In advance of the upcoming Dobbs v. Jackson Whole Women’s Health Organization decision, the following information provides context for what’s at stake in Missouri and what can be done to improve abortion access in Illinois, a critical access state in a post-Roe world. This is meant to be used on background as a resource for you as you cover the Supreme Court decision that could overturn Roe v. Wade.
This memo includes:
- Background on Missouri’s HB 126
- Missouri’s trigger ban
- What overturning or gutting Roe means to other sexual and reproductive health care
- Proactive measures to address the future of abortion access
HB 126 AND WHERE IT STANDS NOW
Just one day before the 8-week abortion ban was to go into effect in June 2019, a federal judge blocked the law. Then, in June 2021, a three-judge panel of the 8th U.S. Circuit Court of Appeals in St. Louis blocked HB 126 after the state of Missouri appealed the lower court’s decision. In an unprecedented move, the full court changed its mind and decided to hear the case (en banc), which it did on September 21, 2021. The full court’s decision is expected to be released soon after the Supreme Court’s Dobbs decision.
- House Bill 126, passed in May 2019, criminalizes providing abortion as early as eight weeks before many people even know they are pregnant. It also includes an unprecedented cascading ban, which includes 14-week, 18-week, and 20-week bans meant to take effect if the lower gestational age ban is blocked by a court.
- Reproductive Health Services of Planned Parenthood of the St. Louis Region along with Planned Parenthood Federation of America and the ACLU of Missouri challenged the law in July 2019.
Missourians and people across the U.S. don’t support abortion bans
Despite the extreme unpopularity of abortion bans, politicians in Missouri and dozens of other states are enacting abortion bans while real public health crises are being ignored.
- 2022 state legislature action on abortion bills (January 1–May 25, 2022)
- Abortion restrictions introduced: 541 restrictions in 42 states
- Abortion restrictions passed at least one chamber: 38 in 11 states
- While the state is attempting to cut off access to abortion, maternal and reproductive health in the state is in crisis. Maternal mortality rates in Missouri are more than 50 percent higher than the national average, and a syphilis outbreak is sweeping the state.
- Already, 1 in 3 women of reproductive age lives in a state where abortion could be outlawed if Roe is overturned. That’s over 36 million people across 26 states.
- The Devastating Economic Impacts of an Abortion Ban [The New Yorker, 5/11/22]
- The majority of Americans don’t want Roe overturned [PBS, 5/19/22]
- While access to abortion is expanding across the globe, the US is rolling it back [PLOS, 5/26/22]
- Imposing medically unnecessary restrictions on abortions doesn’t stop abortions. [NPR, 5/27/22]
- Abortion is a common, safe medical procedure. Nearly one in four women in the United States will have an abortion in her lifetime. 59% of women who have abortions are already mothers. [Guttmacher Institute, 9/19]
- The majority of Trump voters in Missouri oppose abortion bans and bounty hunter laws.
- Enacted in 2019 in HB 126, Missouri’s “trigger ban” will end abortion access except for life-threatening emergencies and criminalize doctors who provide abortion. Even in life-threatening circumstances, this will have a chilling effect on providers who could face wrongful prosecution just for providing care. This provision of HB126 is in effect and was not blocked by the court.
- Missouri’s trigger ban can be enacted in three ways:
- The Missouri legislature passes a concurrent resolution
- Governor Parson issues a proclamation
- Attorney General Schmitt issues an opinion that the trigger ban will stand. Attorney General Eric Schmitt has already promised to enact the trigger ban as soon as Roe is overturned.
- Missouri is one of 13 states with trigger laws that will ban or severely limit abortion access is Roe reversed.
IMPACT ON OTHER SEXUAL AND REPRODUCTIVE HEALTH CARE IF ROE IS OVERTURNED
The legal definition that applies to questions about whether overturning Roe v. Wade will impact birth control, IVF, or Plan B comes down to the state’s definition of abortion.
- Missouri law clearly defines abortion as the intentional termination of an intrauterine pregnancy. Medically speaking, that means an embryo that has implanted into the uterus.
- Let’s be clear: contraception and Plan B prevent pregnancies; they don’t terminate existing pregnancies.
- In the case of IVF, we’re talking about an embryo outside of the uterus. Terminating an embryo outside of the uterus falls outside the definition of “abortion”.
- The law is clear: any Missouri prosecutor who dares to take action against a person who uses birth control—or who provides birth control—would be acting outside the law.
Banning abortion and/or restricting access delays care and pushes people later into pregnancy.
- Since Texas’ abortion ban took effect, RHS in IL has seen a 50 percent increase in abortions after 15 weeks of pregnancy, compared to the same time period (9/1/20-4/30/21) the year before.
- In the wake of the Texas ban, RHS has already seen a massive ripple effect in the region that has driven a 121 percent increase in out-of-state patients traveling to southern Illinois. (Timeframe: 9/1/21-4/30/22 compared to the same time the previous year)
WHAT MORE CAN BE DONE — INCREASING CAPACITY
- The Regional Logistics Center (RLC) located in Fairview Heights, IL started navigating patients in January 2022.
- The RLC is a centralized operation to help arrange travel and lodging, and help connect patients with other practical support resources patients need when accessing an abortion. The RLC is about easing the burdens our patients face when trying to access an abortion.
- Since January 2022, we’ve (Regional Logistics Center) navigated more than 1,000+ patients who are already fleeing their home states because abortion is inaccessible where they live.
- The federal government needs to declare a public health emergency and allocate disaster relief funding to help cover logistical costs of abortion care.
- Allow nurse practitioners and physician assistants in Illinois to practice to the full scope of their training including in-clinic abortion care.
- Illinois is a critical access point in a post-Roe future. Nearly every state that borders Illinois is poised to ban abortion if Roe is overturned. This poses an immediate capacity challenge to abortion providers in the Land of Lincoln as patients will be forced to flee to Illinois for abortion care.
- Already, 12 states have expanded the pool of abortion providers to include nurse practitioners and physician assistants.
- In peer-reviewed studies like one published in the American Journal of Public Health, data show trained advanced clinicians are more than qualified to provide this care.
- Illinois’ 2019 Reproductive Health Act repealed an outdated abortion law that included restrictions on who can provide abortions. Governor Pritzker and Attorney General Raoul need to update nurse practitioners’ scope to include in-clinic abortion.