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Abortion Care in Massachusetts and Rhode Island: What Are the Issues?

On account of the Supreme Court of the United States (SCOTUS) decision on the Dobbs versus Jackson Womens Health Organization abortion case this past June, we are exploring some particular US states and regions with respect to reproductive care, including the issue of the right to choose whether to terminate a pregnancy. Just to remind you, the Dobbs case involved a Mississippi law prohibiting abortions after 15 weeks gestation. Along with upholding the Mississippi law with 6 justices for and 3 against, the Dobbs decision also overturned the Roe versus Wade decision of 1973, 5-4. Written by Associate Justice Samuel Alito, the Dobbs decision reverses Roe v Wade by taking issue with what is known as substantive due process, a mechanism through which Roe v Wade applied the 14th Amendment to protect abortion as a privacy right. Rather than representing a sudden loss of abortion rights, the Dobbs decision, overturning Roe, was the latest of almost a 50 year process of chipping away at abortion rights. Today, we’ll focus on two New England states: Massachusetts and Rhode Island

Overall, New England is a region where abortion is accessible and where the right to choose is not in jeopardy, unless the nation-wide anti-abortion movement gets enough anti-abortion politicians into office to enable laws restricting abortion at the federal level, which is not likely in the near future. For many years, the Bay State, Massachusetts, has been a particularly strong, reliable supporter of the right to choose, even in the context of New England as a whole. In 1981, eight years after the Roe v Wade decision made legalized abortion throughout the United States, Massachusetts codified Roe v. Wade-style reproductive rights into its state constitution. Additionally, the Bay State has set in place a legal framework for people to recover damages in the event that any party from another state attempts to bring legal action against somebody who has traveled to Massachusetts to receive an abortion.

To give you an idea what this means, suppose that you reside in the state of Ohio. As of July, 2022, Ohio prohibits abortion, after an embryonic “heartbeat” can be detected, with no exceptions for victims of rape or incest, or for the presence of chromosomal conditions such as Down syndrome detected on prenatal testing. Generally, a “heartbeat” (which is not really yet a heartbeat, but simply a pulsating structure of fused blood vessels) shows up around gestational week 5 or 6. This means just a couple of weeks after pregnancy begins with the blastocyst (an early kind of embryo) implanting into the endometrium of the uterus. It’s very unlikely that you’d discover that you’re pregnant prior to the point when the so-called heartbeat shows up on ultrasound. To be sure, if your periods are regular and predictable, there is a narrow window of time after you miss your period, when you could home test, get a positive result, go to your doctor, confirm the positive test and receive a medication abortion before ultrasound shows a heartbeat. It is possible that ultrasound will reveal an early gestational sac without the heartbeat showing up yet, but usually the first ultrasound reveals a heartbeat, along with the gestational sac. The Ohio law was written with a heartbeat cutoff point to make it ridiculously difficult to catch a pregnancy early enough for an abortion to be legal. Now, in Massachusetts, abortion is especially accessible, because, in addition to obstetrician/gynecologists and abortion-trained family practice physicians, mid-level practitioners with training can provide abortion care as well. Midlevel means physician assistants, nurse practitioners, and midwives with abortion training. Regardless of your reason for seeking an abortion, if you’re pregnant in Ohio and travel to Massachusetts to terminate the pregnancy, Massachusetts will do more than protect the abortion provider from legal action by Ohio. It will protect you too in the event that Ohio attempts to bring legal action against you. The Bay State would go after Ohio legally to recover damages in the form of funding to cover your legal fight against Ohio.

Moving on to Massachusetts neighbor, Rhode Island, which is also abortion-safe. In 2019, the Ocean State passed the Reproductive Privacy Act, which codified Roe-based standards into state law. However, there are a couple of things to keep in mind, if you live in Rhode Island. First, the only on-site abortion provider is the state’s branch of Planned Parenthood in Providence, but there are some nearby facilities in Massachusetts too, plus telemedicine abortion care is available throughout Rhode Island. Telemedicine is all that you need in most cases for a medication abortion, which can be carried out up to a gestational age of 77 days.

Another consideration is that Rhode Island requires that any abortion seeker under the age of 17 obtain the consent of one of her parents, or that she obtain a judicial bypass. The latter means that clinic must contact a judge who must decide whether the young woman is “mature enough” to choose to terminate the pregnancy. This puts judges in a strange position, since how could anyone not be mature enough to have an abortion, yet be mature enough to become a parent. Consequently, an underage individual who wants an abortion will almost certainly obtain one, even if neither of her parents consent, or if she does not contact them.

David Warmflash
Dr. David Warmflash is a science communicator and physician with a research background in astrobiology and space medicine. He has completed research fellowships at NASA Johnson Space Center, the University of Pennsylvania, and Brandeis University. Since 2002, he has been collaborating with The Planetary Society on experiments helping us to understand the effects of deep space radiation on life forms, and since 2011 has worked nearly full time in medical writing and science journalism. His focus area includes the emergence of new biotechnologies and their impact on biomedicine, public health, and society.

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