Arkansas: Abortion and Reproductive Care in the Bear State

Today, our US state of focus is Arkansas, also known as the Bear State, the Toothpick State, the Bowie State, the Wonder State, the Natural State, and by various other names. It seems that Arkansas has numerous different nicknames, but one of those names definitely is not the State of Choice. This is a state that is not abortion safe in any way. Back in June, the Supreme Court of the United States (SCOTUS) decided the Dobbs versus Jackson Women’s Health Organization case on abortion. This has led the United States to become a patchwork of different situation, when it comes to the legality of abortion, in many cases also with implications for pregnancy care overall, and in some cases with fertility treatment being threatened as well. The Dobbs versus Jackson Women’s Health case involved Arkansas’ neighbor, Mississippi. Specifically, the case involved a law prohibiting abortion after 15 weeks of pregnancy, meaning 15 weeks counting from the first day of bleeding of the last menstrual period. 6 out of 9 justices voted to uphold the Mississippi, but 5 of those six also joined onto a majority opinion written by Associate Justice Samuel Alito overturning the 1973 Roe v Wade decision that protected the right to choose.

In the aftermath of Dobbs, states that are very supportive of abortion and reproductive rights, both for their own residents and those from out-of-state, include New York, Connecticut, Illinois, Oregon, New Mexico, Washington, and North Carolina. Of such states, many protect the right to choose up to the point of fetal viability (24-26 weeks gestation) or close to that point. Additionally, there are states with strong majorities of anti-choice Republican politicians in the state legislatures and governors, because of either the state constitution or the court system. Such states include Kansas, Alaska, Montana, and Ohio. In Kansas, despite its strong Republican leanings and active anti-abortion politicians and organizations, the people voted strongly on a ballot measure in favor of keeping a guarantee of the right to choose in the Kansas state Constitution. But there also are many states with laws extremely hostile to abortion, and with it reproductive health overall. Such states include Mississippi, Tennessee, Georgia, Alabama, Arizona, and Missouri, and sadly they also include Arkansas.

In Arkansas, you cannot have an abortion at any time, even during the first few weeks of pregnancy. There are exceptions only if the mother’s life is in danger and there are reasons why doctors in Arkansas might hesitate, since saving the mother’s life does not usually involve a situation in which the mother is about to die right at that moment. Arkansas is at the extreme among anti-choice states in that there are no exceptions to the abortion ban in cases of rape or incest.

Not even one of the states sharing a border with Arkansas has legal abortion, but it is plausible for those in Arkansas seeking abortion to drive several hours to Illinois, or to Kansas. If you are going to try something like this, you may have to travel as far as someplace like Chicago, which has ample abortion services. Simply driving into a state that has legal abortion does not mean that abortion providers are accessible just over the border. It is best to find out in advance about abortion services in your destination. Flying to another state might be a better option and not matter what is your mode of travel, there are organizations that can help you with the needed finances, both for travel and lodging, and also just for organizational and logistical purposes. In the event that you absolutely cannot travel, a last resort option is that it is fairly easy to obtain the needed medications for a medication abortion via mail, from a healthcare provider working from a state with legal abortion. Medication abortion is possible up to a gestational age of 77 days. Medically, the abortion that you would experience as a result of the medication would be indistinguishable from a spontaneous abortion (miscarriage). This means that, if you receive abortion medications and take them in the privacy of your home in Arkansas, and if you then arrive at a clinic or an emergency department, on account of symptoms, such as bleeding, cramping, fever, or anything else, you will not be in any kind of trouble —as long as you do not declare that your abortion was self-induced. In some cases, a  thoughtful doctor or nurse may warn you that you are not required to reveal anything about what led to the abortion, but not in all cases. If you are in a situation in which you cannot travel to a pro-choice state, if you undergo a medication abortion with help from someone in another state, and then you feel that you need medical help, simply act as if you are suffering a spontaneous abortion. Say that you are having a miscarriage. This will keep you out of trouble, plus it will keep the healthcare providers out of trouble. In a state such as Arkansas, they can actually get into serious trouble for managing the aftermath of your abortion, if it goes into the record as an induced abortion. Most likely, with a medication abortion, you will be able to get through the entire thing at home and from a distance your out-of-state providers will be communicating with you, making sure that there are no signs of trouble that would require you to seek care in person.

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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