It’s an early Saturday morning at the EMW Women’s Surgical Center in Louisville, Kentucky—the last abortion clinic in the state. Already, the hallways are bustling with staff streaming in and out of rooms, efficiently moving patients about. There are about 15 women seated inside the clinic waiting area, waiting to meet with doctors or counselors so they can get ultrasounds or go ahead with their procedures. A few of them are having open, friendly conversations with one another. The majority, however, seem exhausted, some with the hoods on their jackets pulled over their heads as if to block out the reality of their surroundings.
Diane is one of the quieter patients but becomes very forthcoming once we sit down to speak. (The names of every patient interviewed have been changed in order to protect their privacy.) She is a 29-year-old single mother with three young children at home, who is working two jobs to support her family. Diane is pregnant, she tells Broadly, because she was raped by an acquaintance. “I didn’t go to the hospital or report it or anything, because more than anything I was embarrassed,” she says, her voice measured and stoic. “I felt dirty. I was ashamed.”
The abortion procedure will cost as much as a month’s rent, but Diane is “focused on taking care of my children,” she affirms, and knows this is what’s best for her emotionally and financially.
Women in Kentucky who are pregnant and don’t want to be already have few options. If Republican legislators have their way, they’ll be forced into far more desperate circumstances. In March, Gov. Matt Bevin’s administration notified EMW that the clinic had failed to meet a set of onerous health regulations requiring abortion providers to have transfer agreements with local hospitals. The clinic, they said, would have to forfeit its license and close its doors. In response, EMW Women's Surgical Center—and later Planned Parenthood—filed a federal lawsuit, arguing that the attack was politically motivated. There is “no medical justification for the standards,” they argued.
While a federal judge deliberates, with no clear timeline on when a final decision will come down, EMW’s fate remains uncertain. And while Kentucky politicians use the clinic as a political football, women’s health and safety hangs in the balance.
Women “will always continue to get abortions no matter what, and that will become dangerous,” says Crystal, a 20-year-old nursing student who is also waiting to get an abortion. She has elected to get the procedure because “now is just not the right time,” she says. She’s been having surmounting anxiety over the past few years, and she’s deep in a particularly difficult semester of nursing school; carrying a pregnancy to term would derail her schooling and potentially wreak havoc on her mental health.
According to the World Health Organization (WHO), up to 68,000 women will die every year from an unsafe abortion. It is both one of the leading causes of maternal mortality and one of the easiest preventable causes of maternal death. (In stark contrast, legal abortions have a fatality rate of less than one death per 100,000 procedures.) Of those women that survive unsafe abortions, up to seven million will suffer long-term health complications including infection, significant blood loss, and internal injuries such as damage to the uterus, bowel, or bladder.
Studies have shown that restriction abortion does not make it any less frequent—the world’s lowest abortion rates are in Europe, where abortion is legal and widely available. And copious evidence shows that women throughout history have had abortions, whether or not abortion is legal, and that they will always continue to do so despite existing laws or religion.
Contrary to claims often made by anti-abortion groups that abortion is “the easy way out,” none of the women in the waiting room are getting abortions out of convenience. They’ve endured emotional hardship, stigma, and financial strain throughout their ordeals, and many of them have chosen abortion because it’s what’s best for their family. Another patient in the waiting room, Lauren, says she decided early on that she couldn’t keep her pregnancy: The man who’d gotten her pregnant, who was also the father of her other two children, struggles with addiction issues, she explains, and is “not someone you want to have kids with.”
“I just can’t have him around my children anymore,” she emphasizes. “I’ve tried to help him in the past, and you can’t help someone who can’t help themselves.”
Another woman, Brittany, tells Broadly the main reason that she’s choosing to get an abortion is because of finances. She’s a single mother with a three-year-old son, and she’s also the primary caretaker for her young cousin, whose mother is chronically ill; she simply can’t afford another child. “You gotta save money for a rainy day. When [my son] gets older, he’s got [to have] choices, he’s got to go to school,” she says.
If EMW Surgical Center closes, women will have to travel as far as 200 miles to a neighboring state such as Ohio, Tennessee, or Indiana in order to obtain an abortion. This could prove very difficult for a woman of lower socioeconomic standing. Such a long trip would require more money for transportation, possibly for overnight lodging, for lost wages from increased time off work, and for potential childcare costs. In the state of Kentucky, close to one-fifth of the residents are considered poor.
I don’t ask any of the women I meet at the clinic what they would do if they couldn’t obtain a safe and legal abortion. Because every single one of them tells me that she simply cannot have a baby right now, I already know the answer.