All photos by Crystal Monds Photography via FWHC

At a Georgia Clinic, Abortion Bill Causes Uncertainty and Fear

House Bill 481, which proposes making abortion illegal after around six weeks, is adding to a national debate around "fetal heartbeat" bills. But at a women's health center in Atlanta, it's already stirring very real worry and confusion for patients.

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Apr 5 2019, 4:42pm

All photos by Crystal Monds Photography via FWHC

The day after the Georgia Senate approved one of the strictest abortion bills in the country, patients arrived at Feminist Women’s Health Center (FWHC) in Atlanta with questions. The clinic offers a wide range of health services, including abortion care.

Almost every single patient who came in that Saturday asked clinic escorts if they still had an appointment, recalls Libby Mandarino, a grassroots organizer with FWHC who’s also in charge of the clinic escort program.

“People are very concerned about getting the care that they need,” Mandarino tells Broadly.

On March 29, Georgia lawmakers approved one of the most restrictive abortion bills in the country. House Bill 481, which is currently awaiting Gov. Brian Kemp’s signature, bans abortions after doctors detect a fetal heartbeat in the womb—about six weeks into a pregnancy. This is before many women know they're pregnant, and opponents of the bill say it would effectively outlaw abortion in the state. Currently, state law allows the procedure up to 20 weeks into a pregnancy.

After a narrow vote of 92–78 in favor of the legislation, Kemp applauded lawmakers’ “undeniable courage.” If the governor signs HB 481 into law, the legislation would take effect in January 2020. Many opponents, however, believe it will be ruled unconstitutional in the courts, replicating what’s happened in states like Kentucky, Iowa, and North Dakota who attempted to pass similar bans. The ACLU has also said it will sue if the law is passed.

However, one resounding concern from pro-choice advocates is that Georgia’s bill is part of conservative lawmakers' efforts to bring such legislation to the Supreme Court in order to challenge Roe v. Wade.

HB 481’s entrance into the national debate around abortion rights isn’t an abstract issue for clinics like FWHC. Kwajelyn Jackson, the clinic's executive director, explains that the impact of restricted access to abortion would be real and lasting for women in her state. “When bills like this come around, what we want folks to understand is that, in a lot of ways, it’s not just about a particular pregnancy in a particular moment,” she says. “These decisions are really about a full-life trajectory in a lot of ways.

“When you restrict people’s ability to be able to choose how and when and under what circumstances they want to parent, then you’re actually inhibiting them from being able to live their best life.”

Throughout its 41-year history, FWHC has provided supportive abortion care to its patients, many of whom travel long distances and across state lines to get there. In the face of legislation that’s set to disrupt that mission, the staff and volunteers at the clinic are undeterred.

waiting room

On a sunny Tuesday afternoon, just days after the state legislature advanced HB 481, also known as the Living Infants Fairness and Equality (LIFE) Act, I pull into the parking lot of FWHC. The clinic sits on a hill off an access road parallel to Interstate 85, making it easy to get to, no matter where you’re coming from. Across the street from the clinic, two men and a woman hold up signs in silence. One reads “Jesus forgives.”

On the day I visit, fewer than 10 patients are scheduled for services. On a typical Friday or Saturday, that number is closer to 25.

In 2018, FWHC offered medical services to 5,052 patients, 3,867 of whom had come for abortion care, according to center’s most recent impact report. The majority of the people they serve are people of color and from low-income households. Some of those patients are parents who've decided it's in the best interests of their families to not have any more children. Others are fetal anomaly cases or minors. Everyone’s case is different.

In addition to offering healthcare services, FWHC is active in community organizing, outreach and leadership development. With that increased visibility comes increased risks.

Since HB 481 started gaining traction, the center has seen an increase in protest activities. Staff say more protesters have shown up, and many are staying longer. They’ve also started appearing on days the clinic doesn't perform abortions.

Mandarino says some of the protestors’ tactics have become more aggressive, including wearing safety vests similar to those worn by clinic escorts. “This confuses patients and allows the protesters to snag people in the driveway and talk to them before they're safely into the parking lot as they think the protester is a member of clinic staff,” Mandarino explains. Per federal law, protesters may not physically block or intimidate patients from entering the clinic. “It makes the patients scared to use the clinic escort services because they're afraid our escorts are protesters, so patients are having to walk up to the clinic past the barrage of noise without support.”

The staff of FWHC feels the weight of what’s at stake with this bill. “Some of us are raw,” says Wula Dawson, the center’s development communications director. “So many of us have our own personal connections, and our family member’s connections, to this story, and I do think pressing up against that vulnerability, day in and day out, is taxing."

Yet they all view the work of providing women's as imperative. Georgia has the highest maternal mortality rate in the country: For every 100,000 live births, 46.2 women die, compared to the national average of 20.7. For Black women in Georgia, that number jumps to 66.6. Additionally, half of the state’s 159 counties do not have a single obstetrician. A quarter of pregnant women living in rural areas have to drive more than 45 minutes just to access obstetric services. Until this last legislative session, state lawmakers refused to expand Medicaid as part of the Affordable Care Act, leaving many people without access to health care.

“Forcing people to continue a pregnancy to term against their consent, particularly when they are already oppressed in so many other ways because of the identities they hold, is a problem,” says Jackson, FHWC’s first Black woman executive director. “We think about Black people, immigrant and refugee folks, people who are facing violence in their relationships or in their communities—those are the folks who come to my mind first for whom making this one more thing out of reach [due to HB 481] could be catastrophic.”

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Despite the looming uncertainty around HB 481, which Kemp has until May 12 to sign, each person I speak with at FWHC focuses on the support in recent weeks that the nonprofit has received in their work to keep reproductive care accessible.

“This is one of my first days back in the office because I’ve been at the Capitol every day with volunteers,” Mandarino says. “It’s just been overwhelming, the numbers we have had show up every single day. Yes, there are policymakers who want to restrict access to this care, but it’s been really rewarding to see how everyone has shown up for us.”

What’s really stood out, Dawson says, is the range of diverse voices that joined in the fight for reproductive justice and freedom, describing the participants as “a true coalition, with people of color and queer and trans [people] at the front of the conversation.”

Joining support efforts are key with the long-term vision for this work, says Jackson. FHWC joined other organizations, including NARAL Georgia, Sistersong, and Women Engaged, to form the Georgia Reproductive Health, Rights & Justice Coalition. According to a statement the coalition released earlier this week, “The fight is not over” and they "look forward to advancing reproductive justice for all Georgians."

For now, FHWC is dedicated to patient education efforts to let people know they can still access all of the services—including abortion care—listed on its website. “We’ll continue to see patients,” Jackson says. “We’ll continue to give care. We’ll continue to meet whatever needs folks have.”