I spent a lot of time in the Deep South while making my last two documentaries, Gideon’s Armyand Spies of Mississippi. In 2013, as I was flying to a film shoot, I read an article about the last remaining abortion clinic in Mississippi. I blinked to be sure I was reading it correctly. There was only one clinic offering abortions? In the entire state? How could that possibly be true?
In the 40 years since the Supreme Court decision Roe v. Wade made abortion a constitutional right, the issue of choice has continued to polarize the American public. In 2010, the anti-choice camp gained significant ground when victorious Tea Party-backed candidates in the House of Representatives ushered in an onslaught of new regulations limiting access to abortion. In fact, in the past three years, there have been more laws enacted regulating and restricting access to abortion than in the entire time since Roe v. Wade was decided.
At the state level, Mississippi is one of many that have fervently enacted anti-choice laws. In 2012, the state legislature passed the Women's Health and Safety Act, requiring clinics to meet the same building codes as ambulatory surgical centers, including hallways that meet certain width and height guidelines and other codes that would require clinics to undergo costly renovations.
The Mississippi law also requires abortion providers working in-state to obtain hospital-admitting privileges. But there is a catch: No in-state doctors will perform the procedure at a local clinic, and no local hospital has granted privileges to the out-of-state physicians who travel to the Deep South to perform abortions at these clinics. If these physicians are unable to obtain admitting privileges, and the law is upheld, the last remaining clinic in Mississippi will close its doors.
These onerous regulations, which have been popping up around the country with alarming frequency, are known as TRAP (Targeted Regulation of Abortion Provider) laws because they target abortion clinics and providers with medically unnecessary, and often impossible or prohibitively expensive rules with the single goal of eliminating access to abortion. Either unwilling or unable to challenge Roe v. Wade directly, the anti-choice movement has adopted a death-by-a-thousand-cuts strategy to ban abortions. And it is working.
Alabama now has only one remaining clinic, based in Montgomery, as a result of these tough new regulations. And just last week, on March 27, the 5th Circuit federal appeals court upheld a Texas TRAP law requiring admitting privileges for abortion clinics. (The law is similar to the ones on the books in Mississippi and Alabama.) As a result of that legislation, roughly one-third of the state’s clinics have closed, leaving the women of Texas with far fewer reproductive health options. While the Alabama and Mississippi laws have been temporarily blocked, allowing the clinics to remain open, their ability to stay open is far from secure. Notably, Mississippi is also in the 5th Circuit, so federal appeals of its laws will be heard by the same court that upheld the Texas restriction.
Mississippi’s last clinic, the Jackson Women’s Health Organization, sits on an urban stretch in downtown Jackson, surrounded by fast-food and other chain stores. The only hint of the controversy surrounding its existence is the steady stream of protestors camped at the door who, assuming my two interns were a couple seeking an abortion, called out to us as we approached, praying loudly and begging us not to kill the unborn.
Inside, the clinic was eerily quiet. The waiting room held mostly men who kept quietly to themselves, reading, sleeping or lost in thought. In the conference room, a group of young women was gathered to receive the state mandated “counseling.” TRAP laws in Mississippi, like those in Alabama and other states hostile to abortion, require not only a waiting period before the procedure can be performed, but also that the physician “counsel” the women that, among other things, abortion could cause severe mental distress or breast cancer. (It’s worth noting that there is no medical evidence to support these claims.) I saw the alarm on the faces of several women taking in this “medical advice.”
Jackson’s Women’s Health serves approximately 2,000 women each year, many of them low-income women of color. If these women are forced to travel out of state, and to comply with additional barriers to access, like one- to three-day waiting periods, then the costs of travel, overnight stays and loss of work will make abortion even more prohibitively expensive and possibly out of reach. Many of these women currently seek assistance from private funds, such as the National Abortion Federation, but NAF funds are limited and can often only subsidize a portion of the procedure, leaving poor women to try and scrape together hundreds of dollars they simply don’t have.
On that trip to Jackson’s clinic I met Dr. Willie Parker, a warm bear of a man who is also one of the only physicians willing to perform abortions in the Deep South. Several times a month, he flies from his home in Chicago to work in Montgomery and Jackson. Dr. Parker is African-American and grew up in Alabama in the Evangelical church. Early in his career he refused to perform abortions. But, he told me, he is now willing to endure any amount of harassment to provide medical care to women who need it because he truly believes he has been called to protect the health and safety of all women, but particularly low-income women of color.
I decided then to make a film about Dr. Parker and about clinics like the ones in Jackson and Montgomery. In the short time I’ve been working on this film, this is what I’ve learned:
• About 61percent of abortions are obtained by women who have one or more children.
• Forty-two percent of women obtaining abortions have incomes below 100 percent of the federal poverty level ($10,830 for a single woman with no children), and 27 percent have incomes between 100 to 199 percent.
• One in three American women will have an abortion in her lifetime. Yet 92 percent of the counties in America have no abortion provider, forcing women to travel hundreds of miles from home for the procedure.
In the 1990s, I vividly remember marching with hundreds of thousands of others calling on Congress to preserve a woman’s right to choose. During the march, a woman of about 50 handed me a postcard of an elegant woman with her hair swept up and away from her striking face. She was the marcher’s mother, and she had died from a back alley abortion when the marcher was just a girl. The woman pressed the card in my hands: “Please do not forget these women.”
In that moment, the urgency of the need to stand up for the right to choose became sickeningly real. Women died from unsafe abortions before Roe made the procedure legal. And if women lose access to safe abortions, we will once again put lives at risk.
For many women, particularly those of color or with a low income, the right to choose is hanging by a thread. If there are no clinics, and therefore no access, the “right” to a safe, legal abortion will become a right in name only, and just one more penalty of poverty.
Dawn Porter is a documentary filmmaker who directed such lauded works as Gideon’s Army andSpies of Mississippi. Cecile Richards will appear at The Women in the World Summit on April 4. Watch it live here.