Why Women Seek Abortions After 15 Weeks : The NPR Politics Podcast The Supreme Court could allow Mississippi's ban on abortions after 15 weeks of pregnancy to take effect. In the United States, many women end up getting abortions after that point because of clinic backlogs and cost issues.

This episode: White House correspondent Asma Khalid, national correspondent Sarah McCammon, and legal affairs correspondent Nina Totenberg.

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Why Women Seek Abortions After 15 Weeks

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JANET: Hey, guys. It's Janet (ph) calling from Versailles, Ky. I just checked out my most listened to podcasts from 2021, and guess which one came in first by far (laughter)? This podcast was recorded at...

ASMA KHALID, HOST:

Well, I - she didn't actually say, but I'm going to take a leap of faith there and think that, perhaps, we were her most favorite podcast - most listened to podcast - of the year. If so, thank you. The time is 2:09 p.m. on Tuesday, December 7.

JANET: Things may have changed by the time you listen to this, but it will remain true that I listened to a total of 226 episodes of the NPR POLITICS PODCAST for a total of 4,140 minutes, which just feels like a lot - um, love the show you guys. And all right. Here's the show.

(SOUNDBITE OF THE BIGTOP ORCHESTRA'S "TEETER BOARD: FOLIES BERGERE (MARCH AND TWO-STEP)")

KHALID: Well, thank you. Hey there. It's the NPR POLITICS PODCAST. I'm Asma Khalid. I cover the White House.

NINA TOTENBERG, BYLINE: And I'm Nina Totenberg. I cover the Supreme Court.

KHALID: And today on the show we're joined by NPR National Correspondent Sarah McCammon. She's done a lot of really exceptional reporting on reproductive rights and abortion.

SARAH MCCAMMON, BYLINE: Hi - good to be here.

KHALID: And if you all are a frequent listener to our fine PODCAST, you're probably well aware that the Supreme Court of the United States could be heading down a path to end the right to abortion in the United States as we know it. The court heard arguments last week over a Mississippi law which bans all abortions after 15 weeks. And this did not come out of nowhere. I mean, Sarah, in some ways, isn't it the culmination of a decades-long effort by anti-abortion-rights groups?

MCCAMMON: Yeah, for decades. I mean, really, the first March for Life, which is an anti-abortion rally held on the National Mall every year - that was held in 1974, the year after Roe v. Wade was decided by the Supreme Court. And since then, many, many organizations have been working on opposite sides of this issue. But the anti-abortion-rights movement has been very organized and has worked at all levels of state government from state legislatures all the way up to supporting conservative senators who would confirm conservative Supreme Court justices. And here we are.

KHALID: You know, as we mentioned, arguments were heard last week in the Supreme Court over this Mississippi law. And Nina, I know as you were covering this, there was a moment where Chief Justice John Roberts asked this question that really stood out to you. It really struck you.

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JOHN ROBERTS: And why would 15 weeks be an inappropriate line? See, with viability, it seems to me, doesn't have anything to do with choice. But if it really is an issue about choice, why is 15 weeks not enough time?

TOTENBERG: I want to explain why that question was so important. For nearly a half-century, since Roe v. Wade in '73, the Supreme Court has put the cutoff point for abortion at viability, when the fetus can survive outside the womb, and that's roughly at 24 weeks. That's not changed since Roe. But the Mississippi law that was before the court last week bans all abortions after 15 weeks, and that's about two months before viability.

MCCAMMON: The other thing I'll say about that is that Justice Roberts, during the oral arguments, said that - suggested that 15 weeks isn't a dramatic departure from viability. And I just want to be clear that, you know, again, as Nina said, 24 weeks is roughly viability, so we're talking about nine weeks or so. And from the patients I have talked to, a lot can happen during that interlude between 15 weeks and 24. Many patients have an ultrasound right around 20 weeks. That's pretty standard as most people who've been pregnant know. And that is often where things arise. Sometimes doctors will see things - you know, severe fetal abnormalities and so forth - that will cause a patient to rethink what they want to do with that pregnancy. So from a medical perspective, I think a lot of doctors would say it is a dramatic difference.

KHALID: And Nina, I know you went out specifically to speak with women who had abortions after 15 weeks. You wanted to hear more about why they had waited, what their circumstances were. And we're going to spend some time listening to the voices that you heard from in just a moment. So why don't you introduce that for us.

TOTENBERG: Well, all of them lived in states that are not hostile to abortion rights. Two of them were using birth control. Jessie Rosales (ph) was on the pill.

JESSIE ROSALES: I was on birth control, and so I really didn't think that it could happen to me. And I started getting my first bouts of nausea, and I just thought this was, like, some sort of stomach flu.

TOTENBERG: A series of mishaps with her insurance, misinformation from her college health service in Riverside, Calif., and the need to raise $600 all delayed things by weeks. Even Planned Parenthood couldn't give her an appointment for several weeks.

ROSALES: By the time I actually got to an abortion clinic, I was already in my second trimester. The horror isn't in the fact that I had an abortion. The horror is in, like, these systemic ways in which they are, like, gatekeeping. That's what, like, launched me into a second-trimester abortion.

TOTENBERG: Jen Chalafu (ph) was 18 when she found out she was pregnant. She was taking birth control, so she, too, thought she was sick, not pregnant.

JEN CHALAFU: I mean, I found out first through, like, a - like, peeing on a stick.

TOTENBERG: Though she was in New York, finding a place to get an abortion took time.

CHALAFU: I was constantly finding out that I was going to have to wait longer. And the whole time, I was getting more pregnant, and I was starting to see it and feel it in my body. For me, the trauma was being pregnant, and the abortion was the cure and really helped me to, like, get away from that traumatic experience.

TOTENBERG: Valerie Peterson wanted the baby she was carrying, but she got bad news from her doctor as she was entering her 16th week of pregnancy.

VALERIE PETERSON: The baby I was carrying had a condition that was 100% incompatible with life. And that is because of a condition in which the baby's brain was full of fluid. The spinal cord was not connected to the brainstem. And my doctor gave me two options.

TOTENBERG: Either have an abortion or continue the pregnancy until she either miscarried or delivered a stillborn child.

PETERSON: I had begun bonding with the baby, and so I knew right away that emotionally and mentally I needed to have an abortion.

TOTENBERG: The problem was that the year was 2015, and Peterson lived in Texas, where a law, later struck down by the Supreme Court, made abortions extremely difficult to get.

PETERSON: The majority of the abortion clinics were closed. And at that time, there was a 3- to 4-week wait to get an abortion.

TOTENBERG: She didn't hesitate.

PETERSON: I needed to get the medical care right away. So within 48 hours, I was on a plane to Florida at my expense - for the travel, for the procedure - to get it done.

TOTENBERG: She was in her 16th week of pregnancy. For most of the women we talked to, cost was a huge problem that delayed their abortions. Typical was Brittany Mostiller, who, at the time, lived on the South Side of Chicago.

BRITTANY MOSTILLER: I couldn't afford it. Like, that was just the reality of it, even when I was, like, less than 12 weeks. I had three young children. And I was working part time at a local grocery store and sharing a two bedroom apartment with my sister and niece.

TOTENBERG: So saving $500 for an abortion took time. And she was so desperate that, at one point, she contemplated trying to abort, herself. All of that pushed her well into a second trimester abortion. Eventually, the Chicago Abortion Fund helped her get the money and it changed her life. She volunteered there afterwards and was eventually hired for the staff. She's now the leadership coordinator for the National Network for Abortion Funds.

KHALID: You know, it sounds like there's a lot of factors at play. But for a number of these women, Nina, that you spoke with, it sounds like money, logistics, access were all really a kind of complicating, multipronged factor in making these decisions.

TOTENBERG: Yes, it certainly did. They - most of them, they certainly understood that they were pregnant in the first trimester, but they got kicked into the second trimester by the system, as it were.

MCCAMMON: Yeah, and that really fits with the reporting that I've done, too. You know, I was just in Mississippi at the Jackson Women's Health Organization clinic - the last remaining clinic in the state and the one that is challenging this Mississippi 15-week ban - and I talked to one of the doctors there. Now, they have a hard time even getting physicians at this clinic, but Dr. Cheryl Hamlin comes from Massachusetts about once a month to provide abortions, and she said most of her patients are in the earlier stages of pregnancy. But those who aren't, there's always a reason, and usually it's some kind of obstacle they've run up against.

CHERYL HAMLIN: The ones that are over 15 weeks, almost always they are either adolescents or, you know, just their life is challenging. So by the time they, you know, make the decision and call, and maybe they live four hours away and make it here, they have to have two visits in person. So they come for the first visit and then they drive back four hours and then it's another, you know, week or two. And then they are, you know, 14, 15, 16 weeks. You know, not always, but I think more often than not, they're the most vulnerable. They're - either because they're young or because their lives are just in such a place that they don't have the option to just take off work. Those aren't options for them.

MCCAMMON: And Dr. Hamlin said that, again, some of the delays are due to, you know, challenges that women are facing in their own lives, and some of them, she said, are really caused by existing laws. Mississippi is one of many states that has a waiting period where a patient has to go see a doctor and then come back and get a procedure on another day, and that can complicate and delay these procedures, particularly for people who live hours away, which many people do because of the scarcity of these clinics in places like Mississippi.

KHALID: All right, let's take a quick break. And we'll have lots more on this subject in just a minute.

And we're back. Sarah, another interesting aspect of what the Supreme Court may decide to do is that it's not all isolated to Mississippi. You know, you've done reporting on the fact that there are a lot of abortion bans on the books in other parts of the country and that they could essentially activate if and when the court issues a decision that says they're constitutional.

MCCAMMON: Right. This is really a test case. I mean, it's really about questioning Roe and other Supreme Court precedent that guarantees abortion rights, and whatever the court says will have implications for every other state. So what we're talking about here are what are known as trigger bans, which are laws that are essentially on the books in anticipation of a Supreme Court decision. Elizabeth Nash with the Guttmacher Institute, which supports abortion rights - she said it's essentially an abortion ban in waiting. And some of these laws were passed in the mid-2000s. Several more were passed in the last few years really in response to former President Trump appointing a total of three conservative justices to the Supreme Court. Some more conservative-leaning state lawmakers saw an opportunity there and put laws on the books that are written in such a way, they hope, that if Roe is overturned, abortion will become either illegal or severely restricted.

Now, that can look a lot of different ways. Some states have just very early abortion bans. Others specifically sort of speak to Roe being overturned. But the bottom line, according to the Guttmacher Institute's researchers, is that about half the country would probably find itself in a situation where abortion is very quickly either severely restricted or banned altogether if Roe is overturned or substantially eroded.

TOTENBERG: And of course, even if the court were to just say, well, we're tossing out the viability line, Mississippi, for example, has another law passed banning abortions after six weeks. So presumably, that would go into - it's fighting that out right now. Presumably, that would go into effect very quickly. And I think you could see that this would have a cascading effect, at least in states where there is clear anti-abortion sentiment to make abortion as close to illegal as possible.

KHALID: So it sounds like what both of you are describing is what the circumstances would look like in red states, in states where there are conservative legislatures that have put in place more restrictive laws on abortion. But then the flip side of this equation is, well, what could potentially happen in more liberal-leaning states?

MCCAMMON: Yeah, and more liberal states have also, of course, taken note of what's going on. And so we've seen several states pass laws protecting abortion rights or expanding abortion rights in various ways. Some have actually expanded what kinds of providers can perform abortions - so not just medical doctors, but also physicians' assistants and nurse practitioners with an eye toward a future where perhaps people are traveling even more than they already are to get abortions in other states. And then the other thing that some states have done is to just remove pre-Roe abortion bans that were on the books, you know, decades ago to take those away so that they're not in statute. So whatever happens at the Supreme Court, there is, I think, quite certain to be a lot of flurry of activity again in state legislatures, but also many legal challenges, a lot of court battles over what does it mean and how does it apply to state laws as they stand now.

KHALID: All right, well, as soon as we know what the court is going to do, I'm sure we will have you back on the podcast, Nina. And we'll have lots more to talk about on this issue very soon. Sarah, thank you so much for joining us. Always a treat. Really appreciate it.

MCCAMMON: My pleasure.

KHALID: I'm Asma Khalid. I cover the White House.

TOTENBERG: I'm Nina Totenberg. I cover the Supreme Court.

KHALID: And thank you all, as always, for listening to THE NPR POLITICS PODCAST.

(SOUNDBITE OF THE BIGTOP ORCHESTRA'S "TEETER BOARD: FOLIES BERGERE (MARCH AND TWO-STEP)")

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