Abortion-rights supporters gathered at the Capitol in Olympia for a “Reproductive Freedom Rally” in early January.
Clinics see surge in patients since Roe overturned
Washington was the first state in the country to enact the right to an abortion through a vote of the people. That right is still guaranteed, even though the Supreme Court overturned Roe v. Wade last year. In fact, today, protections for people in Washington to make their own decisions about when and whether to have children have been expanded.
That first Washington referendum on abortion passed by a wide margin in 1970, three years before the country’s high court affirmed a Constitutional right to an abortion (see accompanying story). The Supreme Court’s decision overturning Roe allows individual states to enact their own laws regarding abortion.
Since 1970, Washington voters and legislators have strengthened the right two more times. In 1991, Washington voters narrowly passed a ballot initiative that guarantees every individual’s fundamental right to privacy in making reproductive decisions, including the right to choose or refuse abortion and contraception.
The law also requires insurance coverage and payment for abortion to be equal to coverage for maternity care. It guarantees the right for health care providers to use medical judgment regarding the health of the pregnant person. And it protects providers who object to performing abortions from discrimination.
Last year, before the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe, the Washington Legislature updated abortion protections again. “It is the public policy of the state of Washington to continue to protect and advance equal rights to access abortion care that meets each individual’s needs, regardless of gender or gender identity, race, ethnicity, income level, or place of residence,” the law says.
Less than a week after Roe was overturned, Washington Gov. Jay Inslee issued a directive underscoring Washington’s commitment to “remain a sanctuary for any person seeking abortion care and services in our state.”
Inslee’s directive prevents Washington law enforcement agencies from cooperating with any out-of-state investigation, prosecution or other legal action based on another state’s law that is inconsistent with Washington’s protections of the right to choose abortion and provide abortion-related care.
There is the potential for additional protections of reproductive rights in Washington. In the current Legislative session, with support from Washington Attorney General Bob Ferguson, a bipartisan group of lawmakers has sponsored a bill to protect the privacy of health data. The bill would protect all sensitive health information, including data from period-tracking apps, that could be sold to marketers or used to prosecute people from other states who come to Washington for abortion care. The legislation would also protect people from geofencing, which can be set up at health care facilities to track people through their phones, according to Ferguson’s office.
Inslee and Democratic lawmakers intend to push for a sanctuary policy to protect patients and providers from criminal or civil action connected with lawful reproductive health care or gender-affirming services in Washington.
Another bill introduced in the Legislature would amend the state Constitution to guarantee an individual’s fundamental right to an abortion and to choose or refuse contraceptives.
Responding to the overturning of Roe
Despite the existing protections in Washington, Okanogan County residents were alarmed by the Supreme Court’s actions in Dobbs. After a draft of the decision was leaked in May, people gathered in front of the county courthouse in Okanogan to underscore the importance of the right for people to make their own decisions.
One woman who attended the rally with her adult daughter situated the debate within a broader social context. “Inadequate or unavailable housing in Washington state causes some women to be trapped in abusive relationships they might otherwise leave,” she said. These women struggle to pay for child care, transportation and other needs for themselves and their families, she said.
“I’m here because nobody has the right to tell somebody else what to do with her body, ever,” said another person at the rally. “What is the cost of prolonged emotional neglect to a child from a mother who could not embrace and nurture an unintended child?” said one. Another person said men need to take more responsibility.
At a rally in Twisp after the decision was leaked, demonstrators carried placards reading “Abortion is a human right” and “Regulate your penis, and not my uterus.”
Local reproductive care
For people in the Methow Valley seeking abortion and related reproductive care, the closest services are in Wenatchee, at one of 11 health centers operated by Planned Parenthood of Greater Washington and Northern Idaho (PPGWNI).
People who are up to 10 to 12 weeks pregnant can obtain a medication abortion in Wenatchee (the abortion pill known as Plan C). Procedural abortions (sometimes called surgical abortions) are available only at their clinics in Spokane, Yakima and Kennewick, PPGWNI Vice President of Public Affairs Paul Dillon said.
Medication abortion accounts for 60% to 70% of the abortions at their clinics. Plan C can be prescribed after an in-person or phone consultation.
The Wenatchee clinic also provides health screenings, men’s health care including vasectomies, pregnancy testing, contraception and emergency contraception (also called Plan B, which prevents fertilization within the first 48 to 72 hours after unprotected intercourse), and gender-affirming care.
When someone is pregnant, PPGWNI staff discuss all options with the patient and provide referrals for prenatal care, adoption or abortion. Sixty percent of PPGWNI’s patients are already parents, Dillon said.
Swamped with patients
The PPGWNI clinics were already busy. But since the Supreme Court overturned Roe and many states banned all or most abortions, they’ve seen a dramatic increase in demand and are caring for women from across the country, Dillon said.
In fact, as soon as the Dobbs decision came out, Planned Parenthood got a call from someone in Utah, Dillon said. In the first week of September, PPGWNI saw two patients who’d come all the way from Florida. “We’re already seeing calls from states enacting bans. People need to get care and have no place else to go,” he said.
Even before the Supreme Court overturned Roe, one-quarter of people seeking abortion care in Washington were from out of state.
Idaho’s passage of laws that ban almost all abortions, which went into effect in August, drove patients to Washington almost immediately, Dillon said. In 2021, 43% of patients getting abortion care in Pullman were from Idaho. Now the majority of the clinic’s patients are from Idaho, he said.
PPGWNI has been hiring staff to handle the increase but, with the additional patients, wait times are longer for everyone at their smaller clinics, Dillon said.
The Idaho bans were challenged by the U.S. Department of Justice and a group of 21 state attorneys general, including Ferguson. They argued that Idaho’s near-total ban on abortion fails to protect the rights of patients to access emergency medical care enshrined in federal law.
In January, the Idaho Supreme Court upheld the bans. One prohibits abortions after six weeks of pregnancy, and another bans all abortions from conception, with exceptions for rape, incest or a medical threat to the life of the mother. The justices also upheld a law that allows family members of the aborted fetus to sue abortion providers.
The U.S. Department of Justice filed a lawsuit over part of the law that allows abortion providers to be charged with a crime. That case is still pending.
Uncertainty about state law prompted the University of Idaho to issue guidance last fall regarding the use of state funds or facilities for counseling about abortion or the prevention of conception because of the risk of prosecution. Students can be directed to outside sources of information.
Because Idaho law requires people to get approval from a judge to obtain an abortion after rape, incest or a medical threat, PPGWNI’s practitioners are seeing Idaho residents who fear being prosecuted for seeking abortion care, Dillon said. The legislation adds uncertainty for people who need medical care for a miscarriage or ectopic pregnancy, he said. “It’s another cruel step to prove they need care,” he said.
Watching lawsuits
Providers of abortion care are also watching other cases. Several lawsuits have been filed over mifepristone, the first of two drugs used in medication abortion.
A lawsuit filed in November by a coalition of anti-abortion groups seeks a nationwide ban on the drug. The suit contends that the approval of mifepristone by the Food and Drug Administration (FDA) more than 20 years ago was unlawful.
Concern about the lawsuit among supporters of abortion rights is especially high because it was filed in a Texas district where it will be heard by a judge who has litigated religious liberty cases before the Supreme Court.
In its response, the FDA said the injunction sought by the plaintiffs “would deprive patients of a safe and effective drug that has been on the market for more than two decades.”
Last week, Ferugson and 11 other state attorneys general filed their own lawsuit against the FDA over mifepristone. That suit contends that the FDA’s regulations are excessively burdensome because the restrictions are intended for inherently dangerous drugs like opioids, whereas mifepristone has fewer serious side effects than Tylenol or Viagra, they argue.
Medication abortion using only the second drug, misoprostol, is safe and effective, but it takes longer to complete the procedure than in combination with mifepristone. That would affect wait times and, in particular, patients who travel to obtain the procedure, Dillon said. “It’s going to wreak havoc and chaos on a system that has already been under attack,” he said.
History of abortion rights in Washington
Abortion was not always illegal in the United States, but by the early 1900s every state had criminalized it. In Washington, it became a crime to end a pregnancy except to save the life of the mother, according to a history of the state’s 1970 abortion referendum by the Seattle Civil Rights & Labor History Project at the University of Washington.
The campaign for the 1970 legislation that legalized abortion grew in part out of a recognition that wealthier women could obtain special permission for a “therapeutic” abortion, while those with fewer resources were usually left to find illegal and dangerous procedures. Activists began working for abortion-rights legislation after two young women died from botched illegal abortions in the late 1960s, according to the civil rights project history.
The Washington Legislature passed the 1970 law, 25 to 23 in the Senate and 64 to 31 in the House, and submitted it to voters for ratification and adoption in a referendum, where it passed by a 13% margin.
In addition to being the nation’s first, Washington’s 1970 referendum was noteworthy for the diversity of its supporters. The Legislative effort had bipartisan support, and campaign backers included women, men, and a group of clergy.
The bill’s main sponsor was state Sen. Joel Pritchard, a Republican from Seattle, while Rep. Margaret Hurley, a Spokane Democrat, headed up the opposition. Republican Gov. Dan Evans signed the bill, sending it to the voters for ratification.
There were significant regional differences on the referendum. Almost all eastern Washington counties, including Okanogan, voted against it.
Other local resources
The right to make reproductive decisions has broad impacts. Room One, the social services agency in Twisp, is committed to working against intergenerational poverty and violence, which they see as linked to the ability to make decisions about family planning. “Unwanted pregnancies impact a woman’s educational attainment and income-earning capacity, and increase vulnerability to violence,” Room One said in its summer 2022 newsletter.
Room One provides free condoms, pregnancy tests, and emergency contraception (Plan B). Their advocates help people find prenatal care, abortion care and adoption referrals.
Young people can also get assistance and referrals for reproductive care, pregnancy tests, abortion care, prenatal care or adoption resources from advocates with the Foundation for Youth Resiliency & Engagement (FYRE) in Omak.
Care Net Pregnancy Center provides pregnancy tests, ultrasounds, counseling and referrals for prenatal care, maternity and infant supplies, parenting resources and adoption services in Omak, Brewster and Oroville. Care Net offers “Christ-centered support, and our life-affirming network of pregnancy centers, churches, organizations, and individuals.”
Care Net will provide information to help someone make a decision about an unplanned pregnancy. But if someone comes to Care Net looking for a referral for an abortion, they simply say they can’t help. Most people are familiar with the organization and know they don’t support abortions, Care Net Omak Branch Manager Cathy Den Adel said.
A “Know Your Rights” brochure on reproductive health care is available on the Washington attorney general’s website at www.atg.wa.gov under the Resources tab and then Health & Public Safety.
CLARIFICATION
March 14, 2023
An article about abortion and reproductive health issues described the services of Care Net Pregnancy Center, which has facilities in Omak, Brewster and Oroville. The article described Care Net’s services and quoted an employee who said that if someone comes to Care Net looking for a referral for an abortion, the organization says they can’t help.
Care Net does not provide referrals or perform abortions, but provides help including free pregnancy tests and referrals to primary care physicians and maternity homes. They also refer patients to organizations that assist with adoption and with benefits for mothers including the WIC nutrition program. Care Net also offers abortion-recovery classes.
