activists in Georgia said they are bracing for what could come next. Anti-abortion activists have said there are no plans to pursue additional restrictions next year, but at this time in 2018 many also said they did not plan to push laws limiting the procedure.

Back at the “pink house,” Mississippi’s lone clinic, abortion opponents have shown up in numbers ranging from a handful to more than 160. Sometimes demonstrators use megaphones or a public-announcement system so their voices carry over the volunteers’ music.

Volunteer clinic escorts say they saw a spike in demonstrators in 2017, which is when Dr. Coleman Boyd said he, his wife and several of his 12 children started offering “sidewalk counseling.”

“I’m not here to protest,” said the emergency room doctor from Bolton. “I’m here to preach the gospel of Jesus Christ.”

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Comparing abortion laws and bills

Current law

> Time restriction

Georgia: Abortions are banned after 20 weeks

Mississippi: Abortions are banned after 20 weeks. The lone clinic in Mississippi only provides abortions up to 16 weeks.

> Exemptions

Georgia: Mother’s life is at risk

Mississippi: Mother’s life is at risk

> Who can perform abortions?

Georgia: Licensed doctors

Mississippi: Licensed obstetrician/gynecologists

> Waiting period

Georgia: State-mandated counseling is required at least 24 hours before an abortion can be performed. Counseling can be given over the phone.

Mississippi: State-mandated counseling is required at least 24-hours before an abortion can be performed. Counseling must be done in person and by a doctor.

> Clinic location restrictions

Georgia: None

Mississippi: Must be within 30 minutes of a hospital with an emergency room and more than 1,500 feet from a school or church.

> Construction restrictions

Georgia: Procedure rooms “shall be constructed, equipped, and maintained to assure the safety of patients and personnel.”

Mississippi: Hallways must be 5 feet wide, doors (3 feet) and height of ceilings (7 feet eight inches). 

> New law

Georgia: Bans abortions when there is detectable fetal cardiac activity, usually around six weeks

Mississippi: Bans abortions when there is detectable fetal cardiac activity, usually around six weeks.

> Exceptions

Georgia: Later abortions allowed in cases of rape or incest (police report must be filed), when the mother’s life is in danger, or if a fetus is not expected to survive after birth.

Mississippi: Later abortions allowed if the mother’s life is at risk.

> Legal Fight

Georgia: Abortion rights activists and providers have sued the state over the new law, House Bill 481. A federal judge will hold a hearing Monday to consider blocking the law from going into effect Jan. 1 while the case makes its way through the legal system.

Mississippi: A federal judge in May blocked the law from going into effect, which would have gone into effect on July 1. The state is appealing the ruling.

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