What It's Like to Get an Abortion in Louisiana

Louisiana is notoriously hostile to reproductive rights, and has now become the first state in the Trump era to escalate a legal battle over abortion restrictions to the Supreme Court. On March 4, opening arguments began in June Medical Services LLC v. Russo, a case about whether requiring doctors who provide abortions to secure admitting privileges at local hospitals constitutes an “undue burden” on access.

Abortion opponents in Louisiana and elsewhere see the case as a challenge to Roe v. Wade at the federal level, and if that precedent were overturned, abortion would be illegal in Louisiana, because it has what's known as a "trigger law" on the books. Even with Roe in place, Louisiana could ban abortion at six weeks, if a federal appeals court upholds a similar bill in Mississippi. (Although in that event, it’s likely that Louisiana’s so-called “heartbeat bill” would face its own legal challenge.)

A deluge of laws targeting abortion providers have closed all but three of the state’s abortion clinics: Currently, there’s one in New Orleans, one in Baton Rouge, and one in Shreveport. As of 2017, when there were four providers in the state, 94 percent of Louisiana counties—home to 72 percent of Louisiana women—had no clinic.

• Patients seeking abortion must undergo an in-person counseling session featuring inaccurate information designed to dissuade them from having an abortion 24 hours prior to the procedure, requiring two separate trips to the clinic.
• During that initial appointment, the patient must have an ultrasound, narrated by the provider. The provider also has to show the patient the image.
• Prescribing medication abortion via telemedicine is prohibited.
• Abortions may only be performed up to 20 weeks postfertilization, or, 22 weeks after your last period (provided your period abides the 28-day standard), based on the false assertion that a fetus can feel pain at that point. Exceptions are made only when a pregnancy threatens a patient's life or could severely compromise their health, or when the fetus has a lethal anomaly.
• Health insurance plans on the state exchange cannot cover abortion under any circumstance.
• Medicaid only covers abortion when a pregnancy results from rape or incest, or endangers the patient’s life.
• It is a criminal offense for anyone but a Louisiana-licensed physician to perform an abortion, limiting the number of providers in the state by barring medical professionals like nurse practitioners.
• Abortion providers must adhere to the same physical standards as ambulatory surgical centers, an obligation that often requires pricey remodels to expand halls and doorways, and limits the staffing pool.

People under the age of 18 must secure written consent from a parent or legal guardian before they can get an abortion. Minors for whom that’s not possible can attempt judicial bypass, applying to a judge to waive the parental consent obligation. More information on navigating that process is available at the Louisiana Judicial Bypass Project.

Cost depends on how far along the pregnancy is and whether or not you have insurance that will cover it. You can ask on the phone before scheduling an appointment what the cost might look like. The National Network of Abortion Funds may be able to help with the cost.

There are three abortion clinics in Louisiana: The Delta Clinic of Baton Rouge, the Women’s Health Care Center in New Orleans, and the Hope Medical Group in Shreveport.

This is one person’s experience.

JC, now 30, got an abortion in New Orleans in October 2012, at a clinic that’s since closed. She was a first-year medical student at the time, and roughly five weeks along when she terminated. This interview has been lightly edited and condensed for clarity.

I had been nauseous and I had missed my period. I took a pregnancy test at the prompting of my boyfriend, who had moved to New Orleans with me for medical school, and we found out I was pregnant. It was a huge shock to both of us. I remember him looking at me and saying, ‘What do you want to do?’ And I said, ‘I cannot keep the pregnancy.’ That was really the extent of our conversation. We processed the information together and spent that night researching different options, trying to figure out how soon this could be done, and my boyfriend found out—by looking at a couple of websites and calling a couple of clinics the next day—that there was an option for a medication abortion, which I had never even heard of before. To me that sounded much better, because I was very afraid of having a procedure.

He coordinated my first appointment with the clinic; that’s also when we learned there was a mandatory 24-hour waiting period, which was very frustrating and very inconvenient. I needed to miss class and I had an exam coming up, and I didn’t want to have to tell anyone about the appointment.

Getting my first appointment just took one day. I called a couple of different clinics and basically just went with the soonest one we could get. There was another clinic that was closer to us that I wanted to go to, but they didn’t have an appointment until the next week.

It wasn’t too far, probably a 15- or 20-minute drive.

Yes, which couldn't be used at all, which was also news to me. We had to pay all of it out of pocket. I was very, very nervous about that because at that time, I had my own bank account, but it was very much supplemented by my parents, so my boyfriend withdrew the cash from his own account. We used that to pay for the abortion, $550.

[My boyfriend] came with me to my first appointment, and there was a huge table of protesters outside the clinic, trying to hand me flyers and rosaries and yelling at me. They had no idea what I was going through or what type of decision I had made. We finally made it into the clinic, where I had some of the most compassionate care that I ever received. And that experience really changed my life and made me very inspired to become a women’s health care provider and an abortion provider.

Of course we had to meet with the doctor and the nurses and then go home to “fully think” about our decision, which we had made the moment [when I knew] I was pregnant. I remember having to get the ultrasound, I remember them offering for me to see the screen, and offering me a picture, and talking about both the medication and the aspiration option, and I remember them saying that it was really important that I do the follow-up visit to make sure the medication had worked.

I remember being very shocked by [how few] men were in the waiting room. My boyfriend was, I think, one of two men, out of about 30 women in the waiting room. I thought that was very shocking because obviously it took two people to get to this particular juncture. I remember that they made significant others or people who had come to the appointment with the patients wait in the waiting room, so we could speak with the physicians alone.

Then we got called for the ultrasound and went to another waiting room, which was just the patients, to talk to the doctor. I probably waited in that room the longest, and I remember some people opening up to each other about how they had gotten into this situation. One woman said that she had been on birth control and her husband had been really, really wanting her to become pregnant, so she wasn’t sure how that happened; another woman said she thought her own husband had poked holes in their condoms. But all of them were very open about their stories. I was very stressed about the whole situation, so [that] helped me to process what was happening.

My next visit, I think I had to actually do two days later because of scheduling. I remember the physician handing me the pill and saying, ‘Okay, are you sure about this, because after this there’s no going back.’ I said, ‘I’ve been sure since I found out I was pregnant.’ I took the pill, and went home. I had a class that afternoon: While I was doing that, [my boyfriend] went to the pharmacy to pick up my other medication for me. And then that evening I took the other set of medication and I was very scared throughout the entire process. I remember lots of cramping and bleeding, which they had told me about, and I was so grateful that my boyfriend was there right next to me, just to hold my hand and talk me through everything. The next morning was a Sunday, and I woke up with no cramps, no bleeding, and just this overwhelming sense of relief and gratitude. That’s a feeling that will last forever. I looked over at him and said, ‘It’s over.’

We went to church that day, where we found out that one of our members’ daughters had recently been murdered. The mother was part of the choir, and she sang a hymn, “Order My Steps,” and she sang a solo. It was so full of emotion and sadness and hope. That really resonated with me. I remember thinking about both of our experiences, and how they were so completely different, but still feeling this really strong connection to God and to the church, and this feeling that sadness and difficult circumstances and hope and relief can all be mixed into the same space at the same time. It was during that service that I specifically remember thinking that I wanted to devote my life to women and to abortion care.

The waiting period was absolutely unnecessary. I was very sure about my decision and it just inconvenienced me because I had school—other people had children they needed to get to. For everyone it was just a huge scheduling nightmare to have to do two separate visits and then the follow-up [for medication abortion].

The general stigma around abortion makes the experience very isolating and very emotional when it does not need to be. Now that I’m practicing in a much more liberal state, I see many patients who come in for a termination, and they of course thought about it and are sure about their decision, but it doesn’t seem to be as much of an emotional stressor or logistical nightmare as it was for me and for other patients I encountered in Louisiana.

Here there’s no waiting period, there’s no mandatory counseling, abortion is very accessible, and it just is a big contrast to see what abortion care can be like in a state where it’s much more accepted and less stigmatized, versus in a state like Louisiana.

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