By Alexandria Montgomery
As the COVID-19[1] pandemic continues to spread across the United States, a new wave of abortion litigation has reached federal courts. In the wake of the ongoing pandemic, several states—including Texas, Ohio, Iowa, Alabama, and Oklahoma—have attempted to restrict women’s access to abortion procedures under the guise of promoting social distancing and conserving healthcare resources.[2] These temporary abortion bans have most commonly come in the form of an executive order from a state’s governor regarding limitations on non-essential medical procedures.[3] This raises several legal questions. May abortion be considered a “nonessential” medical procedure? Moreover, are these abortion bans constitutional given that they are supposedly only temporary? And finally, does the public interest in stopping the spread of COVID-19 and conserving much-needed personal protective gear (“PPG”) for healthcare professionals outweigh a woman’s constitutional privacy interest in obtaining an abortion?
On Monday, March 30, a federal judge halted a temporary abortion ban in Texas.[4] Texas Governor Greg Abbott had issued an executive order (“Executive Order GA-09”) on March 22 that required all health care professionals and facilities to postpone “all surgeries and procedures that are not immediately medically necessary to correct a serious medical condition of, or to preserve the life of, a patient who without immediate performance of the surgery or procedure would be at risk for serious adverse medical consequences or death . . . .”[5]
The next day, the Attorney General of Texas, Ken Paxton, issued a press release clarifying that the that the Executive Order GA-09 prohibited “any type of abortion that is not medically necessary to preserve the life or the health of the mother.”[6] Of note, the Attorney General’s interpretation, which explicitly prohibited “any type” of abortion, would not only ban surgical abortions, but medication abortions as well—despite the fact that medication abortions do not require any type of surgery or procedure. The Attorney General’s interpretation also made clear that those who did not comply with Executive Order GA-09 could face criminal “penalties of up to $1,000 or 180 days of jail time.”[7]
Several abortion providers (collectively, “Planned Parenthood”) quickly filed a constitutional challenge against the Governor and state officials seeking a temporary restraining order against both the Texas Attorney General’s interpretation of Executive Order GA 09 and the Order itself. In granting the temporary restraining order, which prohibits Texas from enforcing Executive Order GA-09 as applied to any type of abortion, the court made several determinations.
First, the court stated in no uncertain terms that, “[r]egarding a woman’s right to a pre-fetal-viability abortion, the Supreme Court has spoken clearly. There can be no outright ban on such procedure.” Indeed, for nearly half a century, the Supreme Court has repeatedly and emphatically held that the Due Process Clause of the Fourteenth Amendment includes a right of privacy that protects a woman’s right to make the ultimate decision to terminate a pregnancy at any point prior to viability.[8] Before the point of viability, “a state has no interest sufficient to justify an outright ban on abortion.”[9] In other words, although states may regulate pre-viability abortions, they may not outright ban them.[10]
The court, however, also addressed several factors that are specific to this unprecedented situation caused by the COVID-19 pandemic. Although Texas and some other states have attempted to classify “any type” of abortion as nonessential, abortion is a time-sensitive procedure.[11] Many states such as Texas have placed gestational limits on when a woman may legally obtain an abortion.[12] Because of these limits, even a temporary ban on abortion would allow some women’s pregnancies to progress to a point at which it would no longer be legal to obtain an abortion, effectively stripping some patients of their constitutional right to choose to terminate a pregnancy.[13]
Moreover, it has always been and will continue to be the case that restricted access to abortion services disproportionately impacts low-income women. Long before the COVID-19 pandemic, some of the most common reasons that abortion patients provided for choosing to terminate a pregnancy included the inability to afford raising a child and the belief that continuing the pregnancy would interfere with their ability to work.[14] And now, in the midst of a pandemic that has already wreaked havoc on the United States economy, the risks of requiring someone to continue an unwanted pregnancy are perhaps even greater.[15] In only a two week time-span, unemployment insurance claims in the United States have increased a shocking 1500%.[16] Labor economists estimate that potentially 14 million workers will lose their jobs due to the pandemic by the summer.[17] In the face of such severe economic distress, it is vital now more than ever that women are able to make deeply personal decisions relating to whether they are in a position to bring a dependent child into the world.
Finally, the court noted that because of the pandemic, travelling to other states to obtain an abortion is increasingly risky.[18] The Centers for Disease Control and Prevention has warned that travelling, even within the United States, may increase the possibility of contracting COVID-19.[19] Accordingly, the court determined that allowing medical providers to resume abortion services would not disserve the public interest.[20] Any benefits of conserving a limited amount of PPG for healthcare providers is outweighed by the harm of allowing a state to ban abortions outright.[21] A woman’s constitutional right must take precedence, especially when paired with the unfortunate current economic circumstances and the increased health risks that travelling to other states to obtain an abortion would pose. In short, a woman’s constitutional right to obtain an abortion continues to survive, even in the midst of an unprecedented pandemic.
[1] COVID-19 is the name of the disease caused by the novel coronavirus (SARS-CoV-2). See Naming the Coronavirus Disease (COVID-19) and the Virus That Causes It, World Health Org., https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it (last visited Apr. 1, 2020).
[2] See Kate Smith, Abortion in Texas will resume, despite attorney general orders, CBS News (Mar. 30, 2020, 06:47 PM), https://www.cbsnews.com/news/texas-abortion-ban-halted-federal-judge/.
[3] See, e.g., Tex. Exec. Order No. GA-09 (Mar. 22, 2020), https://gov.texas.gov/uploads/files/press/EO-GA_09_COVID-19_hospital_capacity_IMAGE_03-22-2020.pdf (prohibiting nonessential surgeries and medical procedures in Texas).
[4] See Smith, supra note 2. In recent days, federal judges have also enjoined similar COVID-19-related abortion bans in both Ohio and Alabama. See Ema O’Connor, Judges Struck Down Three State Bans On Abortions During The Coronavirus Outbreak (Mar. 31, 2010, 10:53), https://www.buzzfeednews.com/article/emaoconnor/judge-struck-down-abortion-ban-texas-coronavirus.
[5] See Tex. Exec. Order No. GA-09, supra note 3.
[6] See Press Release, Ken Paxton, Attorney Gen. of Tex., Health Care Professionals and Facilities, Including Abortion Providers, Must Immediately Stop All Medically Unnecessary Surgeries and Procedures to Preserve Resources to Fight COVID-19 Pandemic (Mar. 23, 2020), https://www.texasattorneygeneral.gov/news/releases/health-care-professionals-and-facilities-including-abortion-providers-must-immediately-stop-all.
[7] See id.
[8] See Planned Parenthood of Se. Pa. v. Casey, 505 U.S. 833, 879 (declaring that a state’s regulation is an unconstitutional “undue burden” if the regulation’s “purpose or effect is to place a substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability.”); Roe v. Wade, 410 U.S. 113, 170 (1973); see also Whole Woman’s Health v. Hellerstedt, 136 S. Ct. 2292, 2300 (2016) (reaffirming the central holdings of Roe and Casey that prior to the point of viability, the state may not unduly burden a woman’s constitutional right to obtain an abortion).
[9] Planned Parenthood Ctr. for Choice v. Abbott, No. A-20-CV-323-LY, slip op. at 6 (W.D. Tex. filed Mar. 30, 2020) (citing Roe, 410 U.S. at 163–64)
[10] See id.
[11] See Abortion & COVID-19, Nat’l Abortion Federation, https://prochoice.org/abortion-covid-19/ (last visited Mar. 30, 2020).
[12] See Abbott, slip op. at 7 (citing Tex. Health & Safety Code Ann. § 171.044 (West 2017)) (explaining that Texas bans abortions after 20 weeks post-fertilization).
[13] See id.
[14] See Rachel K. Jones et al., Guttmacher Inst., Characteristics of U.S. Abortion Patients, 2008, at 7, 9 (2010) (“Poor women were overrepresented among abortion patients.”).
[15] See Abbott, slip op. at 8.
[16] See Heidi Shierholz, Unemployment Insurance Claims Jumped Nearly 1,500% in Two Weeks, Econ. Policy Inst. (Mar. 26, 2020), https://www.epi.org/press/unemployment-insurance-claims-jumped-nearly-1500-in-two-weeks-i-have-been-a-labor-economist-for-a-very-long-time-and-have-never-seen-anything-like-this/ (stating that there were 3.3 million unemployment insurance claims in the week before March 26).
[17] See id.
[18] See Abbott, slip. op. at 8.
[19] See Coronavirus and Travel in the United States, Ctrs. for Disease Control & Prevention, https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-in-the-us.html (last updated Mar. 30, 2020). Although the CDC does not typically issue domestic travel restrictions or advisories, it has now issued a travel advisory urging the residents of New York, New Jersey, and Connecticut “to refrain from non-essential domestic travel for 14 days” due to the severity of the COVID-19 outbreak in these states. See id.
[20] See Abbott, slip. op. at 8.
[21] See id.
