Abortion in Indiana

Abortion in Indiana is legal. 43% of adults said in a poll by the Pew Research Center that abortion should be legal in all or most cases. By 1950, the state legislature had tried to pass a law criminalizing women seeking or having abortions. By the early 2000s, the state had passed a law banning abortions after 22 weeks because they alleged that the fetus can feel pain. In 2007, the state had a customary informed consent provision for abortions in place. In 2018, the state legislature tried and failed to make abortion illegal in almost all cases.

The number of abortion clinics in the state has been declining in recent years, going from thirty in 1982 to nineteen in 1992 to nine in 2014. There were 9,765 legal abortions in 2014 and 9,546 in 2015. At least one protest as part of #StopTheBans took place in the state in May 2019. Indiana has also seen violence as a result of anti-abortion rights activities.

Terminology

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

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] The study singled out Oklahoma, Mississippi and Kansas as being the most restrictive states that year, followed by Arkansas and Indiana for second in terms of abortion restrictions, and Florida, Arizona and Alabama in third for most restrictive state abortion requirements.[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-thirds 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] This state was one of a majority that taxed essential hygiene products like tampons and menstrual pads as of November 2018.[11][12][13][14]

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.[15] In the 19th century, bans by state legislatures on abortion were about protecting the life of the mother given the number of deaths caused by abortions; state governments saw themselves as looking out for the lives of their citizens.[15] By 1950, the state legislature would pass a law that stating that a woman who had an abortion or actively sought to have an abortion regardless of whether she went through with it were guilty of a criminal offense.[15]

The state passed a law in the 2000s banning abortions after 22 weeks based on the theory (unaccepted by mainstream medical organizations) that this is the point in development after which the fetus can feel pain.[16] The state was one of ten states in 2007 to have a customary informed consent provision for abortions.[17] In 2011, the state was one of six where the legislature introduced a bill that would have banned abortion in almost all cases. It did not pass.[18] In 2013, state Targeted Regulation of Abortion Providers (TRAP) had provisions related to admitting privileges and licensing. They required clinics have hospital privileges or some similar agreement.[19]

The state legislature passed the "Sex Selective and Disability Abortion Ban" in 2016. The bill banned abortions based solely on the fetus' gender, race, ethnicity or detected disability, holding the doctors that perform them liable, and requiring women undergoing abortions to be notified of this 18 hours before the operation. The bill also demanded that aborted fetus be treated as deceased humans, requiring clinics to bury or incinerate the bodies if the woman did not take control of this. The bill was set to go into effect in July 2016, but courts have enjoined a permanent injunction against the bill's provisions on the basis these violation the right to an abortion established by Roe v. Wade. The challenge to the injunctions reached the Supreme Court of the United States by May 2019, where the Court's per curiam decision in Box v. Planned Parenthood of Indiana and Kentucky, Inc. reversed the injunction on the fetal disposal aspect, stating that had no impact on a woman's right to an abortion. The Supreme Court did not rule on any merits of the non-discriminator clauses, leaving the permanent injunction in place.

In 2018, the state was one of eleven where the legislature introduced a bill that would have banned abortion in almost all cases but were unsuccessful in passing it.[18] Nationally, 2019 was one of the most active years for state legislatures in terms of trying to pass abortion rights restrictions.  State governments with Republican majorities started to push these bills after Brett M. Kavanaugh was confirmed as a US Supreme Court judge, replacing the more liberal Anthony M. Kennedy.  These state governments generally saw this as a positive sign that new moves to restrict abortion rights would less likely face resistance by the courts.[18] The Indiana Legislature passed a ban of the most common type of second-trimester abortion procedure in the state in April 2019.[18] As of mid-May 2019, state law banned abortion after week 22.[18]

A 2021 Indiana law requires an ultrasound 18 hours or more before an abortion.[20]

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.[15]

Clinic history

Number of abortion clinics in Indiana by year

Between 1982 and 1992, the number of abortion clinics in the state decreased by eleven, going from 30 in 1982 to 19 in 1992.[21] In 2014, there were nine abortion clinics in the state.[22] In 2014, 95% of the counties in the state did not have an abortion clinic. That year, 66% of women in the state aged 15 – 44 lived in a county without an abortion clinic.[23] In March 2016, there were 23 Planned Parenthood clinics in the state.[24] In 2017, there were seventeen Planned Parenthood clinics in a state with a population of 1,505,980 women aged 15 – 49 of which four offered abortion services.[25]

Statistics

In 1990, 665,000 women in the state faced the risk of an unintended pregnancy.[21] In 2010, the state had zero publicly funded abortions.[26] In 2013, among white women aged 15–19, there were  abortions 720, 280 abortions for black women aged 15–19, 90 abortions for Hispanic women aged 15–19, and 70 abortions for women of all other races.[27] In 2014, 43% of adults said in a poll by the Pew Research Center that abortion should be legal in all or most cases.[28] In 2017, the state had an infant mortality rate of 7.3 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[29]

Census division and state	Number			Rate			% change 1992–1996
	1992	1995	1996	1992	1995	1996
East North Central	204,810	185,800	190,050	20.7	18.9	19.3	–7
Illinois	68,420	68,160	69,390	25.4	25.6	26.1	3
Indiana	15,840	14,030	14,850	12	10.6	11.2	–7
Michigan	55,580	49,370	48,780	25.2	22.6	22.3	–11
Ohio	49,520	40,940	42,870	19.5	16.2	17	–13
Wisconsin	15,450	13,300	14,160	13.6	11.6	12.3	–9

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

Location	Residence			Occurrence			% obtained by out-of-state residents	Year	Ref
	No.	Rate^	Ratio^^	No.	Rate^	Ratio^^
Indiana	9,765	7.5	116	8,118	6.3	97	6.1	2014	[30]
Indiana	9,546	7.4	114	7,957	6.1	95	5.9	2015	[31]
Indiana	9,501	7.3	114	7,277	5.6	88	7.0	2016	[32]
^number of abortions per 1,000 women aged 15–44; ^^number of abortions per 1,000 live births

Illegal and unsafe abortion deaths

In the period between 1972 and 1974, there was only one recorded illegal abortion death in the state.[33]

In Indiana, where there are also parental consent laws, a young woman by the name of Becky Bell died from an unsafe abortion rather than discuss her pregnancy and wish for an abortion with her parents.[34][35] Bell discovered she was pregnant in 1988. She went to a Planned Parenthood clinic in Indiana with her friend Heather Clark, seeking an abortion.[36] There she was told that state law required consent from her parents for the procedure and that most minors in her area simply went to Louisville, less than 100 miles away, to avoid parental disclosure.[37] She also had the option of going before a judge to argue for a waiver of parental consent, but reportedly feared that her parents would find out.[38] Bell was subsequently confused about what to do, according to Clark, alternating between plans to have an abortion in Kentucky, carrying to term and placing the baby for adoption, or running away to California.[37] On a Saturday night in September 1988, Bell left her house, telling her parents that she was going to a party.[37] She came home ill, disheveled, and in tears.[37] Her illness worsened over the next few days but she would not seek medical attention.[37] Her parents ultimately forced her to see their family physician who diagnosed severe pneumonia and had her hospitalized.[37] She died on September 16, 1988.[39]

Bell's autopsy revealed fetal matter and evidence of infection in her genital tract, but no evidence of internal injury or marks on the cervix.[37] The official cause of death was attributed to septic abortion complicated by pneumonia.[40] The county coroner and pathologist both later told the press that the abortion and infection were most likely caused by the use of unsterile instruments during an illegal abortion procedure.[37][38] After Bell's death, her parents found among Bell's possessions contact information for abortion clinics in nearby Kentucky, which did not have parental consent laws, but there was no record of her visiting a Kentucky clinic.[37] It remains unclear whether Bell obtained an induced abortion or induced the abortion herself.[37][41][42] Two years after her death, Clark, the friend who went to Planned Parenthood with Bell, told reporters that she did not believe that Bell had an induced abortion.[37]

Criminal prosecutions of abortion

Purvi Patel was sentenced to 20 years in prison in Indiana in March 2015 for attempting to induce an abortion using medications she had ordered over the internet.[43]

Abortion rights views and activities

Protests

#StopTheBans was created in response to 6 states passing legislation in early 2019 that would almost completely outlaw abortion. Women wanted to protest this activity as other state legislatures started to consider similar bans as part of a move to try to overturn Roe v. Wade. At least one protest as part of #StopTheBans took place in the state.[44]

Anti-abortion views and activities

Disciple at the Pro-Life Music Festival, Winona Lake, Indiana 2006

Abortion protester plane at 2009 Notre Dame Commencement Ceremony.

Violence

On April 11, 2013, Benjamin David Curell, 27, caused extensive damage to a Planned Parenthood clinic in Bloomington, Indiana, vandalizing it with an axe.[45][46] Curell was convicted in state court of felony burglary, and pleaded guilty in federal court to one count of violating the Freedom of Access to Clinic Entrances Act. In the federal case, he was sentenced to three years of probation and ordered to pay restitution.[47]

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. Buell, Samuel (1991-01-01). "Criminal Abortion Revisited". New York University Law Review. 66: 1774–1831.
16. Times, The New York. "Abortion Restrictions in States". archive.nytimes.com. Retrieved 2019-05-25.
17. "State Policy On Informed Consent for Abortion" (PDF). Guttmacher Policy Review. Fall 2007. Retrieved May 22, 2019.
18. Tavernise, Sabrina (2019-05-15). "'The Time Is Now': States Are Rushing to Restrict Abortion, or to Protect It". The New York Times. ISSN 0362-4331. Retrieved 2019-05-24.
19. "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.
20. "Law requiring ultrasound before abortion goes into effect Jan. 1". www.wthr.com.
21. 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.
22. 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.
23. businessinsider (2018-08-04). "This is what could happen if Roe v. Wade fell". Business Insider (in Spanish). Retrieved 2019-05-24.
24. Bohatch, Emily. "27 states with the most Planned Parenthood clinics". thestate. Retrieved 2019-05-24.
25. "Here's Where Women Have Less Access to Planned Parenthood". Retrieved 2019-05-23.
26. "Guttmacher Data Center". data.guttmacher.org. Retrieved 2019-05-24.
27. "No. of abortions among women aged 15–19, by state of residence, 2013 by racial group". Guttmacher Data Center. Retrieved 2019-05-24.
28. "Views about abortion by state - Religion in America: U.S. Religious Data, Demographics and Statistics". Pew Research Center. Retrieved 2019-05-23.
29. "Abortion Incidence and Services in the United States, 1995-1996". Guttmacher Institute. 2005-06-15. Retrieved 2019-06-02.
30. 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.
31. 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.
32. Jatlaoui, Tara C. (2019). "Abortion Surveillance — United States, 2016". MMWR. Surveillance Summaries. 68. doi:10.15585/mmwr.ss6811a1. ISSN 1546-0738.
33. 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.
34. "Pacifica Radio". 2003-01-22. Archived from the original on 2009-04-06. Retrieved 2009-05-31.
35. Platner J (2006-09-15). "Remembering Becky Bell". Planned Parenthood Golden Gate. Retrieved 2009-05-31.
36. Frolik, Joe (September 9, 1990). "Abortion debate shifting: Individuals become symbols in dispute." The Plain Dealer (Plain Dealer Publishing Co). p. 1-A, 14-A.
37. Dettmer, Jamie (May 5, 1992). "Abortion's combat zone; Parents". The Times. London.(subscription required)
38. "Becky's Story". 60 Minutes. CBS News. February 24, 1991.
39. Brotman, Barbara (April 8, 1990). "Abortion Law Blamed In Death". Chicago Tribune. On Sept. 16, 1988, Becky Bell died of what the Marion County coroner ruled was infection following an abortion and of pneumonia.
40. Abbot, Karen (October 29, 1998). "Foes of Notification Enlist Grim, Dirty Images". Rocky Mountain News. Denver. p. 11A.
41. James, Rich (June 27, 1990). "New Ruling Rekindles Abortion Debate". Post-Tribune. Becky was a vivacious, blue-eyed, blonde when she died of an infection after self-aborting in September 1988.
42. Brotman, Barbara (April 8, 1990). "Abortion Law Blamed In Death". Chicago Tribune.
43. Larson, Jordan. "Timeline: The 200-Year Fight for Abortion Access". The Cut. Retrieved 2019-05-25.
44. Arnold, Amanda (2019-05-21). "How to Join the Nationwide Abortion-Ban Protest Today". The Cut. Retrieved 2019-05-25.
45. Susan Guyett, Indiana man charged in ax attack on abortion clinic, Reuters (April 11, 2013).
46. "Police: Man caused 'extensive damage' inside Planned Parenthood using ax". FOX59. 2013-04-11. Retrieved 2019-05-22.
47. Indiana Man Sentenced for Damaging Property and Equipment at Planned Parenthood (press release), United States Department of Justice Office of Public Affairs (July 1, 2014).