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How will abortion bans be enforced?

The good news is that anti-abortion zealots don’t yet know how they’re going to force women to give birth. The bad news is we cannot count on that to continue to be true.

Right there with them

It took next to zero effort for pandering Republican state legislators to obtain cut-and-paste, ALEC-generated laws banning and criminalizing all abortions in their states, then brag and fundraise after such laws were passed by a willing Republican governor. But now that the Supreme Court is apparently set on overruling Roe v. Wade, the much harder part—as Republicans are about to find out—is figuring out how such laws terrorizing pregnant people will actually work in practice.

How do you go about catching and punishing someone who violates these laws? What tools of law enforcement will be necessary? How do you collect the evidence necessary for a prosecutor to charge someone with “aiding and abetting” an illegal abortion, for example? Can you dangle a lesser sentence if they agree to confess or cooperate against the suspect? And once the unrepentant offender has been apprehended, what sort of forensic examination methods or interrogation techniques should be utilized to prove their “crime?” Under what conditions?

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None of the states that provide “exceptions” in cases, for example, involving rape or incest, or to protect the health and life of the mother could provide any guidance as to how such determinations would be made. As Einbinder and Kaskins point out, nearly two-thirds of rapes go unreported, so what type of evidence would be required to apply such an exception? Idaho, Mississippi, and Utah require that the rape be reported to law enforcement before an abortion will be “permitted,” while other states do not. Do prosecutors expect the rapist to voluntarily confirm his behavior?

And what type of medical testimony would be sufficient to establish that a person’s life was actually threatened by their pregnancy? Would there exist a ready cottage industry of experts used by prosecutors to rebut such a claim? Would doctors in a state that provides no such exception be forced to simply sit and watch the pregnant person die?

As Einbinder and Kaskins observe, no one in any of these states so eager to criminalize reproductive choices seems to know the answers to any of these questions. Most of Insider’s requests yielded no records (one district attorney from Shelby County, Tennessee, called their inquiries “political grandstanding”), or were met with bland statements that the agency was not involved in “enforcement”.

It seems clear to me that a big part of the playbook is just having laws that criminalize abortion in whatever form on the books. As we know from the SB8 experience, that by itself serves to intimidate and scare many women away from exploring whatever options they may still have, and also incentivizes fellow zealots to rat out anyone they suspect of engaging in behavior they don’t like – remember, it was someone involved in Lizelle Herrera’s medical care that reported her to law enforcement. If that’s not enough, the next step will be to make it easier for law enforcement to investigate the women in question, which will necessarily mean invasive searches of medical records, Internet and phone records, and who knows what else. Just look at the DFPS investigations of the families of trans kids for a preview of what that might resemble.

It’s likely that at least at first, enforcement of new anti-abortion laws will be uneven, as prosecutors will exercise their discretion as they can. The current Bexar County DA has already said he won’t prosecute abortion cases, and he won’t be alone in that. But DAs can lose elections, and with Ken Paxton actively seeking to bulldoze over DAs who refuse to go along with his agenda, authorizing the AG to pick up these prosecutions will be on the agenda if the zealots deem it necessary. There are no norms or traditions or existing laws that will stop them.

There do remain some ways for blue cities and suburbs to put up resistance even with all that.

Data. Immigration sanctuary cities responded to shifts in federal law during the Trump administration with a data management strategy. Do you need someone’s immigration status? If not, don’t write it down or put it in a database. Local hospitals, whether in red or blue states, should carefully consider what kind of records they must keep about people accessing care related to abortion or miscarriage, along with other kinds of soon-to-be-banned care. County hospitals can also commit to objecting to subpoenas requesting medical records, and instead force courts to compel their cooperation. They can choose not to question a patient’s narrative; they can decline to allow police to question a hospitalized patient.

Nonprosecution. Progressive district attorneys have won election in cities across the country in recent years, including in red states. Some in red states have already said they will refuse to prosecute criminal cases involving abortion. We need to demand that progressive prosecutors nationwide use their broad discretion to decline to prosecute doctors and patients for accessing abortion, for “suspicious” miscarriages, and for using types of birth control outlawed by state abortion laws that mistake pregnancy prevention for pregnancy termination. Even in states like Texas and Florida, it is often local elected prosecutors who will be making those determinations, at least for now.

On the flip side, advocates should be partnering with civil liberties organizations to scrutinize local police departments’ use of big data technologies, which could be used to identify and locate those who have accessed abortion care. Some cities, such as Oakland, California, have privacy task forces that must approve any new technology used for surveillance purposes. Such government bodies could, for example, refuse to approve any technology that makes use of data from period- or fertility-tracking apps. Cities might also consider directing their own police departments not to run searches of residents’ internet searches related to health care.

With the right resources, public libraries could also provide a space for residents to search for information related to self-managed abortion without leaving a search history on their personal devices. Blue cities in red states could provide funds to advertise the availability of library computers, purchase more devices if needed, and even set up the physical space in a way that affords computer users some degree of privacy.

Advice. Another important role cities play is giving advice to their agencies and hospitals and to the public at large. Cities can advise OB-GYNs concerned about their own vulnerabilities, particularly given laws that seek to criminalize routine care even when performed out of state and to deputize citizens to sue health care providers. These localities should develop a clear channel for providers to ask questions about how best to protect themselves while still providing care. Many local governments already have systems in place for disseminating information. During the pandemic, cities have used websites, automated texts, central phone lines, and more to make rapidly changing information and guidance available about COVID-19. Drawing on these strategies, local librarians and public health departments can play an important role in providing information about self-managed abortions. Cities need to think about how their employees might provide guidance, such as by handing out informational pamphlets or via websites and transit ads, and explore strategies for protecting employees and residents alike from liability.

These are all good ideas, but we’ve already seen in Texas that the Republican legislature and state leadership will not let cities stand in their way of anything. As long as they have the power to pass laws that overrule local ordinances or compel cities to do things, they will. It always comes back to the same truth that until we change who’s in charge of the state, we’re not going to be safe from this kind of abuse. We can brainstorm and strategize all we want, and we will have to for at least the short term, but in the long term that’s a losing battle. Winning more elections is the only way forward.

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