Tomorrow Magazine profiles a woman’s attempt to obtain an abortion in Alaska, showing the perils of trying to balance privacy and convenience in accessing safe abortion care. The author discovers her pregnancy at just five weeks, yet by the time she is finally able to end it, she is nine weeks along. In Alaska, an abortion requires far more than just the surgery; it also means airplane tickets, multiple appointments scheduled and rescheduled, and finally a trip to a private doctor. It didn’t have to be that way, but a combination of limited clinics in a vast geographic area, the fact that only a handful of practitioners are willing to provide abortions, and restrictive rules governing safe medication abortion all make what could be a very simple process overly burdensome.
“Oh, God, yeah, everyone’s had one of those,” Megan said, going into detail about the one she had in her early 20s. “I really don’t know why we don’t do them here. We’ve got ultrasound equipment and half the stuff for a medical abortion. We use the meds for ulcers, I think. I was actually thinking of getting certified for them when I go back to Washington, but you can’t do them in Alaska without an MD.”
There are two types of first-trimester abortion: vacuum aspiration, which uses suction to remove the embryo, and medication, which means you take drugs to trigger contractions and then check in with the provider a week later to ensure it worked. I was about to travel hundreds of miles for the aspiration kind, even though there was a person right here in town whom I trusted, with the equipment to do a less invasive procedure.
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“I’d like to do them if we could,” the local clinic’s executive director told me in a later conversation, in which she also talked about her own abortion. But her providers, she said, are terrified of malpractice lawsuits on the slim chance anything should go wrong. “You won’t see young doctors doing it. It’ll be a 70-year-old doctor who’s not worried about combative medicine”—her term for health care where patients are treated as future litigants. On top of that, there’s the conscience clause issue. One of the clinic’s doctors—the one who tried to change my prescription—has religious concerns about prescribing the pill and certainly wouldn’t provide medication abortions. And even if the providers didn’t have qualms, some very vocal members of the community would. The clinic sees no reason to fight to provide abortions to a few women a year.
With a nearly $700 bill for an abortion, not including her plane ticket to the clinic, Annoymous incurred well over $1000 so as not to be forced to be pregnant for longer than she wanted to be. For women in Alaska without financial means, those expenses would be nearly impossble. Yet the state continues to try to find ways to block even more low income women from using state funding for any abortion coverage.
Will the redefinition of a “medically necessary abortion” come up before the 2013 legislature as it has in the past? For the sake of Alaskan women, lets hope not.