It's been more than two weeks since Florida's six-week abortion law went into effect on May 1. But residents in nearby states like Georgia have been dealing with similar restrictions for nearly two years.
Like in Florida, Georgia's law bans abortions after six weeks of pregnancy, with exceptions for medical emergencies, rape and incest.
Georgia Gov. Brian Kemp signed the measure into law in 2019, but it wasn’t allowed to go into effect until June 2022 after the U.S. Supreme Court overturned Roe v. Wade. The law was briefly overturned that November, but days later the Georgia Supreme Court granted an emergency stay while appeals continued, then ruled last fall to keep it in place.
The ban has caused a lot of harm, according to Dr. Nisha Verma, an OB-GYN and complex family planning specialist in Atlanta. Verma, a member of the American College of Obstetricians and Gynecologists, spoke to Health News Florida's Stephanie Colombini about her experiences practicing under Georgia’s restrictions.
Having gone through about two years with the ban in Georgia, have you encountered patients whom you felt may have needed abortions but the law inhibited you from caring for them in the way you wanted to?
Absolutely, every day. I am turning away patients that need abortions for all kinds of reasons every day. Even though I have the skills and the training to provide the care that they need to them, the law prevents me from doing so.
I just took care of a 15-year-old who came in and didn't realize she was pregnant until after six weeks. Because if you think about that, six weeks from the last menstrual period is two weeks from a first missed period. That is hardly any time for people to realize they're pregnant, to be able to come in for care – particularly folks like adolescents or people with irregular periods, that is just really hard to be able to get in in that time frame.
So I see people that don't realize that they're pregnant until after the six weeks that can't get care. I see people that have fetal anomalies of highly desired pregnancies that don't meet the very strict criteria of the law that can’t get care. And I see people whose pregnancies are making them very sick, but also don't meet that stringent exception in the law, that can’t get care. And I expect to see the same thing in other states like Florida.
And so how do you handle supporting patients while still following the law?
I mean, I'm pretty upfront with them. I say like, “This sucks, I'm so sorry that we can’t provide you this care, you should be able to get this care in this state.” I usually try to say something along the lines of, “You can still get this abortion. But I'm sorry that you're not able to get it here with me in your community.”
And I go over resources – that they can use abortion funds, other resources that help with funding, help with transportation, ways to get out-of-state care and other options.
When Georgia's law went into effect, Florida had to pick up a lot of need and volume and is a place that we sent a lot of our patients that can no longer get care with us. Now that Florida is no longer able to provide care, that is just creating these longer and longer distances and more burdens that people have to go through.
And I know travel isn't an option for some people.
Exactly, it’s just not doable for some people. Particularly people with lower financial incomes. People that have kids, that can't find child care, they can't take time off work. I have patients that just can't leave the state or get the abortion care they need, and have continued high-risk pregnancies and delivered.
On the flip side of that, I just saw a patient who found out she was pregnant, she got pregnant with an IUD in place, which makes the pregnancy more high-risk. And she was pregnant about five weeks and a couple of days, and so had like three days to make a decision if she was to get the care in Georgia, and had an abortion. I saw her for follow-up, and she was very upset that she felt that the law pushed her into a decision that she would have otherwise had more time to make.
There's some data that shows doctors are leaving or avoiding states that have abortion bans. What's keeping you in Georgia? Or are you considering leaving if you don't mind sharing?
Yeah, I mean, I’m from the South. I was born and raised in the South, I have done much of my training here and made a very intentional decision to stay. But it's definitely been hard.
I mean, it is hard to practice with the threat of criminal prosecution of losing your livelihood over you every day. And also just not being able to do what you know is best for patients, not being able to practice the skills that you have spent time training in because of a law that is based in politics, not medicine. And so that's really, really hard.
I have thought about leaving. I have colleagues that have left. I talked to a lot of trainees, medical students and residents that I mentor that have said similarly they're from the South, this is their home, their community, they would absolutely have stayed if this law wasn't in effect. But they feel like they can't get the training that they need or practice in the way that they need, so they are leaving.
And in places like Georgia, right, we already have a workforce shortage, so 50% of our counties do not have an OB-GYN. This workforce shortage is just going to get worse and worse and people are going to have to travel further for any type of reproductive health care as more people leave the state.
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