Abortion in Montana

Abortion in Montana is legal. 56% 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 in Montana has fluctuated over the years, with twenty in 1982, twelve in 1992, eight providers of which seven were clinics in 2011, five clinics in 2014.  There were four clinics from 2015 to February 2018 when All Families Healthcare clinic in Whitefish re-opened.  There were 1,690 legal abortions in 2014, and 1,611 in 2015.

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]

Context
See also: Abortion in the United States

Free birth control correlates to teenage girls having a fewer pregnancies and fewer abortions. A 2014 New England Journal of Medicine study found such a link.  At the same time, a 2011 study by Center for Reproductive Rights and Ibis Reproductive Health also found that states with more abortion restrictions have higher rates of maternal death, higher rates of uninsured pregnant women, higher rates of infant and child deaths, higher rates of teen drug and alcohol abuse, and lower rates of cancer screening.[8]

According to a 2017 report from the Center for Reproductive Rights and Ibis Reproductive Health, states that tried to pass additional constraints on a women's ability to access legal abortions had fewer policies supporting women's health, maternal health and children's health.  These states also tended to resist expanding Medicaid, family leave, medical leave, and sex education in public schools.[9] According to Megan Donovan, a senior policy manager at the Guttmacher Institute, states have legislation seeking to protect a woman's right to access abortion services have the lowest rates of infant mortality in the United States.[9]

Poor women in the United States had problems paying for menstrual pads and tampons in 2018 and 2019. Almost two-third of American women could not pay for them. These were not available through the federal Women, Infants, and Children Program (WIC).[10] Lack of menstrual supplies has an economic impact on poor women.  A study in St. Louis found that 36% had to miss days of work because they lacked adequate menstrual hygiene supplies during their period.  This was on top of the fact that many had other menstrual issues including bleeding, cramps and other menstrual induced health issues.[10] As of November 2018, fstates did not have a state sales tax and so menstrual items were not taxed.[11][12][13][14]

History

Legislative history

In 1997, the state passed a law that said only physicians could perform abortions. After a lawsuit, they changed the law to allow nurse practitioners to perform abortions.[15]

As of 2017, California, Oregon, Montana, Vermont, and New Hampshire allow qualified non-physician health professionals, such as physicians' assistants, nurse practitioners, and certified nurse midwives, to do first-trimester aspiration abortions and to prescribe drugs for medical abortions.[16] As of May 1, 2018, there were no major legal restrictions on abortions.[17]

As of May 14, 2019, the state prohibited abortions after the fetus was viable, generally some point between week 24 and 28. This period uses a standard defined by the US Supreme Court in 1973 with the Roe v. Wade ruling.[18] In 2018, advanced practice clinicians were legally allowed to provide abortion services.  This group included  physician assistants, certified nurse midwives, and advanced practice nurses.[15]

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.[19] In 1997, All Families Healthcare took the state to court to challenge its law stating that only physicians could perform abortions.[15] In April 2018, two nurses succeeded in getting an injunction as part of a lawsuit against the state to try to allow advanced practice nurses to perform abortions. Montana's Attorney General Tim Fox appealed the injunction.[15]

Clinic history
Number of abortion clinics in Montana by year.
See also: Abortion clinic

Between 1982 and 1992, the number of abortion clinics in the state decreased by eight, going from twenty in 1982 to twelve in 1992.[20] All Families Healthcare opened in 1994.[15]

In 2011, there were 8 abortion providers in the state, of which seven were classified as abortion clinics.[17] In 2014, there were five abortion clinics in the state.[17][21] 93% of the counties in the state did not have an abortion clinic. That year, 55% of women in the state aged 15 – 44 lived in a county without an abortion clinic.[22] In March 2016, there were 5 Planned Parenthood clinics in the state.[23] All Families Healthcare was destroyed in 2014 after Zachary Klundt destroyed it while searching for prescription drugs.[15]

In 2017, there were five Planned Parenthood clinics in a state with a population of 215,806 women aged 15 – 49 of which four offered abortion services.[24] In 2018, the closest abortion clinics to Flathead Valley were in Missoula, Great Falls, Helena or Billings.  These were all over 100 miles away, requiring women to travel great distances to have an abortion.  All Families Healthcare clinic in Whitefish closed for four years in early 2015, before reopening in February 2018.[15]

Statistics

In the period between 1972 and 1974, there were zero recorded illegal abortion death in the state.[25] In 1990, 84,000 women in the state faced the risk of an unintended pregnancy.[20] Between 2011 and 2014, the abortion rate in Montana declined 26%.[17] In 2013, among white women aged 15–19, there were  abortions 180, 0 abortions for black women aged 15–19, 10 abortions for Hispanic women aged 15–19, and zero abortions for women of all other races.[26] In 2014, 56% of adults said in a poll by the Pew Research Center that abortion should be legal in all or most cases.[27] In 2017, the state had an infant mortality rate of 5.4 deaths per 1,000 live births.[9]

Number of reported abortions, abortion rate and percentage change in rate by geographic region and state in 1992, 1995 and 1996[28]
Census division and stateNumberRate% change 1992–1996
199219951996199219951996
US Total1,528,9301,363,6901,365,73025.922.922.9–12
Mountain69,60063,39067,0202117.918.6–12
Arizona20,60018,12019,31024.119.119.8–18
Colorado19,88015,69018,31023.61820.9–12
Idaho1,7101,5001,6007.25.86.1–15
Montana3,3003,0102,90018.216.215.6–14
Nevada13,30015,60015,45044.246.744.61
New Mexico6,4105,4505,47017.714.414.4–19
Utah3,9403,7403,7009.38.17.8–16
Wyoming4602802804.32.72.7–37
Number, rate, and ratio of reported abortions, by reporting area of residence and occurrence and by percentage of abortions obtained by out-of-state residents, US CDC estimates
LocationResidenceOccurrence% obtained by

out-of-state residents

 YearRef
No.Rate^Ratio^^No.Rate^Ratio^^
Montana1,5048.11211,6909.113613.42014[29]
Montana1,4337.71141,6118.612813.32015[30]
Montana 1,503 8.0 122 1,618 8.6 132 9.8 2016 [31]
^number of abortions per 1,000 women aged 15-44; ^^number of abortions per 1,000 live births


Abortion financing
State Medicaid coverage of medically necessary abortion services.Navy blue: Medicaid covers medically necessary abortion for low-income women through legislationRoyal 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 Montana 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.[32] In 2010, the state had 422 publicly funded abortions, of which were 5 federally funded and 417 were state funded.[33]

Women's abortion experiences

An unnamed woman seeking an abortion in Flathead Valley in 2018 said, "In the Valley it's like, if you want to have an abortion or you want to not carry whatever to term, you're placed in a category of an irresponsible, ill-fitted individual. [...] I'm still trying to focus on getting my life together. [...] So how can I sacrifice all my goals, my dreams, my aspirations, everything I'm still working on, due to an irresponsible act of adulthood? That's being responsible so that I don't to put myself through an abortion again. Essentially in the end, I'm the one who is in this room by myself, making this choice, making this decision."[15]

In 2018, women in Flathead Valley were waiting for insurance companies to pay for IUDs or implants.  While waiting for the company to pay, they got pregnant and ended up getting an abortion.[15]

Abortion rights views and activities

Clinic protection

Around 100 volunteers support All Families Healthcare. This included driving women long distances for appointments, escorting patients inside and shoveling the sidewalk outside the clinic.[15]

Protests

Women from the state participated in marches supporting abortion rights as part of a #StoptheBans movement in May 2019.[34]

Anti-abortion views and activities

Activities

In 2018, anti-abortion rights activists regularly protested outside All Families Healthcare.[15]

Violence

On March 29, 1993, the Blue Mountain Clinic in Missoula, Montana; at around 1 a.m., an arsonist snuck onto the premises and firebombed the clinic. The perpetrator, a Washington man, was ultimately caught, convicted and imprisoned. The facility was a near-total loss, but all of the patients' records, though damaged, survived the fire in metal file cabinets.[35][36][37][38]

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. Castillo, Stephanie (2014-10-03). "States With More Abortion Restrictions Hurt Women's Health, Increase Risk For Maternal Death". Medical Daily. Retrieved 2019-05-27.
  9. "States pushing abortion bans have highest infant mortality rates". NBC News. Retrieved 2019-05-25.
  10. Mundell, E.J. (January 16, 2019). "Two-Thirds of Poor U.S. Women Can't Afford Menstrual Pads, Tampons: Study". US News & World Report. Retrieved May 26, 2019.
  11. Larimer, Sarah (January 8, 2016). "The 'tampon tax,' explained". The Washington Post. Archived from the original on December 11, 2016. Retrieved December 10, 2016.
  12. Bowerman, Mary (July 25, 2016). "The 'tampon tax' and what it means for you". USA Today. Archived from the original on December 11, 2016. Retrieved December 10, 2016.
  13. Hillin, Taryn. "These are the U.S. states that tax women for having periods". Splinter. Retrieved 2017-12-15.
  14. "Election Results 2018: Nevada Ballot Questions 1-6". KNTV. Retrieved 2018-11-07.
  15. Ouellet, Nicky. "Nurses Fight To Expand Abortion Access In Montana". www.mtpr.org. Retrieved 2019-05-28.
  16. "Study: Abortions Are Safe When Performed By Nurse Practitioners, Physician Assistants, Certified Nurse Midwives". Retrieved 25 January 2017.
  17. "State Facts About Abortion: Montana". Guttmacher Institute. 2016-01-26. Retrieved 2019-05-28.
  18. 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.
  19. Buell, Samuel (1991-01-01). "Criminal Abortion Revisited". New York University Law Review. 66: 1774–1831.
  20. 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.
  21. 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.
  22. businessinsider (2018-08-04). "This is what could happen if Roe v. Wade fell". Business Insider (in Spanish). Retrieved 2019-05-24.
  23. Bohatch, Emily. "27 states with the most Planned Parenthood clinics". thestate. Retrieved 2019-05-24.
  24. "Here's Where Women Have Less Access to Planned Parenthood". Retrieved 2019-05-23.
  25. 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.
  26. "No. of abortions among women aged 15–19, by state of residence, 2013 by racial group". Guttmacher Data Center. Retrieved 2019-05-24.
  27. "Views about abortion by state - Religion in America: U.S. Religious Data, Demographics and Statistics". Pew Research Center. Retrieved 2019-05-23.
  28. "Abortion Incidence and Services in the United States, 1995-1996". Guttmacher Institute. 2005-06-15. Retrieved 2019-06-02.
  29. Jatlaoui, Tara C. (2017). "Abortion Surveillance — United States, 2014". MMWR. Surveillance Summaries. 66 (24): 1–48. doi:10.15585/mmwr.ss6624a1. ISSN 1546-0738. PMID 29166366.
  30. Jatlaoui, Tara C. (2018). "Abortion Surveillance — United States, 2015". MMWR. Surveillance Summaries. 67 (13): 1–45. doi:10.15585/mmwr.ss6713a1. ISSN 1546-0738. PMC 6289084. PMID 30462632.
  31. Jatlaoui, Tara C. (2019). "Abortion Surveillance — United States, 2016". MMWR. Surveillance Summaries. 68. doi:10.15585/mmwr.ss6811a1. ISSN 1546-0738.
  32. Francis Roberta W. "Frequently Asked Questions". Equal Rights Amendment. Alice Paul Institute. Archived from the original on 2009-04-17. Retrieved 2009-09-13.
  33. "Guttmacher Data Center". data.guttmacher.org. Retrieved 2019-05-24.
  34. Bacon, John. "Abortion rights supporters' voices thunder at #StopTheBans rallies across the nation". USA TODAY. Retrieved 2019-05-25.
  35. "- History". Blue Mountain Clinic. Retrieved 2019-05-22.
  36. "A choice alternative". Missoula News. Retrieved June 28, 2015.
  37. MCAT Community Media (2013-10-25), Blue Mountain Clinic Aftermath, retrieved 2019-05-22
  38. "Arson suspected in abortion clinic fire". Amarillo Globe-News. Associated Press. May 30, 2000.
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