What Moving From Louisiana to Maine Has Taught Me About Disparities in Abortion Access

As a long-time volunteer with the New Orleans Abortion Fund, my activism has taken me to the front lines of the battle over bodily autonomy, politics and reproductive health in the deep south. I recently moved to Maine, and the disparities in access illustrate both what is possible to lose, and what is possible to gain when it comes to reproductive healthcare.

The Supreme Court’s soon-to-be-heard Louisiana case, June Medical Services v. Russo, may set the stage for the dissolution of Roe v. Wade. In contrast, Maine recently made abortion more accessible and affordable. A person’s state of residence is the ultimate litmus test on whether you can easily access reproductive healthcare. 

(Lorie Shaull / CC BY-SA 2.0)

The stark contrast in access to reproductive healthcare between Louisiana and Maine echoes back to the inequalities faced by same-sex couples before the Supreme Court granted the federal right to marry. As a member of the LGBTQ community, I know that fighting for recognition of my family is about more than just ensuring protections and benefits of marriage are recognized in all 50 states: It is also about safety and security in employment, housing, and family-making—battles the LGBTQ community continues to fight.

Similarly, reproductive justice is about more than access to abortion. It is also about fiercely private issues, like bodily autonomy, economic ramifications of childbearing and rearing, and the safety of both intimate relationships and neighborhoods where children are raised. For both the LGBTQ community and those who seek access to abortion, stripping an individual of their human right to determine how and when to create family strikes at the core of our democratic principles.

I watch my former home state with trepidation. If the Supreme Court, in the highly anticipated case June Medical Services v. Russo, determines that physicians performing abortions in Louisiana require admitting privileges at local hospitals, only one clinic and one physician will remain. Should the newly conservative makeup of the Supreme Court uphold Louisiana’s law, other anti-choice states will likely follow by imposing similar restrictions, chipping away at constitutional protection for abortion nationwide.

If Roe v. Wade is overturned, Louisiana’s “trigger law” goes into effect, banning abortion without delay—while in my new state of Maine, access to abortion is protected

Reckoning with the lack of equity and injustice in Louisiana, compared to the improved access to abortion care in Maine, has been shocking. Since the 1990s, Roe v. Wade has suffered a death by a thousand cuts, as targeted regulation of abortion providers, or TRAP laws, gained traction in state legislatures.

The introduction of over 1,000 medically unneccesary restrictions governing abortion clinics in Louisiana resulted in the number of clinics dropping from 11 to three since 2001, creating a health care climate prohibitive and unsafe for both patients and staff. In contrast, Maine has 21 reproductive health clinics. Maine’s Medicaid, “MaineCare,” will cover abortion beginning in March 2020. In contrast, insurance coverage of abortion is illegal in Louisiana.

Accessing abortion in Louisiana requires at least two trips to the clinic, with a mandatory 24-hour waiting period between appointments, representing a hardship for many working families and single parents. And entering the clinic is often challenging for patients due to protestors sitting or lying on the sidewalk—resulting in a law enforcement presence which can further fuel patients’ fears.

In Maine, you simply walk through the door to obtain comprehensive, accessible care that may or may not include abortion.

In Louisiana, abortion access could help bring people with additional healthcare needs, like hypertension or diabetes, into contact with providers. However, restrictions limit opportunities to improve health in a state that ranks 49th out of 50 in health outcomes.

Abortions performed by nurse practitioners, midwives or physician assistants is also illegal in Louisiana—despite calls for elimination of these restrictive laws by the American College of Obstetricians and Gynecologists, the American Public Health Association, and the World Health Organization

Maine, in 2019, increased healthcare provider access in this highly rural state, by striking down their physician-only law. As a nurse practitioner, I will now be able to provide abortion as part of comprehensive primary care—something I could not have done in Louisiana.

Politically-driven and religiously-motivated decision-making mires Louisiana in policy that negatively impacts health. Sadly, in a state that I love, efforts to eliminate abortion as part of comprehensive, patient-centered healthcare, position Louisiana in a race to the bottom.

This inequity treats people seeking abortion in Louisiana like second-class citizens—as they are denied quality, affordable, accessible healthcare available elsewhere in the nation.  


Vanessa Shields-Haas is a sexual assault nurse examiner and family nurse practitioner student.