Montana Abortion Clinics Restrict Pill Access for Out-of-State Patients

Missoula, Montana — The four states bordering Montana have “trigger laws” in effect or pending now that the U.S. Supreme Court has ended federal protections for abortion, making conservative Big Sky Country an unlikely haven for women seeking to end their pregnancies.

But Montana’s potential to become an abortion refuge has been diminished — not by the lawmakers and governor whose attempts to restrict abortions have been stymied by the state constitution’s right to privacy, but by the operators of at least four of the state’s five clinics, which are preemptively limiting who can receive abortion pills.

Officials from Planned Parenthood of Montana, which operates three of the four clinics, said the intent is to ensure that they and their patients from states with trigger bans — laws to ban or restrict abortion that were designed to go into effect if Roe v. Wade was struck down — are protected from criminal charges and lawsuits. The policy change creates another problem for women in South Dakota and other neighboring states who want to end their pregnancy.

“That was a state that we were hoping was going to be available,” said Kim Floren, director of the Justice Through Empowerment NetworkSouth Dakota’s Abortion Fund provides financial assistance to women who need it. “At this point, it’s just more bad news on top of more bad news.”

Patients prefer medication abortions to other abortion options because they are less expensive, take less time at the clinic, and allow them more control. The most popular type of abortion is medication. medication abortionThis is a two-part regimen. The first dose is taken in the clinic if necessary; the second is usually at home. The medications can be sent to the patient in many states after a telemedicine appointment.

According to the U.S. Census Bureau, 2020 saw more than half of all abortions in the United States. the Guttmacher InstituteThe, a research group that supports abortion rights. Advocates for medication abortions fear that they will be the target of new state laws. South Dakota’s July 1st law bans telemedicine for abortions.

The Planned Parenthood policy change in Montana is a response to the shifting legal landscape, said Jennifer Sandman, senior director of public policy litigation and law for Planned Parenthood’s national organization. “People are acting under conditions of extraordinary chaos and fear that has been instilled by where the Supreme Court has left us and by threats by anti-abortion politicians in some states,” Sandman said.

Planned Parenthood of Montana voted June 30 not to offer abortion pills at their clinics of Billings, Great Falls and Helena to patients who are residents of states that have passed trigger laws. Although bans were in effect in South Dakota, Arkansas and Missouri at the time, Planned Parenthood officials stated that they see a significant amount of South Dakota patients. When asked how many South Dakotan patients would be affected, the officials didn’t respond.

Montana’s other neighbors — Idaho, Wyoming, and North Dakota — also have trigger laws, but they have not yet gone into effect.

Martha Fuller (President of Planned Parenthood of Montana) wrote in an internal memo, that the risks of cross state provision of services were not clear. Fuller also expressed concerns about the possibility of civil and criminal action against anyone providing medicine that would terminate a pregnancy to women from states with bans. The memo was posted to Twitter by a freelance journalist, and later deleted. Officials from Planned Parenthood confirmed that the policy was changed.

Out-of state residents can still have abortions performed at the three Montana Planned Parenthood clinics. “Right now, we believe that that is the best way of ensuring that out-of-state patients are not afraid to access the essential follow-up care they may need because of the intimidation and fear-mongering of extreme anti-abortion politicians,” said Laura Terrill, a spokesperson for Planned Parenthood of Montana.

The Planned Parenthood decision followed a report by the Missoulian that Blue Mountain Clinic in Missoula would offer medication abortions. only to people with a Montana address. Officials from the clinic did no respond to emails or calls.

All Families Healthcare in Whitefish is the fifth Montana abortion clinic. It declined to answer questions regarding its policies for patients from outside of Montana.

Fuller mentioned in her memo, that the Planned Parenthood Policy could change as the legal risk becomes clearer. Not mentioned in the memo is that Montana’s status as a state with legal access to abortion could soon change, as well.

Montana’s Republican-majority legislature and Republican governor passed four state laws in 2021 meant to restrict abortions, but three were blocked by a judge, who cited a 1999 state Supreme Court ruling that said abortion is a right under the Montana Constitution. The state’s attorney general is asking the Montana Supreme Court to reverse that precedent and let the laws go into effect. A decision is currently pending.

The Montana chapter is not the only Planned Parenthood network that is temporarily changing its policies around abortion pills because of the chaotic aftermath of the Supreme Court’s actions. Planned Parenthood North Central States provides medication abortions for Minnesota, Iowa and Nebraska. its patients must take the pills in states where abortion is legal.

South Dakota’s trigger lawPreparing or administering a substance which causes an abortion is a felony. However, it does not apply to people who have had abortions. Floren, of the Justice Through Empowerment Network, said there’s still fear that South Dakotans might be investigated or charged if they’re caught with pills within the state or if they need to go to a medical provider for assistance because of a complication. “A lot of people really prefer that method and now this is just once again taking people’s choice,” she said.

The policies that restrict access to out-of-state patients are not supported by providers in other states that have made legal abortion illegal. In Colorado, Dr. Nancy Fang, an OB-GYN with the Comprehensive Women’s Health Center in Denver, said she understands caution in the face of the uncertainty that surrounds state abortion bans. She said that limiting access to abortions will not only harm patients but also add stress to other clinics that provide medication abortions.

“I think it is really impactful on the patient because it further restricts their autonomy for access to health care, not being able to access a safe option just based off of where they’re coming from,” Fang said.

Planned Parenthood of the Rocky Mountains, which serves Colorado, New Mexico, Wyoming, and parts of Nevada, does not plan to change its policies, though spokesperson Neta Meltzer said her organization supports other affiliates like the one in Montana “making heartbreaking decisions.”

“We serve all patients equally, those living in our own communities and those fleeing hateful bans in their home states,” Meltzer said.

Abortion procedures are considered to be more effective than abortion pills. However, they are more invasive by nature. The procedure requires a patient’s cervix to be dilated using surgical tools, and patients often take anti-anxiety medication or intravenous sedatives. People who have been abused or abused by their partners may be able to claim they had a miscarriage with pills. The amount of bleeding and other symptoms are the same.

Just the Pill, an organization that is opposed to Planned Parenthood’s ban on abortion pills distribution in Montana, plans to expand. Patients can make telehealth visits with Just the Pill doctors and then pick up the pills in Montana or Minnesota, Wyoming, Colorado.

After the Supreme Court’s decision, the company said it would send a fleet of mobile clinics to state lines to provide services for women from states with abortion restrictions. “By operating on state borders, we will reduce travel burdens for patients in states with bans or severe limits,” the company said in a statement.

Floren said that she hopes Just the Pill can continue to provide services to South Dakotans. Justice Through Empowerment Network has experienced an influx in donations and volunteers. Floren stated that the abortion fund is preparing people to attend a special legislative session in which she expects legislators to target those who distribute or donate abortion aid.

KHNReporter Erica Zurek and Rae Ellen Bichell contributed to this report.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling KHNThis is one of three major operating programs. KFF(Kaiser Family Foundation). KFF is an endowed non-profit organization that provides information to the nation on health issues.