What It’s Like to Get an Abortion in Alabama

A federal judge last October blocked an Alabama abortion law—arguably the country’s most draconian one passed in a decade of nightmarish restrictions—keeping the procedure legal in the state for now.

The law, a near-total ban on abortions even in the case of incest or rape, was set to go into effect November 15, 2019. It also carried a penalty of up to 99 years in prison for doctors who performed the procedure. It made international headlines when it was passed in May, causing confusion for those who might need an abortion in the state, and igniting fierce condemnation from reproductive rights groups. All for a law that Governor Kay Ivey said was probably “unenforceable.” Still, she signed it because it could prompt the Supreme Court to “revisit" the matter, she said.

Indeed, while abortion remains legal in Alabama, the case is now winding its way through the court system, and anti-abortion groups are hoping it could be the case that ends the legal right to an abortion in the U.S.

Meanwhile, getting an abortion in Alabama has been more difficult than need be for some time now, due to a number of laws that restrict access.

The abortion regulations on the books are a confusing mishmash of laws, some enorceable, some not, and a reflection of the state’s multiple attempts to push the line on abortion's legality. The Center for Reproductive Rights categorizes Alabama as “hostile” to abortion rights—meaning if the Roe decision was overturned, abortion would likely become illegal in the state because a pre- Roe ban remains on the books.

People seeking abortions in Alabama face a number of restrictions. The procedure is banned after 20 weeks post-fertilization (22 weeks since last menstrual period), unless the abortion is necessary to prevent the mother’s death or “the substantial and irreversible impairment of a major bodily function.” The 20-week ban states that psychological or emotional conditions don’t count and under Roe, emotional health of the mother is supposed to be taken into consideration, so Alabama's law is more strict than the national standard.

All of these hurdles make abortions after 20 weeks nearly impossible, meaning the minority of abortion patients who need them due to fetal anomalies or health risks must leave the state.

Before an abortion is performed, patients must receive counseling that includes a mandated ultrasound with the option to hear a description of the fetus and to view the image, and a list of adoption or assistance agencies. The state mandates a 48-hour waiting period between the first appointment and the abortion procedure, which requires two trips to the clinic. The appointments themselves can be costly, and even more so if patients have to travel. There are only 3 abortion clinics in Alabama.

Public funding can't be used for abortions, except in the case of rape, incest, or health risks for the mother, meaning people with Medicaid can't use their insurance to cover the procedure. Health insurance plans sold on the Affordable Care Act exchanges also prohibit abortion coverage, outside of the same circumstances.

Minors must obtain consent from a parent or guardian before the procedure.

Finally, Alabama places restrictions on the facilities and medical professionals who can perform abortions. Only licensed physicians (not nurse practitioners or other trained pros who provide abortions elsewhere) can perform abortions. Additionally, Alabama abortion clinics must obtain special permits and follow specific rules of operation—rules other healthcare providers don’t have to follow.

This is one woman’s story.

Chelsea Johnson awoke on October 10th last year to a startling pregnancy dream. It was so vivid that she immediately went out and bought a pregnancy test—which was positive.

“It was crazy. I was just in shock and I was like that for a while,” Johnson says.

At the time, she was between jobs. In the previous year, she had left a tumultuous seven-year relationship, and was starting out on her own financially. Johnson’s new partner, who was also seeking work, was in the process of gaining custody of his child from a previous relationship. It was a complicated situation, and her choice was driven by one factor: “Money,” Johnson says, summing it up. “That was my complete main reason.”

Money was also Johnson’s main barrier to actually getting the abortion she needed. She doesn’t have health insurance, and even if she did, it’s unlikely due to Alabama’s restrictions that it would cover an abortion procedure in her circumstance.

In an interview with VICE, Johnson shared more about her experience of getting an abortion in Alabama. The interview has been edited for length and clarity.

That was the first thing that came to my mind just because of the situation I’m in.

I did wait a little bit, which meant I needed the surgical procedure versus the medication. I felt a little guilty about that, but I also felt that for a decision like that I had to think of every little possibility, negative or positive. It was a long process for me.

But I just knew in my heart that I didn’t want to raise a baby struggling like I am right now. It’s not just material things—it’s about eating. The cost of living is very high. I have severe depression. I lost my dad and my brother close together at a young age. My mom is on disability. My grandmother has dementia; she can’t even remember that I was pregnant now. My boyfriend has a child that he’s trying to get custody of. I just felt, how is that fair? He’s absolutely wonderful and would have been in the picture but he doesn't even have his other kid. It was so much at one time. All I could do was think of the negatives. I didn’t mean to, but that was the reality.

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I didn’t really know what to do when I first found out. I went over to a friend’s house crying and having a meltdown. It was crazy. She had a friend who knew about abortion funds. So we called her friend, who said that help was available from Yellowhammer Fund. I had no idea that existed. At that time I had no idea how much it was going to cost—I only knew I didn’t have any money at all, and I didn’t know what I was going to do.

I called and got information from the clinic. It was $175 for the first appointment [with the ultrasound], and Yellowhammer paid for that. All together, the procedure was going to cost $800. That’s a lot of money. Yellowhammer could only offer $300. I was absolutely hysterical. I called the friend back. She ended up starting a fundraiser on Facebook for me. I actually raised enough money so that I could help other girls. [The money has been kept in the Facebook fund by the friend to be used for other people who need it.]

It went well. They give you all the information that you’d need, they let you ask questions that you need to. They really understood. It was a relief for me afterward. I did feel sad. I looked at the ultrasound, which I wanted to do because I wanted to face it head on. It’s complicated. But mostly, I felt relieved, and I felt like "now I can get my life together."

I’m so glad that it was available. If not, I would be bringing a baby in this world having nothing. I didn’t want to be one of these women that had to live off the government. I don’t want a handout. There were so many factors to my decision, but I’m just glad it was available.

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