Marylanders must travel for abortions late in term

Wednesday, June 10, 2009

"If women in Maryland need that kind of care, they are going to be traveling somewhere" because there aren't many doctors who will do the procedures, said Laura Meyers, president of Planned Parenthood of Metropolitan Washington, which serves Montgomery and Prince George's counties, the District of Columbia and 15 counties in Northern Virginia.

The issue of late-term abortion came into focus late last month when Dr. George Tiller, who performed the procedure at his clinic in Wichita, Kan., was shot and killed May 31 at his church.

In fact, more than three decades after the Supreme Court's decision in Roe v. Wade made abortion legal throughout the United States, access to an abortion, regardless of the stage of pregnancy, remains difficult in many places, including much of Maryland. Some rural counties have no abortion providers. Women who live on the Eastern Shore and in far western Maryland generally have to travel to more-populous areas for abortion procedures, officials said.

The Guttmacher Institute, a nonprofit reproductive health advocacy group that was once a part of Planned Parenthood, estimates that 29 percent of Maryland pregnancies end in induced abortion, compared with 19 percent nationally.

Like its sister organization that covers metropolitan Washington, D.C., Planned Parenthood of Maryland, which serves the rest of the state, refers most women seeking a late-term abortion to distant providers. What's commonly referred to as a late-term abortion is performed late in the second trimester or in the third, when fetuses normally are viable outside the womb.

The three Planned Parenthood clinics in Maryland that perform abortions — in Annapolis, Baltimore and Silver Spring — do not offer the procedure past 13 weeks and six days into pregnancy.

Planned Parenthood clinics in Washington, D.C., do not offer abortion beyond 18 weeks, and in Virginia, the procedure is not allowed beyond 14 weeks.

A few private clinics in metropolitan areas provide abortions as late as 20 to 24 weeks.

Some Baltimore private clinics refer women seeking late-term abortions to the Washington Surgi-Clinic in northwest Washington, D.C., which offers the procedure up to the 26th week of pregnancy.

But Maryland women seeking late-term abortions generally are referred to clinics in Cherry Hill, N.J.; Boulder, Colo.; Atlanta; Seattle and, at least until recently, Wichita.

The D.C. Abortion Fund — which helps low-income women in Maryland, Virginia, Washington, D.C., and, sometimes, other mid-Atlantic states pay for abortions — referred four women to Tiller's Kansas clinic last year, said Tiffany Reed, president of the fund.

"And that's only folks who had problems paying," she added.

Some obstetricians and gynecologists perform abortions, but their practices are not identified as abortion clinics, said Wendy Royalty, spokeswoman for Planned Parenthood of Maryland.

Many doctors say, "‘I'm not equipped to do this' — people also know that those who do late-term abortions are targeted," and they don't want to risk harm to themselves or their families, Royalty said.

Even when abortion is available, "if you don't have the money to pay, you don't have a choice," Reed said.

For Medicaid to pay for an abortion, a physician must certify that it is medically necessary, said officials at Maryland's Department of Health and Mental Hygiene.

Maryland had 3,831 Medicaid claims for abortions in the 2006 budget year and 3,580 in 2007, according to the department.

Aside from Medicaid claims, abortion reporting has been voluntary in Maryland, and DHMH stopped tracking voluntary reports in 2006, citing staff and budget constraints.

In the 2006 budget year, which includes half of 2005, 8,139 abortions were reported to the state from 11 facilities under the state's voluntary reporting policy. That was less than half the 18,429 reported for 1992 by 28 facilities.

The cost of an abortion, which Reed says is about $400 to $500 before the 12th week of a pregnancy, increases about $100 a week or more thereafter.

"Women are not waiting because they want to; a lot of times they are chasing the cost," she said.

Most women who seek late-term abortions wanted the pregnancy, but learned late that there is a life-threatening problem or physical anomaly that threatens their health or that of the child, Reed said.

mhyslop@gazette.net