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People of every age, race and class in every state get abortions


Lots of talk on how voters may react to the draft opinion indicating the Supreme Court might overturn the Roe v. Wade decision. NPR's Selena Simmons-Duffin wanted to know how things stand with health care providers and patients. Selena, thanks for being with us.

SELENA SIMMONS-DUFFIN, BYLINE: Hi, good morning, Scott.

SIMON: And let me ask you to begin with what we know that's in the statistics. Who is getting abortions in the U.S. today?

SIMMONS-DUFFIN: Well, people of every race, age, class in every state get abortions. Here's Dr. Iman Alsaden, the medical director of Planned Parenthood in Great Plains, which covers Kansas, Arkansas, Oklahoma and western Missouri. When I talked to her, she was in Wichita.

IMAN ALSADEN: We see people that are homeless. We see people that live in mansions. We are actually seeing, like, literally the full gamut of who needs abortions in our clinics.

SIMMONS-DUFFIN: According to CDC, most patients in the U.S. who get abortions are in their 20s. More than 90% of abortions are done early in pregnancy before week 13. According to the Guttmacher Institute, in 2020, more than half of abortions were what's called a medication abortion, which involves taking pills. Also, most people who get abortions are already parents, which kind of debunks the narrative that it's mostly teenagers who aren't ready for children.

SIMON: And you've been speaking with abortion providers about the range of circumstances by which patients come to them. What did you learn?

SIMMONS-DUFFIN: Right, so one OB-GYN I spoke with is Dr. Jamila Perritt here in Washington, D.C. She's president and CEO of the groups Physicians for Reproductive Health.

JAMILA PERRITT: We can go through a laundry list - you know, broken condoms, missed pills, travel, missed appointments. We can talk about sexual assault. We can talk about all kinds of reasons - genetic abnormalities, maternal indications.

SIMMONS-DUFFIN: That's just a quick list, but regardless of the circumstances, Dr. Perritt and the other providers I talked with pushed back on the idea of unwanted or unplanned pregnancies. These adjectives just don't capture what's going on in people's lives. So to explain, I talked with Dr. Jennifer Kerns, who works at the University of California, San Francisco, and travels to Oklahoma to provide abortions, and here's what she told me about one of her patients.

JENNIFER KERNS: I saw a patient in Oklahoma who had four kids. She was in her mid-20s. She had been unemployed for a while. She had just gotten a job. And she found herself pregnant. And as much as she, I think, felt connected to the pregnancy and connected to her identity as a mom, she knew that she would be a better mom to the four kids and that she would be better able to care for them if she didn't bring another kid into the world.

SIMMONS-DUFFIN: So she said she talks to her patients with the understanding that people know best what's the right next step in their lives.

SIMON: Of course, abortion is still legal in the U.S. now. If Roe were to be overturned and half of the states ban or restrict abortion, what could that mean for health care?

SIMMONS-DUFFIN: Right, so let's just run through some of the clinical situations in which someone might need abortion services - if they have a miscarriage, if their water breaks too early and they're at risk of infection, if they receive a serious diagnosis like cancer and they need to begin chemo, if fetal anomalies are detected. In all of those situations, state laws restricting abortion can have serious clinical impact on a patient's care. Our colleague Sarah McCammon told the story of one woman whose water broke at 19 weeks. She was at risk of hemorrhage or septic shock. And she had to fly from Texas to Colorado to receive care. And people who can't travel may seek unsafe abortions and face serious health consequences because of that or even die. So we will likely hear more and more situations like this when the ruling becomes final and more state restrictions take effect.

SIMON: NPR's Selena Simmons-Duffin, thanks very much for being with us.

SIMMONS-DUFFIN: Thank you. Transcript provided by NPR, Copyright NPR.

Selena Simmons-Duffin reports on health policy for NPR.