If you’ve spent much time on Auburn Avenue in Mt. Auburn, then you’re familiar with the seemingly permanent protesters outside Planned Parenthood Southwest Ohio (PPSWO), who set up shop on the front sidewalks to make their arguments painfully visible to prospective patients and random passers-by. Recently, state lawmakers have been levying their own brand of protest, a ponderous death-by-a-thousand-cuts assault on reproductive rights that could make it exceptionally difficult to obtain a safe and legal abortion in Ohio—particularly for low-income women. Over the last four years, these same efforts have shut down nearly half of the state’s abortion providers. And if the most recent and extreme of these measures—the so-called Heartbeat Bill, which would criminalize performing abortions after the detection of a fetal heartbeat—is ratified, it would effectively gut PPSWO, leaving Cincinnati as the country’s largest metropolitan area without access to comprehensive reproductive health services. From June 2013 to July 2014, PPSWO provided 118,742 individual services to 20,799 people in Cincinnati and around the region. Nearly 98 percent of these services were not abortions. They were cervical cancer screenings. They were STD tests. They were upwards of 30,000 birth control prescriptions. “The overwhelming work we do is helping people prevent unwanted pregnancies,” says PPSWO president and CEO Jerry Lawson. Taking down Planned Parenthood doesn’t just eliminate access to (safe and legal) abortion—it eliminates an essential family planning healthcare provider.
Passed by the Ohio House in March and referred to the Senate Health and Human Services committee in mid-April, the Heartbeat Bill aims to make abortion a fifth degree felony if performed after the detection of a fetal heartbeat—with no exception for rape or incest. “It could pass the legislature and the governor could sign it,” says Lawson, “but it’s so clearly unconstitutional that we’re expecting it to be enjoined immediately.” HB 69 is a legislative Hail Mary, and “the state will then spend a whole ton of money trying to defend it,” says Lawson.
A heartbeat can appear as early as six weeks into a pregnancy, when many women aren’t even aware that they’re pregnant. If HB 69 survives, physicians would be legally bound to refuse an abortion at this point, an outcome that would put Planned Parenthood at risk. “If it isn’t overturned it would shut us down,” says Lawson. “But we’re a long way from that.”
Heartbeat Bill sponsors Representative Ron Hood and Representative Christina Hagan did not return requests for comment, but co-sponsor Representative Thomas Brinkman (District 27) supports HB 69 in full. “If it moves the ball forward and saves more human lives, then I’m 100 percent for it,” he says. “Planned Parenthood is an evil organization that preys upon vulnerable women.”
Even before HB 69 passed the House, PPSWO had already spent years fighting an uphill battle against aspects of Governor John Kasich’s 2014–2015 budget (HB 59), which prohibits public hospitals from entering into patient transfer agreements with abortion providers. Transfer agreements are a necessary part of operating any ambulatory surgical center, whether you’re performing an abortion or scoping a knee. If your patient goes into cardiac arrest during a procedure, you need to be able to transfer him or her to a hospital for more advanced care. Since Planned Parenthood is unlikely to receive transfer agreements from any of the city’s private religious hospitals, this regulation essentially limits public access to abortion. It was only a loophole called a variance request—included in HB 59 to keep it from being utterly unconstitutional—that allowed PPSWO to enter into agreements with individual physicians that have hospital admitting privileges, keeping Planned Parenthood in compliance.
For the average patient seeking an abortion, these agreements are sufficient. But when a patient needs an abortion to actually save her life because of conditions such as uncontrolled seizures or even the risk of sepsis (in the event of a dead or dying fetus), it’s a different story. “Continuing the pregnancy is a far greater risk to them,” says PPSWO Medical Director Dr. Roslyn Kade, “and there’s nowhere in town that we can send them for their termination.”
So even if a woman is seeking an abortion because the pregnancy could kill her, Ohio’s healthcare system in its current state—which will be still more restrictive if HB 69 sees the light of day—has nothing to offer her. She has to travel as far away as Chicago to get an abortion, if she can afford to do so. And since more than 27 percent of PPSWO patients are on Medicaid, it’s unlikely she can. “The alternative,” says Kade, “is that she will surely have some terrible, terrible outcome.”