As the coronavirus disrupted lives and livelihoods in Utah, it appears that an increasing number of women sought abortions in the state, providers say.
The number of procedures in Utah has generally declined — with some fluctuations — over the past few decades, from approaching 5,000 in 1990 to just under 3,000 in 2019, according to a report from the Utah Department of Health’s Office of Vital Records and Statistics.
The department has not publicly released statewide data for 2020 and 2021. But Planned Parenthood and Wasatch Women’s Center, the two main abortion providers in Utah, performed 3,037 abortions in 2020, according to figures they provided to The Salt Lake Tribune. Last year, there were 3,388 abortions done at their facilities. And those numbers are likely incomplete, as private physicians also perform the procedure.
No matter how the U.S. Supreme Court rules in its upcoming decision on abortion access, or what laws go into effect in Utah, “nothing will make abortion go away,” said Dr. David Turok, an obstetrician/gynecologist practicing in Salt Lake City.
“You can make it harder for people. You can shame and blame people. You can create greater chaos and challenges in their lives,” he said. “But to think that some extreme anti-abortion legislation is going to make abortion go away is a folly.”
The Supreme Court will soon rule in Dobbs v. Jackson Women’s Health Organization, a case that stems from a 2018 Mississippi law banning abortions after 15 weeks of pregnancy, with some exceptions. The high court’s decision wasn’t expected to be released until June, or possibly July, before its session ends.
But a leaked draft opinion, published by Politico on Monday, gave a glimpse of what may come. “Roe was egregiously wrong from the start,” Justice Samuel Alito wrote in the draft opinion about the 1973 landmark Supreme Court decision. “... It is time to heed the Constitution and return the issue of abortion to the people’s elected representatives.”
Chief Justice John Roberts confirmed Tuesday that the draft was authentic, but said, “it does not represent a decision by the Court or the final position of any member on the issues in the case.”
Depending on how the Supreme Court officially rules, either Utah’s trigger law — which outlaws most abortions in the state — or a ban on the procedure after 18 weeks of pregnancy are likely to go into effect in the Beehive State.
The team at Planned Parenthood Association of Utah is “running out of letters of the alphabet” for all the plans they’re preparing to be ready, said president and CEO Karrie Galloway.
“It’s hard to believe that a half century of people, of Utahns, have been able to count on Roe v. Wade,” Galloway said. “... And with this next ruling, things could seriously change.”
“I think about all the people,” she said, “who have never had to make a plan, who have never had to say, ‘But what if I can’t depend on that right?’”
Who’s getting abortions in Utah?
The people who get abortions in Utah are “everyday women,” Galloway said. “... They could be your sister, your neighbor. Someone you don’t know. Someone you love.”
Most of the abortions in Utah in 2019 were done at seven or eight weeks of gestation, and were sought by women in their 20s, according to state data.
More than half of Utah residents said they sought an abortion for socioeconomic reasons (65%), the data shows. Elective abortions were the next most common reason (29%), followed by contraceptive failure (3%), among other explanations, according to the report.
In 2019, 49% of the Utah residents who had an abortion already had a child, while 51% did not, state data shows. And roughly three-fourths of Utahns who had an abortion that year had not had an abortion before, according to the report.
“It’s really important to remember that abortion is not a monolithic experience,” said Jessica Sanders, a family planning researcher in Utah. “My ability to access an abortion, as someone who has really wonderful health care, has providers that I trust, a partner and a community that supports my reproductive anatomy, is very different from someone who maybe doesn’t have the access to information, or the support of family, or the financial resources.”
Putting more restrictions, or a ban, on abortions in Utah will “disproportionately” affect “the people most in need and most vulnerable,” Sanders said.
Help for Utahns after a ruling
As Planned Parenthood prepares for what may happen with access in Utah, Galloway said her team has learned from their colleagues in Texas — where abortions were banned at about six weeks.
There, Planned Parenthood providers started giving “empowerment kits” to people who come to their health centers, which include resources, condoms, emergency contraception and a pregnancy test.
“That helps reinforce for people that they need to know as soon as possible if they’re pregnant,” Galloway said, “in case they have a tough decision to make.”
One bit of “sunshine” during “these dark clouds,” Galloway said, is that Planned Parenthood Association of Utah is now receiving Title X family planning funding again. The organization and its affiliates were “forced out” of the program in 2019, Galloway said in a news release in April, when the Trump administration implemented a “gag rule” restricting Title X funding recipients from making referrals for abortions or telling a patient where to obtain the procedure.
With the loss of this funding over the last few years, Planned Parenthood Association of Utah had to ask people for co-payments, Galloway said.
“For some of them, even just pitching in $10 ... is a lot of money if you’re pinching pennies,” she said.
Now, her organization can serve more people who “come in and get good, reliable contraception to help them plan their families,” Galloway said.
Beyond providing access to abortion, Planned Parenthood offers birth control, vasectomies, breast exams and other women’s health care, vaccinations, testing for sexually transmitted diseases and other screenings.
There’s an opportunity to educate people right now, as potential changes to abortion access loom, Galloway said.
“Women and men, family members, people who care about people who can get pregnant, need to be talking about this,” she said. “It has to be a dinner table discussion. Does everybody who we love know how to manage an unintended ... pregnancy? Because your options are going to be narrowed.”
Sanders said she thinks it will become more important to remove the stigma around abortion and barriers to information.
“If someone’s goal is reducing the number of abortions that happen,” she said, “then they really should rally behind access to contraception and access to all essential health care services around ... sex education” and care before, during and after pregnancy.
That focus should also extend to policies that create an “environment that we want to raise those children,” she said, such as supporting kindergarten programs.
If Roe is overturned, there will be need to be more help than ever to serve Utah women and their babies, said Mary Taylor, president of Pro-Life Utah. Over the last few years, Taylor said, her organization has given women financial and emotional support to help address problems in their lives, in the hopes they will make a choice other than abortion.
Every woman’s situation is different, Taylor said, but their assistance has ranged from helping to pay for a car repair bill to helping women who are dealing with long-term issues, such as drug addiction, consider adoption.
“We believe that this model that we do on a very small scale is really the solution to the abortion problem in general in our society,” Taylor said. “We would like to see that kind of attitude and those kind of options be available on a much, much grander scale.”
Taylor said she imagines that effort could involve some type of government aid, along with private efforts.
What exceptions would be allowed?
But the way the exceptions are written, according to Turok, doesn’t always align with the complicated reality that people are facing — and the compassion they need in making tough decisions.
Here are the exceptions and examples of what circumstances could qualify in Utah.
Exceptions for a woman’s life
An abortion would be legal if it “is necessary to avert the death” or if there is “a serious risk of substantial and irreversible impairment of a major bodily function” of the pregnant woman.
Pregnancy can make health conditions life-threatening, Sanders said.
This could include a “wide range of situations,” Turok said, from poorly controlled Type 1 diabetes, cardiac disease, pulmonary hypertension, blood disorders and severe hyperemesis gravidarum — which is “the sort of radical, extreme end of vomiting in pregnancy” — among others.
Exceptions for the health of a fetus
An abortion would be legal if “two physicians who practice maternal fetal medicine concur ... that the fetus has a defect that is uniformly diagnosable and uniformly lethal,” or “has a severe brain abnormality that is uniformly diagnosable.”
An example of a uniformly lethal, uniformly diagnosable fetal anomaly is anencephaly, Turok said, where only the base of the head has developed in a fetus. The top of the skull is missing, he said, and “what little brain tissue is available is essentially open.”
“It is possible that with brain stem tissue, that there could be breathing,” he said, or the “heart might beat spontaneously for some time” with the help of a breathing tube.
“Very rarely, there are people who would want to support that situation and make that decision,” Turok said. “The vast majority of times in that situation, people would not want to prolong that kind of suffering.”
Turok said he invites state lawmakers to “think about the challenges that a family” would face when receiving these diagnoses. For instance, he said, here’s a situation that would not qualify under the exception: The parents are told that the fetus has a complex cardiac anomaly, which would result in a 50% chance of survival to 5 years old.
“And in order to get to that place, their child would need to have multiple surgeries, each which carries a risk of mortality along the way,” he said.
“I have cared for people who have received that kind of diagnosis and have made the decision to continue the pregnancy,” Turok said, and he’s worked with others who decide not to. What’s important, he said, is that people are given the “decency” to talk with their doctor and make the best decision for them.
Exceptions for rape or incest
An abortion would be legal if the pregnancy was caused by a rape or incest. Before performing an abortion, the physician would have to verify the rape or incest has been reported to law enforcement or the proper authorities.
The problem with this exception, Sanders said, is “we know that rape is underreported” for “a wide variety of reasons.” For instance, in Utah, people can have evidence collected with a sexual assault kit, and receive the health care they need, without having to report their rape to police right away.
“We don’t know what the real number of people who experience sexual violence ... prior to attempting to terminate a pregnancy [is],” Turok said. “But saying that ... abortion is available for people who experience rape is not, I think, genuine.”
That’s because with this exception, he said, “you are essentially taking somebody in an extremely vulnerable situation and then forcing them to” go through the judicial process. “That’s not,” he said, “a viable path” for everyone.
Becky Jacobs is a Report for America corps member and writes about the status of women in Utah for The Salt Lake Tribune. Your donation to match our RFA grant helps keep her writing stories like this one; please consider making a tax-deductible gift of any amount today by clicking here.