Post-Roe: Navigating Abortion and Healthcare in TN and Beyond
The overturning of Roe v. Wade has removed the federal constitutional right to abortion, and left it up to the states to ban or protect it. Tennessee is unfortunately one of thirteen states with a Trigger Ban, which automatically goes into effect 30 days after the ruling. Tennessee’s Trigger Ban passed under the name, “Human Life Protection Act” in 2019. There are no exceptions for victims of rape or incest. Tennessee’s ban only allows abortion to prevent death or “substantial and irreversible impairment of major bodily function.” Yet, it explicitly states there are no exceptions for pregnant people who are at risk of committing suicide or self-harm. Shortly after the Supreme Court’s ruling, Tennessee Attorney General Slatery filed an emergency request to allow a 6 week abortion ban to be adopted immediately. While abortion is still legal in Tennessee at this moment, it is unclear how many days we have until the 6 week ban is enacted even before the ban kicks in.
The fall of Roe will have rippling effects into medical care practice for miscarriage, fertility, pregnancy, and birth nationwide, and very much so here in Tennessee. Pregnant people have already been jailed for their miscarriages in the past few years, and the practice will now most certainly accelerate. It is now a Class C Felony for doctors to perform abortions outside of the very narrow and yet unclear permissable description. As medical care for a miscarriage, uterine sepsis, and ectopic pregnancy are the same as elective abortion care practices, providers will inevitably act later than they normally would to save the lives of pregnant people experiencing complications: under the Trigger Ban, they must prove that they did all they could to save the life of the fetus. Though pregnancy is not innately a bodily emergency, there is a continuum of risk. As red flags and complications arise, nurses, doctors, and midwives rely on their clinical expertise and experience to navigate pregnancy outcomes in which no two play out the same. There is often not a clear, absolute defining moment of risk to the pregnant person’s life or bodily function in legal terms until it is dire and too late. There will be room for courts to argue that healthcare workers are providing illegal abortion care when they are in fact responding in a way that is clinically responsible and appropriate. Fertility doctors will likely be vulnerable to criminal charges as well: during the IVF process, fertilized eggs found to be unfit for survival are discarded. Even homebirth midwives may be affected in their ability to carry cytotec/misoprostol in order to manage potentially fatal hemorrhages, as it is now required a doctor must prescribe it and be present for its use in our state. While misoprostol is a medication used for abortions, it is also used to induce labor for viable pregnancies and to treat hemorrhage, meaning extreme loss of blood immediately after or during birth or miscarriage. Tennessee already has one of the worst maternal mortality rates of the states in a country with some of the worst maternal mortality rates among “developed” nations. We will see more poor outcomes from forced pregnancies, particularly for Black pregnant people, who are already experiencing higher rates of mortality and morbidity due to the racial weathering that results from systemic, institutional, and medical racism.
Music City Doulas stands unwaveringly behind your right to choice and autonomy. We believe in evidence based care and harm reduction. This ongoing assault on a globally acknowledged human right in our country is scary, and plunges the public and healthcare workers into a challenging time of inaccessibility and uncertainty. We will continue to support you and stand against forced pregnancy and birth, alongside the American College of Obstetrics and Gynecology, American College of Nurse Midwives, American Nurses Association, Association of American Medical Colleges, American Academy of Pediatrics, and others.
What to Do if You Need an Abortion in TN
As of June 24, 2022, Planned Parenthood of Tennessee and North Memphis, and The Knoxville Center for Reproductive Health are not taking future abortion appointments. Planned Parenthood Memphis was taking appointments as of this past Friday, June 24. CHOICES Memphis was seeing abortion patients this weekend, though they noted that the 48 hour waiting requirement in our state is actively preventing many people from getting the care they need in time. It’s unclear what the landscape will look like on Monday morning. Here’s what you can do as of now:
If you are under 12 weeks pregnant, you can order abortion pills through Plan C Pills as well as Aid Access. You will need to use a forwarding address or a trusted individual to forward them to you from a state with less strict laws. Please do not order more than you need, as this can contribute to inaccessibility for those who need them urgently and the medications do have a shelf life.
If you are beyond 12 weeks pregnant, the closest abortion clinic is the CHOICES clinic in Carbondale, Illinois. You can find more brick and mortar abortion clinics through I Need an A, Abortion Finder, and the National Abortion Federation. Do not rely on Google searches alone, as you may be misdirected to a “crisis pregnancy center.”
Plan ahead. Even with precautions, unplanned pregnancies happen. You can make an abortion plan with a template from Abortion Access Nashville.
Use the Miscarriage and Abortion Hotline if you have medical questions during a loss or abortion at home.
For legal questions, use the Repro Legal Helpline.
How to Support Abortion Access in Tennessee
Now is the time to donate to your local abortion fund (ours are listed above as well as a national fund), as well as follow and listen to organizers who have been fighting for reproductive justice for years and planning for this possibility. In addition to the organizations above, we recommend getting involved with orgs like Healthy and Free Tennessee and Sister Song.
If you are a birth worker who wants to learn more about abortion support, we recommend this course through Birthing Advocacy Doula Trainings.
If you are a healthcare provider or lawyer, we recommend this resource from National Advocates for Pregnant Women.
Protecting Yourself from Cyber Surveillance
One of the major differences between now and Pre-Roe is the existence of more far reaching surveillance technology, both directly online and off. Our phones can be used to track our location to specific doctors’ offices and clinics, and can be required to be turned over by law enforcement. Most commonly used modes of communication are not secure, and can also be used against you. Here’s what you can do right now to protect yourself and others:
If you are doing internet searches, use a private search engine free of tracking, like duckduckgo.
For free and secure text and phone communication, use Signal.
For free and secure email communication, use ProtonMail.
Use caution in your choice of fertility app. There is a history of apps handing over information subpoenaed in past criminal cases. If you must use a fertility app, European apps like Clue or an app that does not store as much information like Euki may be safer options. If possible, it may be safest to go analogue. For those who wish to track their cycles on paper, we recommend this downloadable chart.
We will continue to be here for individuals and families in Nashville and beyond, in support of the full spectrum of their reproductive lives. We will continue to share information as we can. Please remember that this is a long-term fight, and to strategize what you can bring and sustain for the movement. We keep eachother safe.