More fear, more delays, more travel: The effects of Iowa’s abortion ban

Iowa’s abortion ban has changed the way Iowans are getting care three months after it took effect.

Chelsea Cooper’s doctor was surprised she was alive.

Earlier this year, Cooper’s pregnancy quickly started to feel off. She was spotting and blood tests showed abnormal hormone levels, but she wasn’t in pain.

“At this point, I was five weeks along and starting to feel a little anxious and hoping that my body would do what it was supposed to do—knowing that in the next week it would be six weeks,” she said. “And, in our state, we’re at a very near total abortion ban, and I didn’t want to have to have those difficult conversations.

“I worried about being able to even get an abortion if I needed to, which was adding extreme stress to everything else going on with my body and my emotions,” she continued.

Cooper finally saw a doctor after a few more days. Her ultrasound revealed her abdomen was full of blood, and she was having an ectopic pregnancy that had burst in her fallopian tube.

“The doctor immediately sent me to have emergency surgery,” Cooper said in a Monday press conference hosted by Planned Parenthood North Central States. “At that day, I was six weeks pregnant.”

It’s been three months since Iowa’s near-total abortion ban went into effect, prohibiting abortion as early as six weeks, which is before most people know they’re pregnant.

Iowans living with the ban have still been getting care, but Planned Parenthood staffers said many aren’t getting it in Iowa.

“We are extremely limited in the patients that we can see in Iowa,” said Kristina Remus, a patient services associate for Planned Parenthood. “Most are forced to seek care in other neighboring states, including Minnesota, Nebraska, and Illinois.”

Planned Parenthood employees said they don’t yet have an exact number of people who have been denied care in Iowa.

Secrecy and stress

Another big change, Planned Parenthood staff said, is how scared and stressed patients are.

Remus takes phone calls from people looking for information about abortion or who are trying to set up travel out-of-state. She said the ban has meant more Iowans are making their plans in secret now, and they’re scared about people finding out they’re getting abortions.

“They don’t want anyone to know that they have an appointment,” she said. “They don’t tell their closest friends or family, and they are even afraid to call their insurance company to find out if abortion care is covered.”

A lot of the patients she talks to already have children and they need extra help to figure out their options if they have to travel out of Iowa. Others don’t have the resources to pay for a stay in a different city or a way to get out of state.

“They kept apologizing because they didn’t have the resources, and there was just so much guilt that was palpable on their end,” Remus said of one patient. “People shouldn’t feel guilty when they seek health care. People shouldn’t have to hide their health care decisions for fear of future retaliation.”

Alex Sharp, the senior health center manager for Iowa, said the situation for patients in Iowa has been stressful and, in some cases, heartbreaking.

“This near-total abortion ban has changed the entire environment and culture of what we have been doing for years,” said Sharp. “The conversations we have with patients are much more difficult, and we know they will only get harder.”

Patients are coming in earlier, she said, but she’s also had to turn some away because they’re too far along in their pregnancies.

“They have very little time to make the choices and consider their options,” Sharp said.

What the law gets wrong

Anti-abortion politicians who championed and voted for the ban call it a “heartbeat” bill, but there is no physical heart that early in pregnancy. What ultrasounds find are electric pulses, and abortion in Iowa is banned as soon as they can be detected.

There are limited exceptions to Iowa’s ban, but abortion bans around the country have revealed that exceptions don’t work in practice and abortion bans lead to worse health outcomes. Even in cases where a patient’s life is at risk, doctors may still deny care or delay it until a patient is close to the point of death.

Polling shows 59% of Iowans oppose the ban and 64% think abortion should be legal in all or most cases.

“We are in a moment where we are holding each other up even though we are tired. It’s been hard to swallow, but we have managed to create a system in which Iowans can get abortion care,” Sharp said.

Will it work long-term

Whether these efforts are sustainable beyond three months is up in the air, said Dr. Sarah Traxler, chief medical officer for Planned Parenthood North Central States.

There isn’t an infinite amount of money even if there are a lot of people who care and support the work through donations to Planned Parenthood and abortion funds.

“The other piece that is difficult and needs to be understood is that no matter how much we do to expand abortion care in Minnesota or Nebraska, a lot of patients are unable to travel regardless of the resources or money or support that we give them,” she said.

Cooper, the woman who had an ectopic pregnancy this year, said she’s scared for other Iowans.

“No one should be forced to knock on death’s door in order to obtain that care,” she said. “I almost died, but I consider myself among the lucky ones. It’s a punch in the gut to know that it’s our reality that we are living in, where just surviving is a win.”