The Waiting Room: Abortion Clinics in Legal Limbo

By Jeremy Arnold

On Thursday, February 18th, a crowd of new faces packed the back half of Twelve Mile Limit, a Mid-City establishment known for its cocktails, barbecue, and vintage jukebox, for a trivia night fundraiser benefitting the New Orleans Abortion Fund, a non-profit organization that helps local women pay for abortions. Clusters of four or five people completely filled the low couches and tables that face the bar’s stage. A hush fell over the crowd as Amy Schully, president of Tulane Social Work Students United for Reproductive Freedom (SWURF) picked up the microphone to ask the first round’s final question.

“Alright folks, you should know this one: How many abortion clinics in Louisiana?”

Everyone was confident in their answers, but the field was split between four clinics and five. The correct answer was four, but those who said five could be forgiven for their error: the day before, Causeway Medical Clinic in Metairie, which was vandalized in a hate crime last August, shut its doors for good. Had the fundraiser been held a week later, the correct answer would have been two. Had it been held a week after that, it would have been four again.

This see-saw of closing and opening is the result of a legal dispute that began three years ago in Texas, where state legislators passed a bill requiring abortion providers to obtain admitting privileges at a hospital within thirty miles of their clinic. The law also requires that facilities where abortions take place be up to the same structural standards as hospital surgical centers, with restrictions on everything from the square footage of waiting rooms to the width of hallways. Supporters of these provisions claim they are working in the interest of women’s health by increasing safety measures in case patients suffer life-threatening complications. Critics point out that serious complications occur in less than one half of one percent of abortion procedures, and that women’s overall health will suffer when the clinics they depend on for their healthcare close down.

Though lower courts have tended to favor the arguments made by clinicians, both the Texas and Louisiana lawsuits met with fierce opposition in the Fifth Circuit Court of Appeals. The court, situated on Lafayette Square in New Orleans’ Central Business District, is a favorite of conservative jurists—it overturned the Obama Administration’s Deferred Action Program for Childhood Arrivals, which had placed high-achieving undocumented college students and military personnel at the lowest priority for deportation, last year. On February 24th, a three-judge panel of the Fifth Circuit ordered the Louisiana state government to enforce the clinic restrictions, forcing Delta Clinic of Baton Rouge and Abortion Assistance in Bossier City to close the same day.

Schully sees the so-called “TRAP” laws—Targeted Regulation of Abortion Providers—as yet another barrier to safe and legal abortion. “The operation itself costs between $400 and $600,” she says, “and that’s not even factoring in driving to the clinic, the childcare you might need, the day off work you might need. And a lot of these clinics have waiting periods, so you go in to get your consultation and you can’t get your abortion until after 24 or 48 hours. All these costs add up. I’ve been in a clinic before that didn’t let you have a young child with you. You couldn’t bring your kid with you. And the majority of women who are having abortions already have kids.”

According to Schully, one of the biggest barriers to reproductive healthcare for New Orleans’ women is simply not knowing: “I didn’t think about abortion growing up,” she says. “I didn’t know where you could get one. I didn’t get comprehensive sex education.” Her schools didn’t teach sex ed, and even if they had, state law has long forbid anything but abstinence-only programs.

Louisiana is one of only two states in the nation where the abortion rate increased between 2010 and 2014, by 12%. At the time, the AP attributed this “in part to women coming from other states where new restrictions and clinic closures have sharply limited abortion access.” In other words, Texans and Mississippians who have seen their local clinics shut down by TRAP laws are traveling to Louisiana to access abortions. The state’s clinics serve a large swath of the Deep South, well beyond its defined borders.

On March 4th, two days after opening arguments in Whole Woman’s Health v. Hellerstedt, the United States Supreme Court reversed the Fifth Circuit ruling that ordered the enforcement of the Louisiana admitting privileges law pending their decision in the Texas case. That same day, both Delta and Abortion Assistance announced they would reopen.

The fate of millions lies, as is often the case, in the hands of Justice Anthony Kennedy, who has retained his position as the court’s perpetual swing vote even after Justice Antonin Scalia’s death tipped the scales ever so slightly toward the court’s four liberal stalwarts. If Kennedy decides the TRAP laws are constitutional, the resulting 4-4 tie will allow the Fifth Circuit’s precedent to stand, and the laws will go into effect immediately.

Kathaleen Pittman, administrator of Hope Medical Group in Shreveport, testified last year that her clinic would likely have to close if the admitting privileges provision were to become law. That would leave the entire population of Louisiana with a single abortion clinic: the Women’s Healthcare Center in New Orleans—its doctor has been granted admitting privileges at Tulane Medical Center, around the corner from the Fifth Circuit Court of Appeals. However, it would be impossible for a single clinic that size to provide enough procedures to serve everyone looking for an abortion. People would inevitably be turned away.

For the better part of a decade, Planned Parenthood Gulf Coast has been in various stages of planning and construction on a new, full-service health center on Claiborne Avenue in New Orleans that will be the second abortion provider in the city. Community leaders participated in the symbolic groundbreaking of the project in 2013, but currently, the large plot of land has only the concrete footings for a building—the six-foot fence is the tallest thing on site. Adjacent to the construction site is a large placard that reads, “PLANNED PARENTHOOD SELLS ABORTION… and THEY PLAN TO SELL MORE HERE.” Beside the bright letters is a typically gruesome image of a fetus.

Opponents already have plans to set up across the street in a crisis pregnancy center called Hope Woman’s Clinic, where counselors will try to steer women away from Planned Parenthood’s services. The new center is proposed by leaders at Woman’s New Life Center in Metairie, who did not respond to multiple requests for comment. Testimonials from clients of the center describe it as a place of hope and healing. What Schully calls “barriers,” a Woman’s New Life Center client named Keisha sees as “excuses,” so when “it just seemed that life was impossible… my boyfriend had lost his job, my job certainly couldn’t pay the bills, we already had a three-year-old, and I was diagnosed with gestational diabetes,” Keisha carried the child to term. “Now,” she says, “as I look into the eyes of my amazing son, I don’t know what I would [do] without him.”

Though the entire network of Louisiana abortion clinics hangs in the balance, Schully remains optimistic. However, what passes for optimism these days is simply a return to the way things were five years ago: “we can get it back to seven or eight [clinics].”

In the meantime, SWURF is hosting another fundraiser for the New Orleans Abortion Fund in April. Trivia is out for a while, what with all the uncertainty. Instead, the organizers have opted for a game-a-thon at Shamrock, a Dave & Buster’s style barcade, also in Mid-City. Their overtures were rebuffed at Rock ’n’ Bowl, a popular bowling alley and bar in the same neighborhood, purportedly after the proprietors discovered what NOAF stands for. Conversation will no doubt revolve around the Supreme Court decision—expected in June—that will alter the reproductive health landscape in this city, state, and region for decades to come. Until then, they’ll just have to wait.

Jeremy Arnold is a junior at Tulane University’s School of Liberal Arts.