New Jersey abortion providers are willing to help pregnant people from other states if the U.S. Supreme Court overturns the Roe v. Wade decision and allows states to restrict or ban such services. Over the past year, the state has taken steps to protect and expand access to abortion.
A few people from Texas have already had abortions in New Jersey, in the wake of that state’s law banning abortions after six weeks, providers report. In 2019, more than 1,300 out-of-state residents received abortions in New Jersey, according to the latest data from the federal Centers for Disease Control and Prevention.
That number is expected to grow.
Texas is one of 13 states with already on the books laws severely limiting access to abortion, while 13 others are on the cusp of enacting such laws. As a result, experts predict that nearly half of women of childbearing age in the United States could lose access to abortion.
But New Jersey has taken the opposite approach: expanding access to abortion by increasing the number of providers who can perform the procedure. Within the state, abortion pills can be prescribed through telemedicine. And help private groups where necessary to pay for travel, accommodation and medical costs for pregnant people who want to terminate a pregnancy.
“We’re going to get an influx from other states,” says Dr. Glenmarie Matthews, professor of obstetrics, gynecology, and reproductive health at Rutgers Robert Wood Johnson Medical School and director of the Reproductive Choice Program at New Jersey Medical School. A Texas woman recently called her office to ask for the price of an abortion, she said.
Matthews spoke after doing several abortions Tuesday afternoon in the operating room of Robert Wood Johnson Medical Center. She said the atmosphere among her colleagues had been troubled after Politico published a leaked draft U.S. Supreme Court opinion that would overturn Roe v. Wade, the 1973 decision that affirmed the constitutional right to abortion nationwide.
The Supreme Court said Tuesday that the leaked draft overturning Roe, written by Judge Samuel A. Alito Jr., was authentic but did not represent a final court decision or the final position of any judge. A decision is expected at the end of June.
“We’re trying to figure out what actions we can take,” Matthews said, “and how we can use our voice to stop this from happening. [decision] forward.”
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Wider access to abortion in NJ
New Jersey affirmed the right to reproductive choice, including termination of pregnancy, in a state law signed by Governor Phil Murphy on Jan. 13. The law was passed pending the new Supreme Court majority overthrow Roe and allow states to set their own abortion policies.
The New Jersey Board of Medical Examiners, which regulates physicians, has also broadened access to abortion services by increasing the number of licensed providers allowed to perform the procedure. The new regulations allow licensed midwives, licensed midwives, advanced practice nurses and physician assistants to perform surgical abortions, in addition to physicians.
This would allow approximately 12,000 advanced practice nurses, 4,500 physician assistants, 400 certified nurse midwives and 18 certified midwives — nearly 17,000 additional health care professionals — in New Jersey to perform the procedure, once their respective regulatory agencies establish appropriate rules. , according to the Public Prosecution Service.
The rules for physician assistants have already been approved, but the licensing committees for midwives and nurse practitioners are still in the process of drafting rules for those professions.
“We are training those providers” to handle any increase in demand for out-of-state patient services, said Kaitlyn Wojtowicz, director of public affairs for New Jersey’s Planned Parenthood Action Fund. “We’ve seen more patients from out of state and we expect this to really continue and expand in the coming years.”
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In 2019, hospitals and outpatient surgical centers in New Jersey reported 22,178 abortions, according to the CDC. But the data is considered incomplete, as clinics and doctors’ offices are not required to report their numbers to the state.
A study by the Guttmacher Institute, an abortion research organization, estimated that there were 48,110 abortions performed in New Jersey in 2017, which would put the state third in the number of abortions per 1,000 women of childbearing age.
Pregnant people in their 20s accounted for the highest rate of abortions in hospitals and surgical centers in the state — 55%, according to CDC data — while those 19 or younger accounted for less than 10%. The same data showed that 38% of abortions were performed in black patients, 27% in whites and 18% in Hispanics.
According to the latest information from the Guttmacher Institute, in 2017 the state had 79 abortion facilities, including 41 clinics. At the time, one-third of the state’s counties did not have an abortion provider. (A list of facilities is at abortionfinder.org.)
Planned Parenthood has 20 facilities that offer drug abortions or abortion pills. Surgical abortions in the clinic are also available at two of them, in Trenton and Shrewsbury, Wojtowicz said.
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Medication abortions and procedures in the clinic
Medicated abortions now account for more than half of all abortions in the United States and in New Jersey. They are considered a safe and effective method of terminating pregnancies up to 10 weeks. They are different from emergency contraception or morning after pills, which must be used within five days of unprotected sex.
For drug abortions, two pills — mifepristone and misoprostol — are prescribed and taken a day or two apart, according to a provider’s instructions. The first stops the progress of the pregnancy and the second causes bleeding and cramping to empty the uterus.
“Anyone can walk into a Planned Parenthood health center and say, ‘I’m pregnant. I’m on it pretty early,’ and have a doctor check me out,” Wojtowicz said. At Planned Parenthood, the first pill is taken in the office and the second at the office. home at a certain time.
During the COVID-19 pandemic, the federal Food and Drug Administration began allowing the pills to be mailed to prevent pregnant people from being exposed to COVID in a clinical setting, a decision that became permanent in December 2021. taken. Twenty states, including New Jersey, currently allow the pills to be shipped after a telemedicine appointment. They are also available through Abortion on Demand, an online service.
The cost of the pills averages about $500. Surgical procedures are generally more expensive, depending on the number of weeks the patient is pregnant, where the procedure is performed, and what type of anesthesia is used.
Suction or vacuum aspiration abortion is the most common procedure in the clinic and can be performed up to about 16 weeks of pregnancy. Dilation and evacuation (D&E) procedures use suction and medical instruments in a clinic or operating room to remove the contents of the uterus and are usually done after 16 weeks of pregnancy or later, according to Planned Parenthood. And depending on the circumstances, some women may need a “dilation and curettage” (D&C) with full anesthesia at a hospital or surgical center, which can cost up to $10,000, Matthews said.
Most insurance plans in New Jersey cover abortions, but plans offered through the Affordable Care Act are not required to do so. Financial aid is available, and Planned Parenthood says it doesn’t turn anyone down for financial reasons.
For those who find cost an obstacle, groups like the National Abortion Federation offer financial assistance to pregnant people who must travel to other states to have abortions, often with childcare, travel and lodging costs, as well as procedure costs.
Locally, the New Jersey Abortion Access Fund works directly with specific clinics to provide abortion funding to those in need. A person must first make an appointment and ask about the financing.
In Texas, where abortions are now severely restricted, reproductive choice advocates have created the Abortion Wayfinder program to help pregnant people navigate the travel system and to appointments as far away as Minnesota, Maryland and Virginia. Many of them have never traveled from Texas or flown on a plane, said Sonja Miller of the Whole Woman’s Health Alliance there.
“If abortion is illegal, people will still have abortions,” said Matthews, the New Jersey obstetrician-gynecologist. “We will have more complications and deaths.”
The maternal mortality rate is already increasing in the United States, only among the industrialized countries. “This marginalizes already marginalized people,” she said.
But for now, abortion providers emphasized that the Supreme Court’s decision is not yet final.
“Abortion is still legal across the country,” Wojtowicz said. “This was a draft decision, not the final decision. People should not be afraid to seek the care they need.
“If the final decision is made,” she added, “abortion will still be legal in New Jersey.”
Lindy Washburn is a senior healthcare reporter for NorthJersey.com. To stay informed about the impact of healthcare changes on you and your family, register today or activate your digital account.
Email: washburn@northjersey.com
Twitter: @lindywa