In Indiana, a changing landscape of abortion without clinics

INDIANAPOLIS– About nine years ago, Sarah Knowlton sought an abortion at a now closed northern Indiana clinic, where she encountered anti-abortion protesters as she approached the entrance.

Knowlton reflected on how that experience led her in 2019 to Whole Woman’s Health, another abortion clinic in South Bend, to train workers to bring patients safely to its doors, creating a resource that she wished she had years ago.

But the program — and Knowlton’s work at the clinic — will end Sept. 15, when Indiana’s abortion ban goes into effect, shutting down abortion clinics across the state.

Indiana’s legislature became the first in the nation to approve abortion restrictions after the U.S. Supreme Court struck down Roe v. Wade and that Republican Governor Eric Holcomb signed the ban on August 5.

The ban, which has exceptions, prohibits abortion clinics from providing abortion care, leaving such services only to hospitals or hospital-owned outpatient surgical centers.

“My last shift as a clinic escort is coming up,” Knowlton said Wednesday. “And I’m not ready for that.”

At Indiana University Health, which is the largest hospital system in the state, providers have been trained to continue to offer abortion care under permitted circumstances.

Under the new law, abortions will only be allowed in cases of rape and incest before 10 weeks after fertilization; protect the life and physical health of the patient; or if a fetus is diagnosed with a fatal abnormality.

A physician who performs an illegal abortion or fails to file required reports must lose their medical license.

IU Health officials outlined a new 24/7 response team — which will include a clinician, ethicist and attorney — that providers can contact to assess nuanced emergencies.

“The law is broad,” said Dr. Caroline Rouse, medical director of maternity services at IU Health. “Patient situations are very specific and unique.”

Last year, the majority of abortions in Indiana occurred at abortion clinics. Hospitals performed 133 of the state’s 8,414 abortions, according to a 2021 annual report from the state Department of Health, while the remaining 8,281 took place at abortion clinics.

Indiana clinics that will not be able to provide abortion services on Sept. 15 include Whole Woman’s Health in South Bend, Women’s Med in Indianapolis and Clinic for Women in Indianapolis.

The four Planned Parenthood clinics that provide abortion care in Indiana will no longer do so, but will continue to see patients for other medical services such as STI testing and treatment, contraception, and cancer screening. , said Rebecca Gibron, CEO of the Planned Parenthood division. includes Indiana.

“Planned Parenthood has been one of Indiana’s leading reproductive healthcare providers since 1932. And we’re not going anywhere,” Gibron told the AP in August.

Sharon Lau, director of Midwest Advocacy for Whole Woman’s Health Alliance, said while the South Bend clinic will stop abortion care, patients can still access a program that refers patients to abortion appointments. in other states.

“We will continue until we are forced not to,” she said.

The Indianapolis Women’s Clinic declined to speak to The Associated Press.

Lau said her clinic’s plans may hinge on two lawsuits filed by the American Civil Liberties Union of Indiana that seek to block the abortion ban before it goes into effect.

The first lawsuit, filed Aug. 31 in Monroe County, says the ban violates the Indiana Constitution, while the one filed Thursday in Marion County says the ban violates the law on religious freedom of the state, which Republicans signed into law seven years ago. The timing of the two lawsuits is unclear.

Mike Fichter, CEO of Indiana Right to Life, said in a statement that delaying the ban would mean “the indiscriminate killing of unborn children will continue in Indiana’s abortion clinics.”

“We are confident that the state will prevail and pray that the new law will not be prevented from coming into effect,” he said.

Women’s Med will also stop offering abortions after the ban, but will continue to refer patients to states where abortion is legal until about a month after, said Dr. Katie McHugh, an abortion provider at the clinic.

McHugh said he has seen a change in patient behavior since Indiana’s ban was passed. While some pursue abortion sooner, others choose surgical rather than medical abortions to avoid complications, she said.

Other patients assume abortion is already illegal, “and yet they choose abortion anyway, if it can demonstrate the desperation people feel,” McHugh said.

Knowlton said she was worried about patients who would put their health or life at risk if they couldn’t have an abortion. She knows that feeling; that was his mindset nine years ago.

“I was going to find a way, whether there was hell or hell, whether there was a clinic that I was able to access or not,” Knowlton said.

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Associated Press Tom Davies contributed to this report. Arleigh Rodgers is a member of the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places reporters in local newsrooms to report on underreported issues. Follow Arleigh Rodgers on Twitter at https://twitter.com/arleighrodgers

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