Abortion in Maryland

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Abortion in Maryland is legal. 64% of adults said in a poll by the Pew Research Center that abortion should be legal in all or most cases.

The number of abortion clinics have been declining in recent years, going from 52 in 1982 to 51 in 1992 to 25 in 2014.

Terminology[]

Main article: Abortion
See also: Definitions of abortion

The abortion debate most commonly relates to the "induced abortion" of an embryo or fetus at some point in a pregnancy, which is also how the term is used in a legal sense.[note 1] Some also use the term "elective abortion", which is used in relation to a claim to an unrestricted right of a woman to an abortion, whether or not she chooses to have one. The term elective abortion or voluntary abortion describes the interruption of pregnancy before viability at the request of the woman, but not for medical reasons.[1]

Anti-abortion advocates tend to use terms such as "unborn baby", "unborn child", or "pre-born child",[2][3] and see the medical terms "embryo", "zygote", and "fetus" as dehumanizing.[4][5] Both "pro-choice" and "pro-life" are examples of terms labeled as political framing: they are terms which purposely try to define their philosophies in the best possible light, while by definition attempting to describe their opposition in the worst possible light. "Pro-choice" implies that the alternative viewpoint is "anti-choice", while "pro-life" implies the alternative viewpoint is "pro-death" or "anti-life".[6] The Associated Press encourages journalists to use the terms "abortion rights" and "anti-abortion".[7]

History[]

Legislative history[]

By the end of the 1800s, all states in the Union except Louisiana had therapeutic exceptions in their legislative bans on abortions.[8] In the late 1960s and early 1970s, Arkansas, Colorado, Georgia, Maryland, New Mexico, North Carolina and Oregon made reforms to their abortion laws, with most of these states providing more detailed medical guidance on when therapeutic abortions could be performed.[8]

In 2013, state Targeted Regulation of Abortion Providers (TRAP) had provisions related to organization structure, requiring them to be similar to a surgical center in structure.[9] Cities like Baltimore, Austin, and New York passed legislation to require crisis pregnancy centers (CPCs) to disclose their status and that they did not offer abortion services, but organizations representing the CPCs have been successful in courts challenging these laws, principally on the argument that forcing the CPCs to post such language violated their First Amendment rights and constituted compelled speech.[10][11] Whereas the previous attempts at regulating CPCs in Baltimore and other cities were based on having signage that informed the patient that the CPC did not offer abortion-related services, the FACT Act instead makes the patient aware of state-sponsored services that are available rather than what the CPCs did or did not offer.[12] The law went into effect January 1, 2016.[13] In Maryland in 2013, according to The New York Times, something "rare in this era of polarized abortion politics" occurred when laws that significantly tightened the licensing and inspection of abortion clinics were supported by those on both sides of the abortion issue.[14]

As of 2017, Washington State, New Mexico, Illinois, Alaska, Maryland, Massachusetts, Connecticut, and New Jersey allow qualified non-physicians to prescribe drugs for medical abortions only.[15] In August 2018, the state had a law to protect the right to have an abortion.[16]

As of May 14, 2019, the state prohibited abortions after the fetus was viable, generally some point between week 24 and 28, unless pregnancy threatens the life or health of the mother or there is a fetal abnormality. This period uses a standard defined by the US Supreme Court in 1973 with the Roe v. Wade ruling.[17] At least one abortion facility in the state advertises that it performs abortions through 35 weeks of pregnancy.[18] Two fetal heartbeat bills have been filed in the Maryland House of Delegates in 2019. On February 8, 2019, Ric Metzgar filed HB 933.[19] On February 8, 2019, Robin L. Grammer, Jr. filed HB 978, a bill entitled "Keep Our Hearts Beating Act".[20] In 2019, Former Maryland House Speaker Michael Busch proposed an amendment to the state's constitution to enshrine the right for women to have an abortion.[21][22] His replacement Maryland House Speaker Adrienne Jones said she would try to re-introduce the amendment in 2020 in response to the abortion bans in the states of Alabama and Georgia.[21][23]

In March 2022, the Maryland House of Delegates voted to enshrine a broad right to abortion access into the state constitution. The move was in response to the possibility that the more conservative leaning U.S. Supreme Court could weaken abortion right protections nationwide. The constitutional amendment needs approval by the Maryland Senate and the voters before being enacted.[24] The state house also passed the Abortion Care Access Act. The bill allows a broader range of healthcare workers—nurse practitioners, nurse midwives, and physician assistants—to perform abortions and allocates $3.5 million dollars to a new program within the Maryland Department of Health to train healthcare workers. Additionally, the bill requires the majority of health insurance plans, including private health insurance plans, to cover abortions cost free. The bill passed with a veto-proof majority in the state house, but still needs approval from the state senate.[25]

Ballot box history[]

There was a ballot effort in 1992 where Maryland voters codified women's right to have abortions up to viability.  They wanted this in place in case Roe v. Wade was ever overturned.[21]

Judicial history[]

The US Supreme Court's decision in 1973's Roe v. Wade ruling meant the state could no longer regulate abortion in the first trimester.[8]

Clinic history[]

Number of abortion clinics in Maryland by year.
See also: Abortion clinic

Between 1982 and 1992, the number of abortion clinics in the state decreased by one, going from 52 in 1982 to 51 in 1992.[26] In 2014, there were 25 abortion clinics in the state.[27] In 2014, 67% of the counties in the state did not have an abortion clinic. That year, 24% of women in the state aged 15–44 lived in a county without an abortion clinic.[16] In March 2016, there were ten Planned Parenthood clinics in the state.[28] In 2017, there were nine Planned Parenthood clinics, five of which offered abortion services, in a state with a population of 1,416,615 women aged 15–49.[29]

Barriers to access[]

Maryland is a state that has highly ranked reproductive rights protections, but there are still many barriers to safe and legal abortions. According to the Institute for Women's Policy Research, Maryland is ranked #3 across all fifty states for reproductive rights and received an A− rating.[30]

Parental Notification[]

In the state of Maryland, minors can obtain safe and legal abortions but the health care professional must provide parental notification to at least one parent or guardian before the abortion can be administered. This parent or guardian does not have to agree with the patient's choice, they just must be notified. There are exceptions, including: if the minor is capable of giving their informed consent, if notification would not be in the best interest of the minor, if a reasonable attempt to give notification has been unsuccessful, if notice may lead to abuse towards the minor, or if the minor does not live with her parent or guardian.[31]

The parental notification may be a deterrent for minors to get an abortion. The exceptions leave the decision in the hands of the abortion provider which creates uncertainty for the minors looking to get the procedure and might further be a deterrent. Additionally, the abortion providers might not decide to waive the parental notification for minors who need the procedure, proving the deterrent that this parental notification causes.

Contraception[]

There has been an increase in contraception, which is important to note, that has led to a slight decrease in abortions. As of 2014, 14% of women were using a long term contraceptive such as an IUD or implant, as opposed to less than 10% in 2009.[32] Although 60% of reproductive aged-women are currently using some form of contraception, women aged 15–19 are the least likely to use contraception (18%) which further highlights how the parental notice can be a deterrent for this already at-risk group.

Use of contraception rates are also lowest among black women who are at risk of an unplanned pregnancy (83%) than their white (91%) and Asian (90%) peers.[33] Contraception is important to note because while it is readily available, the groups that are not able to get access to contraception are the same demographics with the highest abortion rates. Black women are five times more likely to get an abortion than white women, largely because black women are three times more likely to experience an unplanned pregnancy than white women.[33]

Clinic closures[]

Maryland currently has 25 abortion clinics open; however, The New York Times depicts multiple abortion providing clinic closing in Maryland from 2013 to 2018.[34] In 1981, there were a recorded 29.3 abortions out of every one thousand women aged 15–44, compared to 19.5 in 2005.[32] Increased contraceptive use is only one contributor to abortions going down on a national level.

Safe and legal abortions are on a decrease but closing clinics is still a barrier to access for many women. The closing of clinics only stops safe and legal abortions. Studies prove that clinics closing leads to women attempting to performing their own, much more unsafe, abortions. Closures in clinics also leads to googles such as "self-induced abortions", showing that the need for these procedures still exists. 20-50% of women who have unsafe abortions are hospitalized due to complications, introducing health concerns and also additional costs to both the women and the Maryland government that are greater than an abortion would’ve been.[35]

For the clinics that are still open, some do not offer abortions after 13 weeks. Maryland law states that abortions can be performed after or at viability if there is a fetal anomaly or the patient's life is at risk. Viability is, for the most part, considered 24 weeks. Although the Maryland law is protective of the mother's right to choose, clinics that only offer the procedure before 13 weeks introduce another barrier to access to safe and legal abortions. Additionally, rape and incest is not included as an exception after viability, which lends itself to be yet another barrier to safe and legal abortions for many in Maryland.[30]

Clinic Locations[]

Maryland has many clinics and providers that offer safe and legal abortions, however as you can see in the figure to the right, they are concentrated around Baltimore and Washington, D.C. As of 2017, over 70% of Maryland counties did not have a clinic or provider that provided abortions. These counties include almost 30% of Maryland women who do not have access to a safe and legal abortion within their own county.[30] Pro-choice activists have seen pregnant patients drive as far as three hours (from Salisbury to Baltimore) to complete the procedure, showing that clinic locations are a barrier to abortions for many Maryland women.[36] Low income residents might not be able to take the time off from work, or pay for transportation, further showing the severity of this barrier.

Other Noticeable Legislation[]

Maryland has 38 crisis pregnancy centers with counselors working to convince pregnant patients away from abortions.[36] In 2018, a Federal Appeals court struck down a law that would’ve required Maryland clinics to clearly disclose in their waiting rooms if they do not offer or refer pregnant patients to abortion procedures because it was deemed unconstitutional.[37] This, combined with the existence of the pregnancy centers show lack of information/counseling as another barrier to abortion access for many women in Maryland.

On a national level, barriers exist that prevent Maryland patients from pursuing safe and legal abortions. Even before the Trump administration's 2019 restructure of Title X, federal funds could not be used for abortion services. The new Title X regulations restrict Title X providers from providing abortions within their clinic or referring patients to abortion providers unless they explicitly ask for the referral.[38] Nationally, 4 million people rely on Title X (78% of these patients have incomes below 150% of the poverty level), and Maryland has since pulled out of the Title X network because of the new regulations and gag rule. This loss of funds has reduced Maryland's network capacity by 90-99%. Maryland has passed emergency funding measures to mitigate this funding loss, however it is not a long-term solution.[38] The Title X changes introduce barriers to access to abortion access because of the loss of resources that come with the loss of funding for clinics and providers who provide abortions, but separately also rely on Title X to keep their doors open. The new regulations introduce another barrier because the gag rule limits how much information doctors can provide their patients about all of their choices, including obtaining safe and legal abortions.

Statistics[]

In the period between 1972 and 1974, there were zero recorded illegal abortion deaths in the state.[39] In 1990, 604,000 women in the state faced the risk of an unintended pregnancy.[26] In 2014, 64% of adults said in a poll by the Pew Research Center that abortion should be legal in all or most cases.[40] In 2017, the state had an infant mortality rate of 6.4 deaths per 1,000 live births.[41]

Number of reported abortions, abortion rate and percentage change in rate by geographic region and state in 1992, 1995 and 1996[42]
Census division and state Number Rate % change 1992–1996
1992 1995 1996 1992 1995 1996
South Atlantic 269,200 261,990 263,600 25.9 24.6 24.7 –5
Delaware 5,730 5,790 4,090 35.2 34.4 24.1 –32
District of Columbia 21,320 21,090 20,790 138.4 151.7 154.5 12
Florida 84,680 87,500 94,050 30 30 32 7
Georgia 39,680 36,940 37,320 24 21.2 21.1 –12
Maryland 31,260 30,520 31,310 26.4 25.6 26.3 0
North Carolina 36,180 34,600 33,550 22.4 21 20.2 –10
South Carolina 12,190 11,020 9,940 14.2 12.9 11.6 –19
Virginia 35,020 31,480 29,940 22.7 20 18.9 –16
West Virginia 3,140 3,050 2,610 7.7 7.6 6.6 –14

Abortion financing[]

State Medicaid coverage of medically necessary abortion services.Navy blue: Medicaid covers medically necessary abortion for low-income women through legislation Royal blue: Medicaid covers medically necessary abortions for low-income women under court order Gray: Medicaid denies abortion coverage for low-income women except for cases of rape, incest, or life endangerment.

Seventeen states including Maryland use their own funds to cover all or most "medically necessary" abortions sought by low-income women under Medicaid, thirteen of which are required by State court orders to do so.[43] In 2010, the state had 4,352 publicly funded abortions, of which zero were federally funded and 4,352 were state funded.[44]

Abortion rights views and activities[]

Pro-choice is "pro-life" at Summer of Choice 2011 in Germantown, Maryland

Protests[]

Women from the state participated in marches supporting abortion rights as part of a #StoptheBans movement in May 2019.[45]

Anti-abortion views and activities[]

Violence[]

From February 24–25, 2016, Travis Reynolds, 21, vandalized a Baltimore-area women's health care clinic with anti-abortion graffiti.[46][47] After being arrested, Reynolds "admitted to police that he defaced the clinic's doors, walls and windows because he thought that it would deter women from using the clinic."[47] Reynolds pleaded guilty in federal court to one count of violating the Freedom of Access to Clinic Entrances Act in October 2016.[47]

Peaceful Assemblies[]

The anti-abortion group 40 Days for Life conducts seasonal prayer campaigns outside abortion facilities in various Maryland cities. Individuals and groups sign up with 40 Days for Life to be present outside specific facilities for specific hours to pray for an end to abortion during each seasonal campaign.[48]

Footnotes[]

  1. ^ According to the Supreme Court's decision in Roe v. Wade:

    (a) For the stage prior to approximately the end of the first trimester, the abortion decision and its effectuation must be left to the medical judgement of the pregnant woman's attending physician. (b) For the stage subsequent to approximately the end of the first trimester, the State, in promoting its interest in the health of the mother, may, if it chooses, regulate the abortion procedure in ways that are reasonably related to maternal health. (c) For the stage subsequent to viability, the State in promoting its interest in the potentiality of human life may, if it chooses, regulate, and even proscribe, abortion except where it is necessary, in appropriate medical judgement, for the preservation of the life or health of the mother.

    Likewise, Black's Law Dictionary defines abortion as "knowing destruction" or "intentional expulsion or removal".

References[]

  1. ^ Watson, Katie (20 Dec 2019). "Why We Should Stop Using the Term "Elective Abortion"". AMA Journal of Ethics. 20: E1175-1180. doi:10.1001/amajethics.2018.1175. PMID 30585581. Retrieved 17 May 2019.
  2. ^ Chamberlain, Pam; Hardisty, Jean (2007). "The Importance of the Political 'Framing' of Abortion". The Public Eye Magazine. 14 (1).
  3. ^ "The Roberts Court Takes on Abortion". New York Times. November 5, 2006. Retrieved January 18, 2008.
  4. ^ Brennan 'Dehumanizing the vulnerable' 2000
  5. ^ Getek, Kathryn; Cunningham, Mark (February 1996). "A Sheep in Wolf's Clothing – Language and the Abortion Debate". Princeton Progressive Review.
  6. ^ "Example of "anti-life" terminology" (PDF). Archived from the original (PDF) on 2011-07-27. Retrieved 2011-11-16.
  7. ^ Goldstein, Norm, ed. The Associated Press Stylebook. Philadelphia: Basic Books, 2007.
  8. ^ a b c Buell, Samuel (1991-01-01). "Criminal Abortion Revisited". New York University Law Review. 66: 1774–1831.
  9. ^ "TRAP Laws Gain Political Traction While Abortion Clinics—and the Women They Serve—Pay the Price". Guttmacher Institute. 2013-06-27. Retrieved 2019-05-27.
  10. ^ Winter, Meaghan (June 15, 2015). "Why Are Crisis Pregnancy Centers Not Illegal?". Slate. Retrieved March 15, 2018.
  11. ^ Stempel, Jonathan (January 5, 2018). "Court voids Baltimore law requiring 'no abortion' clinic disclaimers". Reuters. Retrieved March 20, 2018.
  12. ^ McEvers, Kelly (November 5, 2015). "California Law Adds New Twist To Abortion, Religious Freedom Debate". All Things Considered. NPR. Retrieved March 15, 2018.
  13. ^ National Institute of Family and Life Advocates v. Harris, 839 F.3d 823 (9th Cir. 2016).
  14. ^ Eckholm, Erik (July 10, 2013). "Maryland's Path to an Accord in Abortion Fight" – via NYTimes.com.
  15. ^ "Study: Abortions Are Safe When Performed By Nurse Practitioners, Physician Assistants, Certified Nurse Midwives". Retrieved 25 January 2017.
  16. ^ a b businessinsider (2018-08-04). "This is what could happen if Roe v. Wade fell". Business Insider (in Spanish). Archived from the original on 2019-05-24. Retrieved 2019-05-24.
  17. ^ Lai, K. K. Rebecca (2019-05-15). "Abortion Bans: 8 States Have Passed Bills to Limit the Procedure This Year". The New York Times. ISSN 0362-4331. Retrieved 2019-05-24.
  18. ^ "Third Trimester Surgical Abortions". Retrieved 2021-04-05.
  19. ^ "MD - 2019 Regular Session - HB933". mgaleg.maryland.gov. General Assembly of Maryland. Retrieved February 12, 2019.
  20. ^ "MD - 2019 Regular Session - HB978". mgaleg.maryland.gov. General Assembly of Maryland. Retrieved February 12, 2019.
  21. ^ a b c "Are there *any* states working to protect abortion rights?". Well+Good. 2019-05-17. Retrieved 2019-05-25.
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  23. ^ "Maryland House Speaker Jones says she'll likely push for stronger abortion rights". WTOP. 2019-05-16. Retrieved 2019-05-25.
  24. ^ https://www.usnews.com/news/best-states/maryland/articles/2022-03-11/maryland-house-passes-abortion-rights-constitution-amendment. Retrieved 18 March 2022. {{cite web}}: Missing or empty |title= (help)
  25. ^ "Maryland House votes to add abortion rights to state constitution, expand access to abortion". Baltimore Sun.
  26. ^ a b Arndorfer, Elizabeth; Michael, Jodi; Moskowitz, Laura; Grant, Juli A.; Siebel, Liza (December 1998). A State-By-State Review of Abortion and Reproductive Rights. DIANE Publishing. ISBN 9780788174810.
  27. ^ Gould, Rebecca Harrington, Skye. "The number of abortion clinics in the US has plunged in the last decade — here's how many are in each state". Business Insider. Retrieved 2019-05-23.
  28. ^ Bohatch, Emily. "27 states with the most Planned Parenthood clinics". thestate. Retrieved 2019-05-24.
  29. ^ "Here's Where Women Have Less Access to Planned Parenthood". Retrieved 2019-05-23.
  30. ^ a b c "State Data". Women in the States. Retrieved 2020-10-25.
  31. ^ "Maryland Minor Laws". www.plannedparenthood.org. Retrieved 2020-10-25.
  32. ^ a b "Contraceptive Use in the United States". Guttmacher Institute. 2020-01-22. Retrieved 2020-10-26.
  33. ^ a b "Abortion and Women of Color: The Bigger Picture". Guttmacher Institute. 2008-08-13. Retrieved 2020-10-25.
  34. ^ Lai, K. K. Rebecca; Patel, Jugal K. (2019-05-31). "For Millions of American Women, Abortion Access Is Out of Reach (Published 2019)". The New York Times. ISSN 0362-4331. Retrieved 2020-10-26.
  35. ^ Gould, Rebecca Harrington, Skye. "The number of abortion clinics in the US has plunged in the last decade — here's how many are in each state". Business Insider. Retrieved 2020-10-25.
  36. ^ a b KOHN, DAVID. "Abortion gets wide protection in Md. law". baltimoresun.com. Retrieved 2020-10-26.
  37. ^ Stempel, Jonathan (2018-01-05). "Court voids Baltimore law requiring 'no abortion' clinic disclaimers". Reuters. Retrieved 2020-10-26.
  38. ^ a b "Trump Administration's Domestic Gag Rule Has Slashed the Title X Network's Capacity by Half". Guttmacher Institute. 2020-02-04. Retrieved 2020-10-26.
  39. ^ Cates, Willard; Rochat, Roger (March 1976). "Illegal Abortions in the United States: 1972–1974". Family Planning Perspectives. 8 (2): 86. doi:10.2307/2133995. JSTOR 2133995. PMID 1269687.
  40. ^ "Views about abortion by state - Religion in America: U.S. Religious Data, Demographics and Statistics". Pew Research Center. Retrieved 2019-05-23.
  41. ^ "States pushing abortion bans have highest infant mortality rates". NBC News. Retrieved 2019-05-25.
  42. ^ "Abortion Incidence and Services in the United States, 1995-1996". Guttmacher Institute. 2005-06-15. Retrieved 2019-06-02.
  43. ^ Francis Roberta W. "Frequently Asked Questions". Equal Rights Amendment. Alice Paul Institute. Archived from the original on 2009-04-17. Retrieved 2009-09-13.
  44. ^ "Guttmacher Data Center". data.guttmacher.org. Retrieved 2019-05-24.
  45. ^ Bacon, John. "Abortion rights supporters' voices thunder at #StopTheBans rallies across the nation". USA TODAY. Retrieved 2019-05-25.
  46. ^ John Fritze, Man pleads guilty to vandalizing reproductive health clinic, Baltimore Sun (October 14, 2016).
  47. ^ a b c Baltimore Man Pleads Guilty to Damaging Property of a Reproductive Health Services Facility (press release), United States Department of Justice Office of Public Affairs (October 14, 2014).
  48. ^ "40 Days for Life Search your location". Retrieved 2021-04-09.
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