Abortion in North Dakota

Abortion in North Dakota is legal. 47% of adults said in a poll by the Pew Research Center that abortion should be legal in all or most cases. By 1950, abortion or seeking an abortion was a criminal offense in the state.  Informed consent laws were on the books by 2007.  Informed consent materials said things like at 10-weeks, the fetus "now has a distinct human appearance" and that "eyelids are formed."  The materials said at 14 weeks, the fetus  "is able to swallow" and "sleeps and awakens." In March 2013, Gov. Jack Dalrymple of North Dakota signed into law a bill banned abortion at 6 weeks. More laws were passed in 2013 seeking to ban or limit abortions, and these eventually wound up at the 8th U.S. Circuit Court of Appeals.

Following abortion becoming legal by judicial rule in 1973, two abortion clinics opened in the state, one in Grand Forks and one in Jamestown. A third clinic opened in 1981, and the state had three clinics until 1991 when the number dropped to one where it would remain except for a period or between 1998 and 2001 when it was two. In May 2019, the state was one of six states in the nation with only one abortion clinic. Abortion rates in the state have remained in relatively stable decline since the 1990s, with 1,490 legal abortions in 1992,  1,330 in 1995, 1,290 in 1996, 1,264 in 2014,  and 1,166 in 2015. There are both abortion rights and anti-abortion rights activists active in the state.

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-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
Fetal heartbeat bills by state, including time limit without exceptions marked:
  Heartbeat bill passed (to go into effect)
  Law partially passed by state legislature
  Law blocked by court order

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 was one of 23 states in 2007 to have a detailed abortion-specific informed consent requirement.[16] Mississippi, Nebraska, North Dakota and Ohio all had statues in 2007 that required specific informed consent on abortion but also, by statue, allowed medical doctors performing abortions to disassociate themselves with the anti-abortion materials they were required to provide to their female patients.[17] North Dakota's informed consent materials included a definition for fetus of "a Latin word meaning young one or offspring." [17] According to North Dakota's materials, at 10-weeks, the fetus "now has a distinct human appearance" and that "eyelids are formed."  The materials said at 14 weeks, the fetus  "is able to swallow" and "sleeps and awakens."[17]

North Dakota's HB 1572, otherwise known as the Personhood of Children Act, was a bill in the North Dakota Legislature which aims to "provide equality and rights to all human beings at every stage of biological development". This step could eventually eliminate all types of abortion for nearly any reason in the state of North Dakota.[18] It would allocate rights of "the pre-born, partially born." If it had passed, it would have likely been used to challenge Roe v. Wade.[19]

In March 2013, Gov. Jack Dalrymple of North Dakota signed into law a bill presented to him by the legislature that would have banned abortions in the state 6 weeks after a woman's first missed period.  [20][21] Only North Dakota successfully passed "fetal heartbeat" law that year but it was later struck down by the courts.[21] In 2013, state Targeted Regulation of Abortion Providers (TRAP) had provisions related to admitting privileges and licensing. They required clinics have hospital privileges.[22]

The state had a law on the books in August 2018 that would be triggered if Roe v. Wade was overturned.[23] In mid-May 2019, abortion was banned after week 22.[21] North Dakota HB 1456 was signed into law in March 2013[24] by Jack Dalrymple, who stated that it was "a legitimate attempt by a state legislature to discover the boundaries of Roe v. Wade." A federal district court found that it clearly violated the constitutional protections afforded in Roe v. Wade and it was quickly blocked.[25]

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] In July 2015 the Eighth Circuit Court of Appeals affirmed a lower court decision blocking HB 1456 from going into effect.[26] The U.S. Supreme Court declined to review the case and the law remains permanently blocked.[27] In July 2013, a lawsuit had been filed with regard to the law by the Center for Reproductive Rights (CRR), on behalf of the only abortion clinic in North Dakota, Red River Women's Clinic. In July 2015, the 8th U.S. Circuit Court of Appeals blocked the bill.[28] The case was appealed to the Supreme Court, but the court denied a writ of certiorari in January 2015 and let stand the decision of the 8th Circuit Court of Appeals.[29]

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

Following the Roe v. Wade ruling, two abortion clinics opened in the state, one in Grand Forks and one in Jamestown.[30] Around 1981, when the doctors in Grand Forks and Jamestown were getting close to an age where they wanted to thinking about retiring, they reached out to Jane Bovard and asked her to open a clinic in Fargo.  Bovard had a history of supporting abortion rights in the state by assisting women in traveling to Minneapolis or cities in other states to get abortions. She agreed and with the help of Susan Hill opened a Women's Health Organization affiliate in the fall of that year.[30] From 1981 to 1991, there were three abortion clinics in the state. In 1991, the doctors in Grand Forks and Jamestown both retired, leaving the Women's Health Organization as the only abortion provider in the state.[30][31] In the period between 1992 and 1996, the state saw no change in the total number of abortion clinics. While only three states saw gains in this period, this state was one of four to see no changes with one abortion clinic in the state in 1996.[32]

Dr. George Miks was the primary physician at the Women's Health Organization in 1993. Around 1998, he and Jane Bovard felt they could improve on the services offered by the Women's Health Organization so the pair opened a second clinic in the state called the Red River Clinic in Fargo. It officially opened on July 31, 1998. Located only 6 blocks apart, the two clinics were in competition with each other for about two and a half years.[30] In February 2001, Women's Health Organization closed unexpectedly.[30] Around 1998, the number of abortions performed at the Red River Clinic per week was around 25.[30] By 2017, the numbers had dropped slightly to be around 20 to 25 abortions a week.[30]

In 2008 and 2014, there was still only one abortion clinics in North Dakota.[33][34] In 2014, 98% of the counties in the state did not have an abortion clinic. That year, 73% of women in the state aged 15 – 44 lived in a county without an abortion clinic.[23] In 2016, only a small section of the state required women to drive fewer than 40 miles to access an abortion clinic.[35] In 2017, there were zero Planned Parenthood clinics in the state.[36] North Dakota, Wyoming, Mississippi, Louisiana and Kentucky were the only five states as of July 21, 2017 not to have a Planned Parenthood clinic that offered abortion services.[36] In May 2019, the state was one of six states in the nation with only one abortion clinic.[37]

Statistics

In the period between 1972 and 1974, there were zero recorded illegal abortion deaths in the state.[38] In 1990, 68,000 women in the state faced the risk of an unintended pregnancy.[31] The lowest number of legal induced abortions by state in 2000 occurred in Idaho with 801, while South Dakota was second with 878, and North Dakota was third with 1,341.[39] Idaho had the fewest induced abortions in 2001 with 738, while South Dakota was second with 895, and North Dakota was third with 1,216.[40] In 2003, the state of South Dakota had the lowest number of legal induced abortions with 819. Idaho was second with 911, while North Dakota was third with 1,354.[41] In 2010, the state had 0 publicly funded abortions.[42] In 2014, 47% of adults said in a poll by the Pew Research Center that abortion should be legal in all or most cases.[43] In 2017, the state had an infant mortality rate of 4.3 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[32]
Census division and stateNumberRate% change 1992–1996
199219951996199219951996
West North Central57,34048,53048,66014.311.911.9–16
Iowa6,9706,0405,78011.49.89.4–17
Kansas12,57010,31010,63022.418.318.9–16
Minnesota16,18014,91014,66015.614.213.9–11
Missouri13,51010,54010,81011.68.99.1–21
Nebraska5,5804,3604,46015.712.112.3–22
North Dakota1,4901,3301,29010.79.69.4–13
South Dakota1,0401,0401,0306.86.66.5–4
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^^
North Dakota 1,490 10.7 1992 [32]
North Dakota 1,330 9.6 1995 [32]
North Dakota 1,290 9.4 1996 [32]
North Dakota1,0097.0891,2648.811130.32014[44]
North Dakota9766.6861,1667.910329.62015[45]
North Dakota 955 6.5 84 1,160 7.9 102 26.7 2016 [46]
^number of abortions per women aged 15–44; ^^number of abortions per 1,000 live births


Abortion rights views and activities

Protests

Women from the state participated in marches supporting abortion rights as part of a #StoptheBans movement in May 2019.[47]

Anti-abortion rights views and activities

Activities

Protesters picketed outside the home of Jane Bovard many times.[30]

Violence

Anti-abortion rights activist threatened Jane Bovard many times, including while outside her home. She responded by calling the police; her husband helped protect her by loading his shotgun.[30]

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. "State Policy On Informed Consent for Abortion" (PDF). Guttmacher Policy Review. Fall 2007. Retrieved May 22, 2019.
  17. "State Abortion Counseling Policies and the Fundamental Principles of Informed Consent". Guttmacher Institute. 2007-11-12. Retrieved 2019-05-22.
  18. North Dakota Personhood Bill Passes, First in US History - Standard Newswire
  19. "US state's 'personhood' law would hit birth control: opponents" 2009-02-18 AFP
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  25. Lithwick, Dahlia (July 23, 2015). "A Regrettable Decision". Slate. Retrieved August 11, 2015.
  26. Pieklo, Jessica Mason (July 22, 2015). "Federal Court Blocks North Dakota Heartbeat Ban, Calls on the Supreme Court to Overturn 'Roe'". Rewire News. Retrieved February 10, 2019.
  27. "Heartbeat Bans". rewire.news. Retrieved February 10, 2019. As with Arkansas’ law, the U.S. Supreme Court declined to review the case. The law remains permanently blocked.
  28. "N.D. makes next move after controversial abortion law overturned". CBS News. Associated Press. May 14, 2014. Retrieved August 11, 2015.
  29. Williams, Pete. "Supreme Court Rejects North Dakota Appeal on Abortion Restrictions". NBC News. NBC News. Retrieved December 7, 2016.
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  37. Holly Yan. "These 6 states have only 1 abortion clinic left. Missouri could become the first with zero". CNN. Retrieved 2019-06-02.
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