New Jersey abortion providers stand ready to help pregnant women in other states if the U.S. Supreme Court overturns Roe v. Wade and allows states to restrict or prohibit these 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, following that state’s law banning abortions after six weeks, providers report. In 2019, more than 1,300 out-of-state residents had abortions in New Jersey, according to the latest data from the federal Centers for Disease Control and Prevention.
This number should increase.
Texas is one of 13 states that have already passed laws severely limiting access to abortion, while 13 more are on the verge of passing such laws. As a result, experts predict that almost 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 types of providers who can perform the procedure. Within the state, abortion pills can be prescribed via telemedicine. And private groups help pay for travel, accommodation and medical care, if needed, for expectant mothers seeking to terminate a pregnancy.
“We will have an influx from other states,” said 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 asking for the cost of an abortion, she said.
Matthews spoke after performing several abortion cases in the operating room at Robert Wood Johnson Medical Center on Tuesday afternoon. She said the atmosphere among her colleagues was charged after Politico released a leaked U.S. Supreme Court draft opinion that would overturn Roe v. Wade, the 1973 decision that affirmed the nationwide constitutional right to abortion.
The Supreme Court said Tuesday that the leaked draft quashing Roe, authored by Judge Samuel A. Alito Jr., was genuine, but did not represent a final court decision or a judge’s final position. A decision is expected at the end of June.
“We’re trying to figure out what actions we can take,” Matthews said, “and how to use our voices to not let that [decision] Advance.”
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Expanded Access to Abortion in New Jersey
New Jersey cemented the right to reproductive choice, including termination of pregnancy, in a state law signed by Governor Phil Murphy on January 13. The law was passed in anticipation that the new Supreme Court majority would overturn Roe and allow states to set their own abortion policies.
The New Jersey Board of Medical Examiners, which regulates doctors, has also expanded access to abortion services by increasing the types of licensed providers allowed to perform the procedure. Its new regulations allow certified nurse midwives, certified midwives, advanced practice nurses, and physician assistants — in addition to physicians — to perform surgical abortions.
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 healthcare professionals – in New Jersey to be licensed to perform the procedure, once their respective regulators have promulgated the appropriate rules, according to the state attorney general’s office.
Rules for physician assistants have already been approved, but licensing boards for midwives and advanced practice nurses are still developing rules for those professions.
“We’re training these providers” to handle any surge in demand for services from out-of-state patients, 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 that to continue and grow over the next few years.”
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In 2019, hospitals and outpatient surgery centers in New Jersey reported 22,178 abortions, According to the CDC. But the data is considered incomplete because clinics and doctors’ offices are not required to report their numbers to the state.
A study by the Guttmacher Institute, an abortion rights research organization, found that 48,110 abortions were performed in New Jersey in 2017which would rank the state third in the nation for the rate of abortions per 1,000 women of childbearing age.
Pregnant women in their 20s accounted for the highest number of abortions at hospitals and surgical centers across 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 on black patients, 27% on whites and 18% on Hispanics.
The state had 79 abortion centers in 2017, according to the most recent information from the Guttmacher Institute, including 41 clinics. At that time, one-third of counties in the state did not have an abortion provider. (A list of facilities is at abortionfinder.org.)
Planned Parenthood has 20 facilities that offer medical abortions or abortion pills. In-clinic surgical abortions are also available at two of them, in Trenton and Shrewsbury, Wojtowicz said.
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Medical abortions and in-clinic procedures
Medical abortions now account for more than half of all abortions in the United States and New Jersey. They are considered a safe and effective method of terminating pregnancies up to 10 weeks. They are different from emergency contraception or the morning after pill, which must be used within five days of unprotected sex.
For medical abortions, two pills – mifepristone and misoprostol – are prescribed and taken a day or two apart, as instructed by a supplier. The first halts the course of 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 pretty early and being checked by a doctor,” Wojtowicz said. At Planned Parenthood, the first pill is taken at the office and the second at home at a specific time.
During the COVID-19 pandemic, the federal Food and Drug Administration began allowing the pills to be sent to avoid exposing pregnant women to COVID in a clinical setting, a decision it made permanent in December 2021. Twenty states, including New Jersey, currently allow the pills to be sent after a telemedicine appointment. They are also available through Abortion on demandan online service.
The cost of the pills averages around $500. Surgical procedures are generally more expensive, depending on how many weeks the patient is pregnant, where the procedure is performed, and the type of anesthesia used.
A suction abortion or vacuum aspiration is the most common procedure in the clinic and can be done 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 performed at 16 weeks of pregnancy or later, according to Planned Parenthood. . And depending on the circumstances, some women may need “dilation and curettage” (D&C) with full anesthesia at a hospital or surgical center, which can cost up to $10,000, Matthews said.
Most New Jersey insurance plans cover abortions, but plans offered by the Affordable Care Act are not required to do so. Financial assistance is available and Planned Parenthood says it does not turn anyone away for financial reasons.
For those who find cost a barrier, groups such as the National Abortion Federation provide financial assistance to pregnant women who must travel to other states for abortions, often helping with childcare. , travel and accommodation costs and procedural 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 financing.
In Texas, which now severely restricts abortions, reproductive choice advocates have created the Abortion Wayfinder program to help pregnant women navigate the travel system and get to appointments as far away as Minnesota. , Maryland and Virginia. Many of them have never traveled outside of Texas or flown before, said Sonja Miller of the Whole Woman’s Health Alliance.
“If abortion is illegal, people will still have abortions,” said Matthews, the New Jersey obstetrician-gynecologist. “We are going to have more complications and deaths.”
The maternal mortality rate is already rising in the United States, alone among industrialized countries. “It will marginalize people who are already marginalized,” she said.
But for now, abortion providers have stressed that the Supreme Court’s decision is not yet final.
“Across the country, abortion is still legal,” Wojtowicz said. “It was a draft decision, not the final decision. People shouldn’t be afraid to seek the care they need.
“When the final decision is made,” she added, “abortion will still be legal in New Jersey.”
Lindy Washburn is senior healthcare reporter for NorthJersey.com. To keep up to date with how changes in healthcare are affecting you and your family, please subscribe or activate your digital account today.
E-mail: washburn@northjersey.com
Twitter: @lindywa
