Just weeks after the U.S. Supreme Court enabled states to further restrict or ban abortions by overturning Roe v. Wade, a Ramsey County judge’s ruling made abortions more accessible in Minnesota.
Judge Thomas Gilligan, Jr.’s July 11 ruling struck down most of Minnesota’s abortion restrictions, including requirements that clinics give patients what he called “misleading and confusing” information about the risks of abortion at least 24 hours prior to the procedure, that minors inform both parents or get a court waiver before obtaining the procedure and that only doctors — not other licensed and qualified medical professionals — perform abortions.
Already, Minnesota abortion providers say they’re starting to feel what could turn out to be sweeping effects of both the federal and the state court’s actions and planning ahead to meet a predicted increase in demand.
“The restrictions that were struck down last week will just really make it easier for everybody. It’ll make it easier for us to provide care and it’ll make it easier for patients from Minnesota and from out of state to be able to seek out care,” said Sharon Lau, the Midwest advocacy director for Whole Woman’s Health, a clinic in Bloomington.
An island of abortion access
With the June 24 overturning of Roe in Dobbs vs. Jackson Women’s Health Organization, Minnesota has become something of an island in the Upper Midwest where abortions are accessible.
As of August, abortion will be mostly banned in both Dakotas. Wisconsin clinics stopped performing abortions after the Dobbs ruling and the state has a pre-Roe abortion ban now being challenged in court. Many predict Iowa could restrict abortion before long.
No waiting period or informed consent script
While demand may well increase as a result of the Dobbs ruling, the removal of restrictions via the state district court judge’s ruling will help free up staff time, providers say.
Under an informed consent provision in Minnesota law, abortion providers were required to provide certain information to abortion patients at least 24 hours prior to the patient’s abortion procedure. Part of that information could be delivered by any staff.
At WE Health Clinic in Duluth, staff would typically provide some of that information when patients called to make appointments. But some of the information was required to be provided by a physician, typically over the phone for the convenience of patients, said Paulina Briggs, the clinic’s lab supervisor.
“So we had to coordinate a phone call time with all of our patients and our doctors. It had to be (at least) 24 hours before they had their actual abortion,” Briggs said. “And then we had to provide a bunch of documentation saying that they received that information from that doctor.”
Briggs said the process required a lot of coordination and paperwork for the clinic, and put a burden on patients who didn’t always have reliable access to phones — particularly if they were working, taking care of kids or living in areas like northern Wisconsin or the Upper Peninsula of Michigan where phone service is spotty.
Sometimes, if the clinic couldn’t reach the patient, they’d have to cancel an appointment because they couldn’t comply with the 24-hour law. Additionally, providers say the information they were required to give patients on things like the potential risks of abortion was misguided.
“The information itself that we had to give the patient was medically inaccurate, it used gendered language and it’s not information that is medically necessary,” Briggs said.
Restrictions for minors removed
Prior to the state district court judge’s ruling this month, minors were required to notify both biological parents they were seeking an abortion at least 48 hours prior to the procedure, or go to court to get a waiver from the parental notification requirement.
In Minnesota, 2 percent of 2021 abortion patients were under the age of 18. Even in scenarios where both parents of a minor seeking an abortion were involved in the child’s life and supportive, Briggs said the parental notification requirement presented unnecessary obstacles that could delay patient care.
“They had to provide some documentation, like a birth certificate, IDs, marriage records, divorce records, to prove that they were in fact that patient’s parents,” Briggs said. Best-case scenario, it could still be tough for parents to get off work to sign the necessary paperwork.
When minors didn’t have both parents in their lives, were living with relatives or were in the foster care system, the documentation process was more difficult. In some cases, the clinic would help coordinate a court hearing for the minor so they could get a waiver from the parental requirement — something Briggs said could require additional coordination, in addition to intimidating minors and sometimes delaying patient care.
Lau, of the Bloomington clinic, agreed that the process could be detrimental to a patient’s mental health, especially for people who don’t have both parents in their lives.
Expanding access
In the wake of the Dobbs decision, abortion providers are looking for ways to expand capacity to serve a likely increase in patients who will be coming to Minnesota. In Duluth, Casey’s staff see about 16 patients on the one day a week they do abortions, but may be able to increase that number to 20 in one day, plus add an additional half day to do five or six medication abortions.
Additionally, with the removal of Minnesota’s requirement that abortion providers be physicians via the Ramsey County judge’s ruling, WE Health Clinic may bring on a nurse practitioner to facilitate some of the medication abortions it does.
Ultimately, WE Health Clinic’s Executive Director Laurie Casey said they’ll have a clearer picture of what patient needs are like in the fall — they’re likely to get busier then, when colleges in the Duluth-Superior area are back in session.
“We’re just kind of waiting, each week, to see what happens and how many phone calls we receive,” Casey said.
Whole Woman’s Health in Bloomington also anticipates the ruling could lead to more out-of-state patients, specifically people who might have previously elected to go to states with fewer restrictions and closer to them, like Illinois.
“We’ve already seen patients from as far away as Texas and Ohio, even before the Minnesota ruling came down. I think it will just make it easier in that they don’t have to do the 24 hour waiting period. Maybe folks that would’ve gone to Illinois, because it doesn’t have as many restrictions, can now come to Minnesota if that’s closer,” Lau said.
Since the Supreme Court ruling, the clinic has already seen an increase in calls and out-of-state patients. As of early July, around 20 percent of its patients were out of state, according to Lau.
Looking ahead in a post-Roe world, the ruling lifts a burden on patients and staff, Lau said.
“The staff has just been thrilled that they don’t have to impose these completely unnecessary restrictions on patients who are coming to see us,” Lau said.
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