Family Planning in Today’s Ohio
“I don’t want to deal with a pregnancy in this political climate.” I’ve been hearing that from many of my clients of child-bearing age. We live in Ohio, so their fears are justified: Although our state voted two years ago to keep abortions legal, our Attorney General is challenging this mandate in the notoriously right-leaning Ohio courts.
The women saying they are afraid to become pregnant are in stable relationships and hope one day to be able to have a family. In fact one client and her husband started trying to get pregnant in early 2024, hoping to be able to conceive well before inauguration day 2025 on the off-chance anti-abortionists were elected to office, as they in fact were. My clients weren’t quite ready to start the process, which they knew could be long and arduous and full of miscarriages because of her diagnosis of PCOS, but given the fact that there was a real scenario in which she could be forced to carry a miscarriage until it expelled itself from her body, they were willing to start the process a bit before it was ideal.
And can I tell you, she did lose a pregnancy, and had to keep the fetus in her womb until the clinic could schedule a D&C, five days later. My own experience with miscarriage amounts to one missed period and a positive pregnancy test followed by a heavier-than-normal period a week later. That one positive pregnancy test and a very late period, which came two years after my first child was born, had, in my mind, a due date and possible names. My older child was a sister, and we were the parents of two. For a week, I nurtured this fantasy, until the heavy bleed that announced its death. And while it was just a period, like so many hundred I’d had before, it did feel like a death. We’d looked up what its astrological sign would be. We wondered what it would be like to have a spring baby, after our summer baby. We began thinking of our year in terms of that pregnancy, I’d be so big by the time the family reunion rolled around; if we as a couple were going to go on vacation, we should do it soon … in no time at all, that absent period evolved into a chuckling baby, keeping us up at night, making its sister laugh, foiling our plans for a May getaway.
The period announced the end of the pregnancy; was, in fact, the end of that formation of cells. Cells even? Mitochondria? DNA strands? A week of rapid reproduction is nothing compared to the fetus my client miscarried in her body.
Even as we wait for our Ohio judges to strike down the ban on bans on abortions after 6 weeks, our women are challenged: as this article in Mother.ly makes clear, in the aftermath of the loss of Roe v. Wade clinics and doctors have had to make difficult decisions about their liability in performing uterine care procedures which could be mistaken for “illegal” abortions:
Because the procedures for miscarriage care after pregnancy loss (like a D&C, or dilation and curettage) are the same as those for abortion care, clarification on how those procedures are used is critical to avoid putting both providers and patients at risk of committing a crime. Now, the question of is a D&C an abortion may depend on if fetal heart tones are present before the procedure is performed. If they are, in some states, a D&C could be considered an abortion in that it results in the termination of pregnancy. That ultimately means that whether a D&C is an abortion may now depend on where you live.In states where abortion is essentially banned, “There could be barriers and delays to getting a D&C that should not exist, but that now likely will,” says Sarah Hartwick Bjorkman, MD, a board-certified OB-GYN and Motherly’s Maternal Health Advisor, who practices in Iowa. (https://www.mother.ly/health-wellness/womens-health/is-d-and-c-an-abortion-dilation-and-curettage/).
As mental health providers we must be knowledgeable about pregnancy loss and the surrounding political climate. Although I’ve always voted in favor of pro-choice, I’m not as educated as I’d like to be about Ohio abortion laws. I’m going to list some links below for those of you who’d like to get educated on this topic, too.
Pregnancy Loss: Consequences for Mental Health
Your Right to Abortion Care in Ohio, ACLU When Miscarriage is a Crime
History of Abortion in the U.S.
Abortion Law Timeline, Including History of Attacks on Women’s Reproductive Health
