Anti-abortion groups tried to distance themselves from Republican presidential candidate Donald Trump on Wednesday after he said in an interview with MSNBC’s Chris Matthews that abortion should be banned and that there should be "some form of punishment" for patients who receive the procedure.
Trump’s comments were out of step with what other Republicans have said about abortion -- namely, that the doctors who perform the procedure are the ones who should be punished, rather than the patients who undergo it. Anti-abortion groups often argue that patients who get the procedure do so out of desperation and regret it later. It's uncommon to hear them say that patients themselves ought to be charged or otherwise penalized.
Trump, for his part, walked back his comments in a public statement later that day (while also denying that he was walking anything back). But the punitive spirit of his initial remarks is wholly of a piece with the types of abortion restrictions that Republicans have already backed in Congress and in state legislatures. Dictionary definitions of "punishment" include “severe, rough, or disastrous treatment” and “suffering, pain, or loss that serves as retribution,” all of which seem like fair ways to characterize many of the rules that already exist. Republicans know they can’t flat-out prevent patients from obtaining abortions -- at least not with the current president and Supreme Court -- so they’ve made it as onerous as possible for the one-third of women who will have an abortion at some point in their lives.
Here are some of the ways women who seek abortions already get punished:
1) Waiting periods
The Supreme Court upheld a 24-hour waiting period in 1992’s Planned Parenthood v. Casey decision, with the rationale that it’s OK for the government to try to persuade women to forego abortion to protect potential life. Since then, states have gone beyond that requirement and passed 48-hour and 72-hour waiting periods, forcing patients to make multiple trips to clinics and incur the extra costs associated with child care, hotels and gas or bus tickets.
A number of states require providers to tell women there are links between abortion and breast cancer or abortion and depression, even though medical authorities say there are no such links. The same goes for requiring providers to perform abortions where they describe features of the fetus to the patient with an ultrasound before the procedure can take place.
3) Restrictions on insurance coverage for abortion
The Hyde Amendment, which prevents Medicaid from covering most abortions, essentially punishes low-income women for being poor -- and that’s exactly what former Rep. Henry Hyde (R-Ill.) had in mind in the late 1970s when he advocated for the proposal. More women are punished when states prohibit private insurance plans from covering the procedure.
4) Banning the most commonly used method for second-trimester abortions
Kansas and Oklahoma have tried to ban dilation and evacuation, a method used in the vast majority of second-trimester abortions and one that providers say is the safest.
Republicans advocate abstinence-based education in schools, and then punish the teens who inevitably get pregnant by requiring them to get permission from their parents to have abortions. Some states, like Texas, make the process of getting a “judicial bypass” to have an abortion without the permission of a parent especially difficult.
6) Laws requiring abortion clinics to look like mini-hospitals
Legislators have passed laws requiring abortion clinics to be constructed as “ambulatory surgical centers” out of a purported concern for women’s health. In reality, this is done because it means clinics are later forced to close when they can’t afford the prohibitive cost of the upgrades.
7) Laws requiring abortion providers to have admitting privileges at local hospitals
Clinics close when hospitals won’t grant admitting privileges to abortion providers out of a fear of harassment and violence from anti-abortion activists.
8) Telemedicine bans
Republicans in a number of states have blocked patients from accessing medication abortion via telemedicine when they live in rural areas without a clinic they can easily travel to.
9) Requiring an outdated regimen for administering medication abortion
Many abortion providers, until Wednesday, had been using an off-label protocol for providing medication abortions to patients, because the Food and Drug Administration’s directions were medically outdated and dictated that the medication be provided at too high a dose. States with Republican-controlled legislatures took advantage of this disconnect between what abortion providers do and what the FDA said they should do to pass laws preventing providers from going off-label, which meant more side effects for patients.
10) Pre-viability abortion bans
Severe fetal abnormalities are usually only detectable after the 20th week of pregnancy, but Republicans in Congress and at the state level have passed laws banning abortions after this point, based on the medically unproven claim that fetuses can feel pain.
11) Congress telling D.C. what to do
In 2011, while trying to avoid a government shutdown, President Barack Obama famously told then-House Speaker John Boehner (R-Ohio), “John, I’ll give you D.C. abortion” -- thus trading away the city’s right to fund abortions for low-income women using its own locally raised revenue. Now, Republicans punish abortion patients for wanting abortions, and punish D.C. for not being a state, by preventing the district from funding abortions for low-income people through Medicaid.
12) Telling patients to go to another state if they want to have an abortion
In its fight over ambulatory surgical center and admitting privileges requirements that’s being considered by the Supreme Court, Texas has argued that patients in the western part of the state could simply travel over the border to New Mexico to have an abortion if clinics in that region are forced to close.
13) Actually jailing women for miscarriages or self-inducing
This is something that is already happening.
In an attempt to clarify his comments, Trump said on Wednesday that he thinks states to be able to decide if and how to punish patients who seek abortions. As Supreme Court Justice Ruth Bader Ginsburg noted last year, if Roe v. Wade were to be overturned, low-income patients would be punished for seeking abortions even more than they are now, because they’d face more difficulties traveling to states where abortion would remain accessible.
There’s a sorry situation in the United States, which is essentially that poor women don’t have choice. Women of means do. They will, always. Let’s assume Roe v. Wade were overruled and we were going back to each state for itself, well, any woman who could travel from her home state to a state that provides access to abortion, and those states never go back to old ways... So if you can afford a plane ticket, a train ticket or even a bus ticket you can control your own destiny but if you’re locked into your native state then maybe you can’t. That we have one law for women of means and another for poor women is not a satisfactory situation.