The Desperate Trail to Safe-Haven Abortions in Colorado

There are multiple metrics by which doctors estimate gestational age. Judging by the length of the femur, Amber was about 15 weeks along. Judging by the size of the head, however, she was well past 24 weeks. The clinic staff’s hands were tied. Amber and Matt turned around and began the 12-hour drive home, devastated, enraged, and desperate.

When the only legal option she’d found for ending the pregnancy turned out to be a bust, Amber found the idea of waiting excruciating. “The assessments you start doing in your head… I’m thinking, okay, how long will it take me to miscarry?” she said. “Will I miscarry next week? I’ve got about 17 weeks left if I go full term. Am I going to have to be pregnant for 17 weeks just waiting?” Depression was setting in, she said. “At one point, I literally said to Matt, ‘You may have to throw me down the stairs,’” she told me, her voice serious.

There was so little time left that Amber kept making calls on the drive home from Florida. Finally, sitting in a Cracker Barrel parking lot, she found a clinic in Boulder, Colorado, one of a small handful of clinics in the country that offers abortions late into pregnancy, and thus attracts visitors to the state that are desperate for an abortion. So, they made an appointment, and borrowed cash from their parents to help pay for what would be a week-long procedure.

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The story of Colorado’s abortion laws actually begins in Peru. In 1967, after becoming aware of the dire public health outcomes associated with illegal abortions while traveling in the country, Dick Lamm, a freshman Democrat in Colorado’s House of Representatives, introduced a bill to legalize abortion in limited cases. It was, by today’s standards, an incredibly conservative bill, allowing the procedure only in cases of rape or incest, if the woman’s physical or mental health was threatened, or if the child might have birth defects. Lamm saw the move as a long shot, and one that was likely to end his political career. It was still six years before the U.S. Supreme Court made abortion a constitutional right, but the bill managed to win strong bipartisan support and was signed into law.

That same year, Dr. Warren Hern had recently completed his medical degree, and like Lamm, was shocked after observing the high death rate associated with illegal abortion, both as a medical student in the states and while traveling abroad in Latin America. Hern tells Jezebel he sent a letter to Lamm after reading about Colorado’s new abortion law asking whether it was better for him to continue his path in public health or pursue a law degree, pointing to Lamm’s success on the issue. Lamm told him to stay in public health, and Hern took his advice.

After Roe v. Wade was decided in 1973, Hern began working as an abortion provider in Colorado. Two years later, he opened his own practice, the Boulder Abortion Clinic. Hern’s clinic was met with immediate hostility from anti-abortion activists, but as abortion became increasingly politicized in the ’80s—when the political right aligned with the religious right—the hostility gave way to all-out violence. The clinic had bulletproof glass installed in 1988 after shots were fired through its windows, narrowly missing a staff member. Hern has seen his colleagues in the field assassinated, including Dr. George Tiller, and has survived threats on his own life throughout his career. Through it all, he kept practicing medicine.

Colorado has become a travel destination for people in desperate circumstances, a rare point of unobstructed access for those making decisions about their pregnancies, their families, and their lives.

Today, Hern specializes in performing abortions late into pregnancy, particularly for those who, like Amber, are seeking third-trimester abortions after experiencing complications. The Boulder Abortion Clinic is one of just four clinics in the country that publicly accept patients seeking later abortion care from anywhere in the world.

Because of this, Colorado has become something of a travel destination for people in increasingly desperate circumstances, a rare point of unobstructed access for people making decisions about their pregnancies, their families, and their lives. The Boulder Abortion Clinic often sees patients from other countries—gestational limits on abortion vary significantly across the globe, but places where abortion laws are as liberal as Colorado’s are scarce. While many states have rushed to restrict abortion over the last decade, Colorado has very few restrictions on abortion, and is one of just seven states that don’t have gestational cutoffs. Over 400 state laws restricting abortion were passed between 2011 and 2017, from mandatory waiting periods to strict regulations on clinics that caused many to close down. Besides New Mexico, its neighbor to the south, Colorado is surrounded on all sides by states where abortion laws are restrictive and abortion providers are scarce. Together, Colorado and New Mexico form an island in a sea of hostility toward abortion.

That might change soon: This year, anti-abortion activists in Colorado have begun pushing a ballot initiative to ban abortion after 22 weeks, except in cases of life endangerment, posing a grave threat to Colorado’s status as a reproductive health safe haven and access to later abortion care worldwide.

Hern said the initiative to ban abortion after 22 weeks would be a “catastrophe” for patients with fetal abnormalities that often aren’t detected until late in pregnancy. “These women are desperate,” said Hern. “They don’t want to have an abortion. They want to have a baby.”

While a significant portion of his patients come to him with wanted pregnancies marred by complications, he provides later abortion care for a variety of reasons. “All these patients have some critical issue for which pregnancy is just the death knell for them,” he said. “There are all kinds of situations.” Some are struggling with addiction, he said. Some have serious mental health concerns. Some are trying to get out of an abusive relationship. Some are minors who have been raped. “Pregnancy is a threat to their lives. Period.”

In spite of Colorado’s status as an abortion care safe haven—or, perhaps, because of it—it’s no stranger to attacks on reproductive care. Between 2008 and 2014, anti-choice advocates pushed three nearly identical ballot measures, each defining life as beginning at conception, thereby establishing “fetal personhood,” or the conferring of legal rights to fertilized eggs and fetuses in the state constitution—a near-total ban on abortion.

These attempts were rejected by Colorado voters. Yet for 2020, state activists have proposed what they see as a more moderate proposal, one that they believe will be much more palatable to voters: a ballot initiative to ban abortion at 22 weeks.

The group advocating for the initiative, dubbed Due Date Too Late, began gathering the 124,632 signatures needed to place it on Colorado’s November 2020 ballot in September, and is confident that they’ll have plenty of support.

“We have built a grassroots coalition of people with diverse interests and backgrounds who believe that abortion up to the date of birth is too extreme,” Giuliana Day of Due Date Too Late told the Denver Post. “This initiative will succeed because 73 percent of Americans think that abortion should have limitations, according to a recent Gallup poll.”

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Children born with lissencephaly, a rare brain malformation, often have trouble swallowing and frequent seizures, in addition to other intellectual and physical challenges. Some need feeding tubes. Some are never able to walk, stand, or sit. Many never show significant development beyond the three to five month level. Early death is common, often before the age of ten years, due to respiratory disease, aspiration of food or fluids, or severe seizures, according to the National Institute of Neurological Disorders and Stroke.

Lissencephaly occurs in roughly one in 100,000 pregnancies. Margot was the one.

In Michigan, where Margot lives and teaches at a university, abortion is banned after the fetus is considered viable, around 24 weeks, except in cases of life endangerment. When doctors first detected abnormalities, Margot wasn’t yet past the cutoff, but still didn’t have a clear prognosis. She could have ended the pregnancy then, without having the information she needed to make the decision, and it would have been legal in her state.

“It was shocking,” said Margot. “I could have an abortion today, and you can’t tell me what’s going to happen to this baby, what even the range of options is, but in a few weeks, we might be able to say what is going to happen with complete precision, and yet at that point, there would be no options at all in Michigan.”

She waited. More tests and more time revealed a particularly severe case. So, at 29 weeks into her pregnancy, she traveled to Colorado to visit the Boulder Abortion Clinic. It was only in retrospect, after the procedure was done and she was home, that it dawned on her how meaningful the lack of interrogation felt: the right way to treat somebody who has made their decision, is to treat them as if they have made their decision. Like they’re the authority over their body and their life.

This lack of scrutiny has become increasingly rare. It was close to what would have been Amber’s due date in the fall of 2016 when Donald Trump was broadcast into her living room during the third presidential debate, launching a graphic and inaccurate assault on later abortion.

“If you go with what Hillary [Clinton] is saying, in the ninth month you can take the baby and rip the baby out of the womb of the mother, just prior to the birth of the baby,” Trump notoriously said at the time. “You can take the baby and rip the baby out of the womb, in the ninth month, on the final day. That’s not acceptable.” Trump’s comments, Amber recalled, made her want to puke. She wanted to throw the TV in the trash. “It’s rage-inducing,” she told Jezebel.

Despite the fact that later abortion is exceptionally rare—less than 2 percent of abortions occur after 21 weeks, and less than 1 percent occur after the third trimester—it is still a reliable target of conservative rhetoric.

Trump’s graphic mischaracterization of later abortion care was a gift to the anti-abortion movement, bringing the issue squarely into the public spotlight, where it’s remained for the better part of three years now. Those who have sought abortion care late into a desired pregnancy have been forced to relive what is often one of the most devastating events of their lives, all while being characterized as murderers.

One byproduct of the renewed attention and escalation in rhetoric is that women like Amber who have ended wanted pregnancies are turning to each other for support. Margot, who now helps run a private online support group called Ending a Wanted Pregnancy, tells me that the need for such groups has escalated. “People are I’m sure headed to therapy in greater numbers, and they’re absolutely headed to us in greater numbers.”

Margot explained that usually new members join the group fresh in their grief, around the time they’ve decided to terminate their pregnancy or shortly thereafter. In the last several months, however, women like Amber, who decided to end desired pregnancies years ago, are flocking to the group.

“We’ve gotten a lot of members whose abortions were three, five, ten, sometimes even 20 or 30 years ago, and the political rhetoric is bringing up emotional issues for them,” Margot said. “All of a sudden, you have our president and one of the two major political parties and most of the people in it talking about procedures that are specifically targeting things that happened to them, and doing it in such violent, inaccurate, and clearly manipulative ways.”

After Amber returned home from Boulder, she felt isolated and emotionally withdrawn, not wanting to pick up the phone or talk to anyone. She wishes she would have known about the group back then. “It’s so important for people to have support and be able to talk with other people who have been through the same thing and not feel like they’re a baby murdering asshole,” Amber said.

Margot says members of the group frequently experience internalized shame and stigma. “If you have shame about it, which is usually produced by that feeling that you’re alone and different and unworthy, finding out that other people are the same is the best medicine for it,” said Margot. “It’s the antidote to it. You’re not alone or unworthy.”

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Days after finding out they’d have to travel to Colorado for an abortion, Amber and Matt boarded a plane. A friend of theirs donated airline miles for their flight and upgraded them to first class, something Amber said she had never before and probably will never again experience.

Who knew eggs and bacon on an airplane could be this fucking delicious, and how weird is it that I’m flying first class to go have an abortion?, Amber remembers thinking as she stared out the airplane window, trying not to cry.

“It felt so bizarre,” she said.

Back home in Huntsville, Amber’s sister and Matt’s brother were looking after the dogs and removing the traces of a baby from the house.

Amber said she can’t imagine what it would have been like to not have that kind of support, on top of the emotional distress and financial hardship. After taking a week off of work at the gun range without warning, Matt feared he wouldn’t have a job when he came back.

Once in Boulder for the procedure, Matt was in and out of the clinic giving updates to Amber’s family. Phones aren’t allowed inside the building for security reasons, something Amber described as a little jarring.

“You can’t even bring in a bag or anything,” Amber said. “You just go in with your ID, and I might have had a book or something. At this point, of course, I realized why.”

For the next week, they were back and forth between the clinic and the hotel, where Amber said she spent a lot of time lying on the floor and binge-watching Game of Thrones while Matt went to go pick up food. When they would go out to eat, Amber remembers thinking, Oh God, does everyone know? I’m barely showing, but I’m showing.

Amber used a payment plan to pay off the procedure, which cost nearly $15,000, and for about a year, she received a monthly reminder of her loss in the form of a charge on her credit card.

Reflecting on her own experience and the ballot initiative that would strip other pregnant people of the ability to access that kind of care, Amber found herself searching for the right words: “Frustrating and irritating are not sufficiently intense emotional words,” she said. “It’s insane.”

She returns to the memory of talking to Matt about how they might have to end the pregnancy without medical care. The “joke” about being pushed down the stairs. “I wasn’t just saying that,” she said. “Women are going to seek unsafe alternatives.”

“You’re putting women in this position of increasing their risks of death and harm needlessly,” she continued. “Why are you risking this woman’s life? How unimportant is a pregnant person’s life?”

Madeleine Schmidt is a freelance journalist based in Denver, Colorado. Find her on Twitter @ByMaddieSchmidt.