Alabama Abortion Law: How Did They Vote?

On May 15, 2019, Alabama Governor Kay Ivey signed a bill into law prohibiting all abortions in the state except those necessary to prevent a serious health risk to the woman. The bill, called the Human Life Protection Act, was approved by all voting Republicans and three voting Democrats in the legislature. It makes performing an abortion a felony punishable by up to 99 years in prison for doctors. The law disproportionately affects black and poor women, who are more likely to seek abortions and less likely to have the resources to obtain an abortion out-of-state.

The Alabama Human Life Protection Act

The act prohibits abortions at any stage of development, regardless of viability. The only exceptions are if the mother's life is at risk or if the foetus has a lethal anomaly. It does not make exceptions for cases of incest, rape, or human trafficking.

The act classifies performing an abortion as a felony, with doctors performing the procedure facing a prison sentence of up to 99 years.

The act closely resembles an abortion ban that has been part of Alabama law for over 100 years, which was rendered unenforceable by the U.S. Supreme Court decision in Roe v. Wade. Governor Ivey acknowledged that the bill may be unenforceable in the short term but expressed her hope that the U.S. Supreme Court would revisit the issue.

The act was sponsored by Rep. Terri Collins and Sen. Clyde Chambliss.

The law does not include exceptions for rape or incest

The Alabama Human Life Protection Act, also known as the state's abortion ban, does not include exceptions for rape or incest. The law only allows for limited exceptions in cases that pose "serious health risks" to the pregnant individual. However, this vague language provides little guidance to abortion providers, who are left with uncertainty about how to interpret and act upon the law.

The lack of exceptions for rape and incest in Alabama's abortion ban has been widely criticised. The American Civil Liberties Union (ACLU) of Alabama has stated its opposition to the law, arguing that abortion ban exceptions are not workable solutions. They claim that expecting survivors of sexual assault or incest to plead their case to a judge, lawyers, and hospital administrators is cruel and unfair. The ACLU also highlights the difficulty of obtaining abortion care for survivors in states with restricted access, even when exceptions are in place.

The absence of exceptions for rape and incest in Alabama's abortion ban has significant implications for those seeking abortion services. In practice, it means that individuals who become pregnant as a result of sexual assault or incest may face barriers in accessing abortion care. This is further compounded by the requirement of law enforcement involvement in reporting rape and incest, which many survivors are reluctant to do due to fear of retaliation and a lack of trust in the police.

The impact of Alabama's abortion ban is felt not only by survivors of sexual assault and incest but also by medical professionals. Physicians may face challenges in providing miscarriage management care and evidence-based medicine due to the limited exceptions in the law. The ban also raises concerns about maternal mortality and health disparities, particularly in states like Alabama, where access to obstetric care is already limited.

The lack of exceptions for rape and incest in Alabama's abortion ban highlights the ongoing debate and legal scrutiny surrounding abortion laws in the United States. While there is broad public support for legal access to abortion in cases of rape and incest, the feasibility of accessing abortion care under these exceptions remains a critical issue.

The law makes abortion a Class A Felony

The Human Life Protection Act, passed in Alabama in May 2019, makes performing an abortion a Class A felony, which is punishable by up to 99 years in prison. The law also makes an exception for any "act to terminate the pregnancy of a woman when the unborn child has a lethal anomaly".

The law was passed by Alabama Gov. Kay Ivey, who said in a statement:

> "Today, I signed into law the Alabama Human Life Protection Act, a bill that was approved by overwhelming majorities in both chambers of the Legislature... To the bill's many supporters, this legislation stands as a powerful testament to Alabamians' deeply held belief that every life is precious and that every life is a sacred gift from God."

The law was opposed by Staci Fox, president and chief executive officer of Planned Parenthood Southeast, who told CBS News:

> "We vowed to fight this dangerous abortion ban every step of the way and we meant what we said... We haven't lost a case in Alabama yet and we don't plan to start now."

The law does not apply to in vitro fertilisation

On February 16, 2024, the Alabama Supreme Court ruled that frozen embryos are to be afforded the same legal protection as children under the Wrongful Death of a Minor Act of 1872. This decision was in response to a case in which a patient at a fertility clinic accidentally destroyed the frozen embryos of three couples. The couples brought lawsuits against the clinic and the hospital, claiming that they had violated the Wrongful Death of a Minor Act.

The ruling sparked outrage across the country, with many concerned about its implications for in vitro fertilisation (IVF) services in the state. In the two weeks following the decision, three fertility clinics from the largest medical providers in Alabama paused new IVF treatments. In response to the public outcry, the Alabama Legislature passed a bill to protect IVF providers from civil and criminal liability for embryo loss or damage during IVF treatments. This was signed into law by Governor Kay Ivey on March 7, 2024.

However, the ruling has had a lasting impact on IVF services in the state. Only one of the three fertility clinics that paused treatments has resumed services as of October 2024. The ruling has also led to concerns that it will create "IVF deserts" in Alabama and that it will encourage anti-abortion groups to push for similar agendas in other states.

The U.S. Supreme Court declined to review the Alabama ruling on October 7, 2024.

The law does not apply to emergency contraceptives

In Alabama, emergency contraceptives are legal and can be used to prevent a pregnancy before it begins. They do not terminate an existing pregnancy but work by delaying ovulation so that the sperm and egg never meet.

Emergency contraceptive pills are distinct from abortion pills. While abortion pills terminate an existing pregnancy, emergency contraceptives are used to prevent a pregnancy from occurring in the first place.

There are a few types of emergency contraceptives available, each with varying degrees of effectiveness. The most effective method is the insertion of a Copper-T (non-hormonal) intrauterine device (IUD) within 5 days (120 hours) of unprotected sex. This method is free for those covered by Medicaid and most insurance plans. For those without health insurance, the cost of inserting the non-hormonal Copper-T IUD, also known as Paragard, can range from $500 to $932. Once inserted, the Copper-T IUD can prevent pregnancy for up to 12 years or until it is removed by a medical provider.

Another effective form of emergency contraception is ella, a single pill that can be taken orally within five days (120 hours) after unprotected sex. Unlike other emergency contraceptive pills, ella does not decrease in effectiveness within that five-day window. A prescription is required to access ella, and it typically costs $55. Some studies suggest that ella may be less effective for people who weigh over 195 pounds.

If a prescription for ella is unavailable, Plan B and other Levonorgestrel-based pills are available over the counter without a prescription. These pills lose effectiveness each day, so it is best to take them as soon as possible after unprotected sex. Research indicates that this method may be less effective for individuals weighing 165 pounds or more. Levonorgestrel-based pills are shelf-stable for several years, so it is a good idea to have them on hand before they are needed.

The availability of emergency contraceptives in Alabama is important, especially given the state's restrictive abortion laws. In May 2019, Alabama passed the Human Life Protection Act, one of the nation's most restrictive abortion laws. This law bans most abortions at any stage of pregnancy, with the only exception being a serious health risk to the mother. There are no exceptions for cases of rape or incest.

The law was blocked by a federal court in October 2019, but after the Supreme Court overturned Roe v. Wade in June 2022, the injunction was lifted, and the law went into effect. As a result, Alabama's remaining abortion clinics were ordered to cease operations, and abortion became illegal in the state except when the life of the pregnant individual is in danger.

The Yellowhammer Fund, an organization that financially assists women in Alabama seeking abortions, has seen a surge in donations following the introduction of these restrictive abortion laws. They have also been sending emergency contraceptive pills via mail to people across Alabama, Mississippi, and the Florida Panhandle since March 2020.

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