SHREVEPORT, LOUISIANA — The phone would not stop ringing. Administrative staff at Hope Medical Group for Women took turns answering, scheduling abortions for people from all over, from Longview, Texas to El Dorado, Arkansas, and even the occasional one from Oklahoma.
But this time, women living in southern Louisiana were also calling Hope, a clinic in the most northwest region of the state. The only other abortion clinics statewide, Delta Clinic of Baton Rouge and Women’s Healthcare Center in New Orleans, weren’t accepting new appointments due to a restrictive law that was set to take effect Friday, which would have essentially shuttered the clinics. That made Hope the only clinic booking procedures on Thursday.
The Shreveport clinic’s name has never been more apt. It is Louisiana’s last hope for women and gender minorities should the Supreme Court ultimately uphold a state law requiring doctors who perform abortions to have staff privileges at a hospital within 30 miles of the clinic.
The law, known as Act 620, might sound reasonable, but there’s only one doctor who fits this description in the entire state and they work at Hope. The reality is abortion providers don’t have to admit patients — abortion is safer than a wisdom tooth extraction. Dr. Doe only has these privileges because they’re primarily an obstetrician. Before performing 27 abortions on Thursday afternoon, for example, they delivered twins at the nearby hospital.
The Supreme Court temporarily blocked the law on Thursday evening, just three hours before the law was set to take effect. But already, abortion seekers were rearranging their lives to accommodate the state’s requirement. Women who had state-mandated counseling at Baton Rouge and New Orleans planned to make the four to five hour trip to Shreveport — and there was already a waiting list for Saturday at Hope.
“We will call them tomorrow and tell them the clinics will be open if they want to be closer to home,” Hope’s administrator, Kathaleen Pittman, told ThinkProgress late Thursday.
Pittman is relieved, at least for now. Near closing time, around 6 p.m., she was pacing around the clinic and wondering how the Supreme Court would rule: would the justices agree with the 5th Circuit Court who upheld Act 620, and let the law take effect Friday? Patients had gone home, the king cake someone had brought in was eaten, and there were no more distractions.
The law was originally passed in 2014, and since then, the district court blocked it twice and the appellate court lifted the block twice more.
But does Pittman have faith that this Supreme Court will put an end to a years-long legal battle? Chief Justice John Roberts ruled in favor of a similar Texas law in 2016, and in a dissent on Thursday, Brett Kavanaugh and three other justices said they were willing to let the new requirement play out as a wait and see what happens.
“I have hope that they will” put an end to it, Pittman told ThinkProgress. It was just two years ago when the Supreme Court said Texas’ admitting privileges requirement was unconstitutional in Whole Woman’s Health v. Hellerstedt, declaring the burden outweighed the medical benefit, but here we are again.
Now, this moment, like all the other abortion rights victories, feels fleeting.
A five-year burden
If the Supreme Court rejects its own precedent, Hope is all Louisiana has left. One clinic — with only one doctor, two full-time staff employees, and just over a dozen part-time or as-needed employees mostly working second jobs — would have to serve approximately 10,000 women in the state each year, per a legal filing.
And the doctor, for one, doesn’t know how long they could do it.
“What I have experienced is marginalization by my peers and so on, and a real feeling of isolation,” said Doe. ThinkProgress agreed to keep the doctor’s anonymity because anti-abortion protesters have targeted them at the clinic, at their private practice, and at home.
“I have said if I’m the only one left, I’m not going to continue. I don’t want to put my life on the line unless other physicians are willing to step up to the plate.
Harassment has noticeably spiked under the Trump administration, and Louisiana is just further emboldening these activists. In fact, the legislature passed a bill in 2018 that awards $1,000 to any person who acts as a “whistleblower” by reporting providers who violate the state’s ban on fetal tissue research.
What’s more is this whole experience has left them not being able to recognize themself sometimes.
“I began to get angry with women for getting pregnant and putting me in this position where I’m having to put my life on the line… I don’t like feeling that way, that’s horrible. But I began to experience that sort of thing — I know that’s totally irrational. It was because I was feeling fearful for my life,” they said.
The state says providing abortions is a “voluntary decision,” but it certainly doesn’t feel that way when you’re the only clinic left in the entire state.
“I have said if I’m the only one left, I’m not going to continue. I don’t want to put my life on the line unless other physicians are willing to step up to the plate. Apparently women don’t care enough to fight for their rights and people aren’t willing to fight for them, for women’s rights in the state of Louisiana. And so if that’s the case, so be it,” they added.
There’s a noticeable frustration and exhaustion in Dr. Doe’s tone; it’s not subtle. Staff sometimes showed signs of this, but as soon as a patient neared, they went back to smiling. It had been raining all day, but it was business as usual “except wetter,” said another employee, Stephanie “Steffi” Chaffee.
The admitting privileges law has been looming over Louisiana patients and providers for nearly five years. A Democrat who headlined this year’s March for Life, state Rep. Katrina Jackson, first introduced the measure in February 2014, saying “if you are going to perform abortions in the state of Louisiana, you’re going to do so in a safe environment and in a safe manner that offers women the optimal protection and care of their bodies.”
Jackson maintains this law is about ensuring access to safe services, but really she’s awaiting the day when abortion is illegal. She recently told The Advocate, “when you’re advocating for life, your hope is always that Roe will one day be overturned.”
If the Supreme Court overturns Roe, leaving legality to the states, Louisiana would be one of the first states to outlaw abortion in virtually all circumstances due to a “trigger” law signed by former Gov. Kathleen Blanco (D). But thanks to Jackson’s law, that day could come even sooner.
“For four years we have been toggling back and forth on this law — it’s going into effect, it’s not going into effect, we’re winning, we’re losing. And now we’re really on the precipice again, hanging on and hoping the Supreme Court respects their own precedent and blocks this law,” said Lift Louisiana’s Michelle Erenberg.
“There was a brief period of time, a couple of weeks, where the law was in effect. It was obvious that we didn’t have enough doctors to have privileges,” Erenberg added. There were five operating clinics in 2014, and now there are only three.
Instead of looking at this history, the court’s conservative justices — including Kavanaugh — took the state’s side. Citing the “45-day regulatory transition” before the law is applied, they accepted Louisiana’s promise to not immediately close clinics as providers make a good-faith effort to get admitting privileges.
“‘Did the doctors try hard enough’ is just the wrong question to be asking,” said Travis Tu, with the Center for Reproductive Rights who’s lead counsel on in the lawsuit. “The question is — the question the Supreme Court should be asking is — ‘does this law have any medical justification?’ It already answered that question: no. And if it has no medical justification, then it shouldn’t matter how hard the doctors tried — they shouldn’t be required to get these admitting privileges in the first place.”
The Center for Reproductive Rights is filing their cert petition — meaning, asking the Supreme Court to review the lawsuit — in April. Thursday’s late vote is about process and the legal battle is far from over.
Hope Medical Group for Women has been around since 1980. Remnants of its history are scattered throughout the clinic. The art work of the original owner who’s now deceased, Robin Rothrock, is practically in every room. The art, like the patients and neighborhood, is eclectic.
Similar to Rothrock’s modern art, you have to really think about what Hope actually means. While it’s technically named after another clinic in Granite City, Illinois, it’s come to mean something more. Pittman likes to think the clinic’s named Hope “because we gave women hope.”
“Hope for a better life — most women that we see here are already moms and they’re struggling to make a better life for themselves,” she said.
On Thursday afternoon, another doctor — a retired OB-GYN who does the clinic a favor by counseling patients sometimes — met with one woman who was already a mother of one. The father had nine other children with various women. They just couldn’t afford to raise any more.
“They certainly don’t make it easy to choose to be a parent,” said Melissa Gibson, who volunteers with Hope, escorting patients inside from the parking lot as there’s always at least one anti-abortion protester outside. (On Thursday, there was a man with a megaphone who traveled from Texas just to keep shouting “repent.”)
Read through government data and academic research, and you’ll learn that Louisiana struggles to create a good quality of life for its residents. It has the second-highest poverty rate, at 19.7 percent; the rate of children living in poverty is worse, at 27.8 percent. The state also ranks third in food insecurity, at 17 percent of households.
Gibson, a mother of three, laments Shreveport’s education system. “I put my kindergarterner in school here and I couldn’t walk him to his classroom because it was a fire hazard,” she said. Gibson now homeschools her children.
Louisiana’s problems only intensify for those with less privilege, and this is why Gibson — a white, church-going military wife — feels she has to do the work so women and gender minorities in the state can have bodily autonomy. Because choosing when to parent means something.
For another Hope patient — a 23-year-old college student working a minimum-wage job — it meant breaking the cycle.
“My mom got pregnant with me when she was 17 and this wasn’t an option for her because her family was very conservative. Because of the fragility of our relationship, a lot of times I always suffered with would she have been better had she not had me?” she said.
“I just know when I do make the decision to have children, if I do, I want it to be when I want to have them and with the husband that I want to have them with. When I can bake cookies for them on Sunday, and put them in swimming lessons, and be that Sunday mom, and I can’t be that right now.”