Abortion Access, with Debora McDell-Hernandez & Prof. Lucinda Finley

Debora McDell-Hernandez of Planned Parenthood & Prof. Lucinda Finley of University at Buffalo's School of Law discuss with host, Tia Palermo, abortion access, cases pending in front of the Supreme Court & implications of abortion restrictions for poor individuals and pregnant people of color.

Debora McDell-Hernandez is the Senior Director of Public and Community Affairs at Planned Parenthood of Central and Western New York.

Lucinda Finley is the Frank Raichle Professor of Law at the University at Buffalo. Her areas of expertise include reproductive rights and justice, gender and the law, tort law, and first amendment free speech. She is the author of several books and many articles in leading law journals. She has also argued a major case concerning the clash between the right to safely access abortion services and the right to protest before the US Supreme Court. She has also handled numerous cases in the federal courts of appeals.

Dr. Palermo: Hello and welcome to this episode of Buffalo Health Cast. I'm your co-host Tia Palermo and today I'll be discussing inequities in abortion access with my guest, Deborah McDowell Hernandez and Lucinda Finley. Welcome to you both.

Deborah McDowell Hernandez : Thank you for having us.

Dr. Palermo: Debora McDowell-Hernandez is the senior director of public and community affairs at Planned Parenthood of Central and Western New York, where she's worked for the past three and a half years.

Lucinda Finley is the Frank Raichle Professor of Law at the University at Buffalo. Her areas of expertise include reproductive rights and justice, gender and the law, tort law and First Amendment free speech. She is the author of several books and many articles in leading law journals. She has also argued a major case concerning the clash between the right to safely access abortion services and the right to protest before the U.S. Supreme Court. She also has handled numerous cases in the federal courts of appeals.

I'd like to start today with Deborah. Can you tell us a little bit about the geography of abortion access in the United States?

Deborah McDowell Hernandez: All right, certainly. First off, I would just like to say we're in. We're lucky to be or fortunate to be in the state of New York, which has a very abortion friendly legislation or law. We have the Reproductive Health Act, which was passed in 2019, which protects our access and right to abortion. But I don't think a lot of people realize how inaccessible abortion is in many parts of this country.

And although abortion is still legal in the US, if it's not accessible, what's the point of it being legal? And according to the Guttmacher Institute, thirty four percent of women or I can say individuals ages 13 to 44 live in states that are supportive of abortion rights, whereas 58 percent of people ages 13 to 44 are in states that are hostile or extremely hostile to abortion rights.

Dr. Palermo: And when you say supportive or hostile to abortion rights, can you just tell us a little bit what you mean there?

Deborah McDowell Hernandez: Right, so when when I say supportive, I mean states that have created legislation to protect access to abortion. They don't require patients to jump through hoops to get an abortion, a state that might be hostile, although abortion is legal in that state. They might have all of these laws requiring a person to get an ultrasound and then return 48 hours, 72 hours later for another appointment and perhaps require that they have biased counseling that isn't medically accurate. But just making them go through these hoops for the sake of shaming them and just making having the actual abortion difficult.

Dr. Palermo: And you mentioned individuals of reproductive age, so realizing the importance of inclusivity and how diverse our community is. What can you say about people who have abortions?

Deborah McDowell Hernandez: Well, we can say that everyone who has an abortion or who is pregnant or has the ability to become pregnant might not necessarily wish to be identified as a woman. There are many people who have children, raise children or choose not to have children, but they are. They identify as non-binary or gender fluid. So trying to look at this from the lens of diversity and inclusion and not excluding anyone, I might refer to folks as individuals or persons instead of always women.

Dr. Palermo: Thank you for clarifying that for us. So, Deborah, can you give us a little bit of a background on the types of individuals who get abortions, some of the statistics and characteristics of people getting abortions in the U.S., right?

Deborah McDowell Hernandez: Most of us probably know someone who has had an abortion. One in four people in the US, will have an abortion by the age of forty five. 59% percent of people who have abortions already have one or more children, so it's not something that is highly unusual. 75% of abortion patients are poor people of all races and ethnicities, and of a variety of faiths make a decision to have an abortion. And as far as race goes, white women make up the highest percentage of abortions at 39%, Blacks at 28% Hispanic or Latino at 25%, and other races account for 9% of abortion patients.

More than half of the abortion patients in this country are in their 20s, and they are in adolescence also make up 12% of patients.

I just I don't want to drown you with statistics. Abortion rate in 2017 was 13.5abortions per 1000 women aged 15 to 44, and that was down eight percent from 14.6 per 1000 in 2014. And 18 percent of pregnancies in 2017 ended in abortion.

Dr. Palermo: Thank you for that very comprehensive overview. Drilling down a little bit, can you tell us a bit about the abortion procedure? So when during pregnancy, do most individuals seek abortion and how risky is an abortion procedure?

Deborah McDowell Hernandez: Well, first off, abortion is a very safe procedure. It's one of the safest medical procedures. anti-abortion folks or anti choice folks will have you believe that abortion can cause cancer and all of these other things that just are not true medically and scientifically inaccurate. But very few people have complications or serious health effects as a result of having an abortion.

So it's a fairly simple medical procedure to have. Two-thirds of abortions occur at eight weeks or earlier, and 88% occur in the first 12 weeks. And also again, as I said, there no relation between breast cancer and abortions, even though people will try to create these false narratives. People, if you can, we have there are a couple of options. Surgical abortion is one option. Medical abortion, which would involve ingestion or taking a tablet medication, is also an option for patients.

We recently had someone from the state of Texas who visited one of our health centers and was unable to get the medical abortion. But we called out to another health center in the Buffalo area and they were able to make space for them to get a surgical abortion.

Dr. Palermo: So you mentioned that an overwhelming majority, so 88% of abortions occur in the first 12 weeks of pregnancy. What are some reasons women seek abortion after the first 12 weeks?

Deborah McDowell Hernandez: Well, abortion is a very personal decision. So there are a variety of reasons that people have this as their final decision. And sometimes it's just a matter of, you know, could be for emotional reasons, financial reasons. I've heard people who decided to have an abortion because they would have felt trapped in an abusive relationship. They were being emotionally or physically abused and knew that was one way that this partner would have kept them if they were forced to have a child.

So some people might make a decision to have an abortion simply for their own mental and emotional well-being. There are times when people might opt to have an abortion because of financial limitations. Maybe they don't feel like they have the financial means to care for themselves or another person could be other things happening in their world. Medical reasons a person might have some health condition that would make it very risky for them to continue with the full term pregnancy and deliver. Or there could be an issue related to the the fetuses’ health. So I think there's just a variety of reasons. But the biggest thing at Planned Parenthood, we try to always respect that it's a personal decision for the individual or anyone else they want to include in their circle, be it a faith member on family and friends.

It's their decision to make and we want them to have the right to make that decision without feeling shamed or stigmatized or anything like that.

Dr. Palermo: How do people pay for abortions?

Deborah McDowell Hernandez: And again, you're going to have a variety of ways, depending on the person's own financial background. Some people are able to pay completely out of pocket if they have the financial means, they might do so in their home state outside of their home state, even outside of the country. People who don't have the financial means might do so with some government assistance.

There are states that are very hostile and you won't be able to get any support from them, but people are able to access abortion sometimes even with the help of their home state, the help of private funds There are many abortion access funds throughout the country that are funded through the generous support of

Individuals, or organizations who want to make sure that abortion is accessible to those with limited means and those with means in between. So you have a variety of ways in which people pay.

And then if you have an organization like Planned Parenthood and many other organizations throughout the country, they might honor a sliding scale system and different people might pay different things, be it for it could be some sort of family planning, type of service or STI treatment.

So it's not necessarily one size fits all. A lot of it, depending on where you are, the state for county in which you live in the health care provider that you are visiting might have some flexibility and understanding what you can't afford.

Dr. Palermo: So you mentioned state funding in some states for abortion. Can you clarify for us whether federal dollars can be used for abortion coverage?

Deborah McDowell Hernandez: Well, with the Hyde amendment that prohibits the use of federal funds for abortion, but even in New York state, New York State supports costs for abortion if someone needs that. So again, when I say about depends on where you live, the state in which you reside, it could be just, as I said, an abortion supportive state like New York. Or you could be in a hostile state which might not offer you much, except for a lot of hassle.

Dr. Palermo: So I'd like to turn now to Professor Finley speaking about payment and access and coverage.

What can you tell us about what the Affordable Care Act says about insurance and abortion coverage and how does this vary by state?

Professor Finley: The Affordable Care Act does not require that insurance plans cover abortion, it requires that insurance plans cover maternal maternity care. But but not abortion.

Again, some states, including New York, have state laws that require that insurance plans within their state have to offer coverage for abortion, but that that New York law is currently under under court challenge by employers who are using religious objections that they don't want to be forced to provide insurance to their employees that covers abortions. So you know that that's a potential barrier to the law any laws that require private companies to provide insurance coverage to employees that covers abortion.

Dr. Palermo: Can you take us back a little bit, Professor Finley, and talk about maybe give us a quick overview of cases important cases in the U.S. with respect to abortion?

Professor Finley: Sure. I'll concentrate on the two main ones because there are way too many to talk about in this podcast, but you know the case that everyone I think knows by name, but few know what it really said is Roe v. Wade, which was decided by the U.S. Supreme Court in 1973. And in this case, the U.S. Supreme Court held that there was a fundamental right of a woman to choose whether or not to carry her pregnancy to term or to terminate her pregnancy, in other words, to have an abortion.

And the U.S. Supreme Court said that this fundamental right was based in constitutional notions of sort of life and liberty that included a right to privacy and the privacy of one's mother making decisions about one's own body. And that was a 7 to 2 decision of the US Supreme Court. You know, people tend to forget that, you know, once upon a time, the idea of abortion becoming legal was not as controversial in this country as it as it is now.

And then in the early 1990s, the other significant case is one called Casey v. Southeastern Pennsylvania.

Planned Parenthood and Casey involved a challenge to whether numerous types of state restrictions on abortion were constitutional or not. Under Roe, the restrictions involved in Casey included a waiting period where a woman had to first consult with the health care provider, then wait a certain period of time to rethink and then come back. It included a requirement that minors have to get the consent of their parents.

It included a restriction that women who were married and want an abortion had to get the permission of their spouse.

In the Supreme Court, Casey struck down the requirement that a woman has to get the permission of the spouse. But it upheld the other restrictions and it it changed Roe in a significant way that made it possible for state laws going forward to become more restrictive or hostile, as Deborah said. So Casey said that although women had a fundamental right to choose whether or not to have an abortion, the state, the state, the government also had its own right to protect potential life. And in balancing those two rights, the court said the state could put limits on abortion that were intended to protect health.

Such as you might regulate any medical procedure, but it also said it could put limits on abortion. As long as they didn't pose an undue burden on a woman's right and they defined an undue burden as a law that either had the purpose or the effect of putting a substantial obstacle in the way of women, and the court went on to say just because you make it more expensive. Just because you make it take, we have to wait longer, just because you make women have to travel further. Those aren't substantial obstacles.

So Casey really unleashed decades of state laws in the hostile states where they said, OK, we're going to try to come up with every restriction or, as Deborah said, hoop to make women jump through that we can and see how many of them we can get away with under this new undue burden standard. And they've gotten away with a huge number of restrictions. The Supreme Court really has only found two or three types of restrictions so far to be an undue burden on a woman's rights.

As I said, the spousal consent provision that was in Casey and a couple of years ago, in a case from Texas and a similar case in Louisiana, the Supreme Court found that a requirement that an abortion clinic have to have a physician on staff that had admitting privileges at a nearby hospital was also an undue burden, one because it was utterly unnecessary. You don't need your physician to have admitting privileges to get an emergency patient into a hospital, and because you know, no hospitals in those state would grant admitting privileges. So it had the effect of shutting down clinics. But everything else, the Supreme Court, under this undue burden standard is said, is just fine. You can, as the world said, you can impose waiting periods,

Mandatory ultrasounds, prohibitions on telemedicine requirements that the state can force you to have a vaginal ultrasound, requirements that the doctors have to give you medically inaccurate information intended to scare you out of having an abortion and, you know, try to basically force you just choose to carry the pregnancy to term. So the current legal framework actually allows for quite a lot of restrictive laws that all these hostile states have taken full advantage of.

Dr. Palermo: So you mentioned how Casey kind of set the stage for allowing increased restrictions that states can put on abortion access. What does the current trend surrounding related cases indicate for the future of abortion rights in the US?

Professor Finley: I think the current trend is actually rapidly getting us towards overruling Roe and Casey and perhaps allowing states to outright prohibit abortion. I should clarify the other key part of Roe that Casey kept in place was that prior to the point at a pregnancy that it's viable whether the fetus is capable of living on its own outside the womb, prior to that point of viability, the state simply could not ban abortion.

But now, several states and a very deliberate strategy to try to create a case that would force the Supreme Court to overrule Roe now that the composition of the court has changed under with the appointments of President Trump and the death of Justice Ginsburg, they started passing some laws, basically banning pre viability abortions, knowing that under Roe and Casey, those laws are unconstitutional.

But hoping that the cases would get to the Supreme Court and the the new composition of justices they

hope will overrule Roe and eliminate viability is the point before which the state can't ban abortion. So right now, pending before the U.S. Supreme Court, in a case that will be argued on December 1st, is a case from Mississippi called Dobbs.

And so Mississippi passed a law that permits abortions up to 15 weeks. Last menstrual period, gestational age but after 15 weeks bans abortion unless necessary to save the life of the woman. Excuse me, of the pregnant person because obviously a pregnant man would not be able to have an abortion either through the Mississippi law. So that and the Mississippi specifically asked the Supreme Court to take up the question of whether, you know, the Roe should be overruled, and states should be allowed to ban abortions pre viability.

The other case that's working its way up, Supreme Court comes from Texas, everybody's been hearing a lot lately about this Texas law. Texas passed a law basically banning all abortions after six weeks post last menstrual period, a time at which most pregnant people do not even yet realize that they are pregnant.

And Texas came up with a very devious, sort of shockingly devious way to try to prevent any federal court from declaring this law unconstitutional.

Normally, if the state passes a law, they designate some state official, you know, like the attorney general or somebody to enforce the law. And so then if you want to challenge the law as being unconstitutional,

the way to do it is to bring a lawsuit against the public official who has the power under this state law to enforce that law. But what Texas did with its new statute is it specifically said no state official can enforce this law at all.

We, the state, have passed along. We're saying we are going to enforce it. They said any citizen, any person, anywhere person in New York, the person in Florida person, California person in Timbuktu, it doesn't matter any person can, you know, go after any doctor in Florida who provides an abortion post six weeks and they

can sue anyone who helps anyone try to get an abortion in Texas after six weeks. And that includes helping them pay for it, helping them arrange an appointment, driving them to the appointment. And so they they said, well, no one in advance of the law going into effect will be able to sue the stop law because in advance, nobody knows who the person who might try to enforce the law against them will be. And you can't bring a lawsuit against a hypothetical person. You need an actual person who's trying to enforce the law against you to bring a lawsuit.

So, so currently, the Supreme Court let that law take effect. So currently in Texas, all abortion is banned post six weeks pass the last menstrual period. But the U.S. Supreme Court just, I believe, just last week quite recently decided that they would at least take up the issue of whether the United States government can sue the state of Texas to try to challenge this law, or whether no one can challenge Texas law.

So those are so right now. And so in fact, in the next few weeks before the end of 2021, there will be two major abortion cases argued before the U.S. Supreme Court. And we may see from the questions of the oral argument some insights into what direction the court may be going. But we probably won't have a decision in those cases until sometime in the spring or early summer of 2022.

Dr. Palermo: Professor Finley, can you tell us a little bit about how this Texas law that you've been talking about might impact women and individuals of low socioeconomic status and people of color who are seeking abortions?

Professor Finley: Yes, we've already seen the impact in Texas, by the way, know Deborah, when she mentioned that Planned Parenthood of Western and central New York has already had at least one patient from Texas come to New York. I, it might have been someone who was just visiting, but I wouldn't be surprised if he was someone who was just trying to get someplace where the state law would permit them to have an abortion. So a law like Texas or the Mississippi law, if it's upheld or any of these restrictions fall disproportionately most heavily on poor women and unfortunately, women of color are disproportionately represented among poor women.

So, you know, these laws that restrict abortion fall more heavily on poor women for multiple reasons. First, the Texas law, in order to be able to afford to travel to another state, you have to have the financial resources to do that. You have to have the ability to take extra time off from work in order to now not just travel 100 or so miles, but to another state or even to fly to a state, you know, far, far away. You have to then have extra resources for for child care, for lodging at the place you are going to travel to. And you know, all of those things cost money. And, you know, many, many lower income women are in jobs with the least amount of flexibility for time off, the least amount of ability to afford child care or extra child care.

And also, you know, then the extra time it takes to arrange to to find a provider where you don't have all

these hoops to jump through often pushes the abortion procedure later into pregnancy, which increases the cost. So, you know, women of women of means women who have flexible jobs can take time off,

have private insurance or private money are always going to be able to travel somewhere to get an abortion. But women who don't have those financial resources and flexibility in their life won't be able to.

The Texas law also falls very disproportionately heavily on undocumented women. Women in prison. Women in in ice detention centers, immigration detention centers. They don't have the option of traveling to another state. And even though the federal government is obligated to provide them with an abortion if they're in a federal immigration detention center, the federal government is not obligated to pay for them to travel to another state to get it. Nor is the Bureau of Prisons obligated to take a prisoner to another state and young women, very young women who now in addition to all of the hoops they would have to jump through in getting, you know, either a, you know, a judge to approve their abortion. If the parents won't, they now, you know, just say to them,

Oh fine, the judge approved it.

“Now just get in your car and drive to Oklahoma.”

“ Excuse me, I'm 16. I'm not allowed to drive.”

And if their grandmother, aunt or mother helps them drive to Oklahoma, they're afraid they might get sued under this Texas law. So it is. It is an absolute tragedy for poor women, young women and women living in carceral facilities.

Dr. Palermo: Those are some really sobering points that you're making right now. Deborah, is there anything you'd like to add about how these different state restrictions on abortion access affect lower income individuals and people of color disproportionately?

Deborah McDowell Hernandez: Well, I'll just I think Professor Finley did a great job in describing the dynamics of excess or inaccessibility, given the different states. But when you think of geography, there are other things you can think of. There are some cities. 27, to be exact, American cities are considered abortion deserts because people who live in that city have to travel one hundred miles or more outside of that city in order to find an abortion provider.

So, I mean, 27 might not sound like a lot, but within those 27 cities, if you're thinking that some of those women or the folks who are needing the abortion might be black, LGBTQ and the disabled 100 miles is a long way to travel, especially if you don't own your own car and you're trying to, you know, cover transportation by train, bus or plane and get time off from work.

So again, depending on which county you call home, you might be traveling quite the distance. And chances are, you know, if you're undocumented, documented and Latina or LatinX or black, there still might be the possibility that you might not be able to get time off from work or have the money to get to where you need to be. And then, you know, if you're a young person, you don't have that type of savings necessarily or a credit card or a job to help fund you to get you from point A to point B in the right amount of time before you exceed limits.

So, you know, when I think of the dynamics of someone who lives in a very rural area, maybe you're in a very rural county or the counties that surround you are all quite rural and you might have quite the distance to travel before you come across a medical provider. And then on top of that, a medical provider that even performs abortions is willing to are qualified to perform abortion services. And many patients who see Planned Parenthood, not just New York state, but in other states, Planned Parenthood is the only medical attention that many patients have because they don't see a doctor regularly or because they live in such a remote area, a rural community, and that might be the only time that they are getting any type of medical exam.

Dr. Palermo: Professor Finley, I want to turn back to some of the cases you were talking about, you mentioned the Dobbs case. Can you tell us about that? What is the likely?

Professor Finley: So it's currently on the Supreme Court docket. What's the likely outcome and what would this mean for access to abortion in the US?

Well, it's always difficult to predict how the Supreme Court is going to rule, but I think in this case when you look at. The fact that there are already four justices that in previous cases have said they think Roe versus Wade is unconstitutional. And have been looking for to take a case where they could make that the majority opinion. And then you look at the fact that, you know, two of the two of the new justices added by President Trump, Justices Kavanaugh and Coney Barrett in many previous writings have expressed.

Let's just say, either in Justice Barrett's case outright, you know, moral and religious adamant opposition to abortion and injustice. In Kavanaugh's case significant legal skepticism as to whether the Constitution protects abortion.

You know, simple counting that seems like, you know, five or six votes to either overrule Roe completely or to substantially change it and permit states to ban abortion prior to viability. If the court says that states can ban abortion prior to viability. You know, that's going to open up all kinds of questions will do. They have to always allow an exception for women's health or or do they have to allow a rape or incest exception? Do they or do they only have to allow an exception when you know, several medical providers say the abortion that the woman carries the pregnancy to term, she will definitely die, and no medical provider in advance will rarely be able to say that she will definitely die if she carries the pregnancy to term. And by the time seer, the serious health complications of pregnancy arise, such as with pre-eclampsia or gestational diabetes. At that point, it may be too late to say, Oh well, let's let's have an abortion.

You know, at that point, the severe damage to the woman's health is is already done. And here I think it's also important to link, you know, whether there will be any kind of an exception to a ban on abortion to protect women's health with health equity issues for facing women of color. And for women of color, it is just tragically appalling that the well-documented serious risk to their health that carrying a pregnancy to term can entail.

So that's another way in which any change in the law that permits states to further restrict or ban abortion is going to have a significantly disparate impact on the health of women of color because pregnancy is is a far more dangerous than an abortion. And it pregnancy is particularly dangerous for women of color in the United States.

Dr. Palermo: Thank you for reminding us of those morbidity and mortality statistics, and as you point out, the U.S. has among the highest rates of maternal mortality for high income countries, and the disparities between groups within our country are are very stark. Turning to New York state now, Professor Finley,

can you tell us what legislation has New York state passed or do we have pending to safeguard the right to abortion? And how will these laws interact with the potential erode vision or overturning of Roe?

Professor Finley: New York State has, as Deborah mentioned earlier, the the Women's Health Act,

which I believe was passed in 2019 and it essentially codifies in New York law the holding of Roe versus Wade, namely that prior to viability, a woman has an absolute right to decide for herself whether to have an abortion, and the state cannot ban it. In New York, law post viability, if the abortion presents a risk to the woman's life for serious health impairment, the state would have to permit her to have an abortion. And yes, that that's protected by statute in New York. So if the Supreme Court overrules Roe, it would have the immediate effect of saying it's up to each state what they want their law of abortion to be.

So New York has already said what it wants its law of abortion to be, and that is that women have the right to choose whether or not to have an abortion and prior to viability, the state cannot ban it.

But something to keep in mind. And you know, we can't forget federal politics here and the composition of the federal legislature. If if you know, in any upcoming election, whether 2024 or whatever, if Republicans control once again, as they did under a little bit under Trump, the White House, the Congress, the House of Representatives in the Senate, there's absolutely nothing to stop them from passing a federal law that bans abortion in the entire United States. And then because federal law is always supreme over state.

There’s really nothing that would stop a federal government with a Republican in the White House, Republicans controlling the Senate, Republicans controlling the House to pass a federal law banning abortion and federal law is always superior to state law, so the federal law would supersede and make void and unenforceable, New York's law saying in New York, we want women to be able to have the right to decide whether to have an abortion.

So, you know, I relate this to the big filibuster debate in the Senate. You know, the only thing that would stop a Republican controlled Senate, House and White House from banning abortion throughout the entire United States would be the filibuster in the Senate. If the Republicans control the Senate with less than 60 votes, you know, so right now everybody's saying yes in order to secure voting rights and do other, you know, in climate protect the climate and other crucially important things, they want the Democrats to get rid of the filibuster. But I always say, well, OK, but remember, you get rid of the filibuster now when the Democrats are in control, just think what's going to happen when the Republicans are in control again?

So it's a really complicated issue.

Dr. Palermo: Turning to you, Deborah. Can you tell us a little bit about what Planned Parenthood is doing to ensure access to abortion in New York state as well as other states?

Deborah McDowell Hernandez: Well, I think if I could give them all the would be actions, labels, I would say advocacy, lobbying and education, education and advocacy are very important, especially now because I think many people who aren't necessarily in this circle of reproductive and sexual health or maybe who

are not activists really don't realize how great of a threat we currently have in losing access to abortion across the country. So education is very important in getting the word out to other coalition members.

Our partners in the community, our supporters, be the donors or volunteers or activists getting out there,

meeting with our elected officials to let them know how important this is to us and ensuring that we can offer our patients and the community community in general, the care that they count on and realizing that many of the people that we are supporting are already in a vulnerable state, not limiting the discussion to abortion, but just simply having access to family planning, care, birth control, contraceptives, sex education in general, you know, testing for sexually transmitted diseases and treatment and things like that.

So we take special care and making sure that, yes, we continue to provide health care to our patients, but we also need to educate the community on the on abortion, the importance of abortion access, lobby as needed to try to continue to get support from the elected officials because we realize that the true change occurs when policies change. So we need all of the energy out there. We need our cheerleaders, attending rallies, going to marches and things like that. But we also really need the people, the cheerleaders, who can sign those bills and make them laws on our side to help support the cause.

One of the things that we're supporting right now, all of the affiliates in New York state Planned Parenthood affiliates is an abortion access fund, which would allow the average citizen to designate a portion of their income on their tax return form to abortion access. And then those funds would be distributed to different nonprofit organizations in the state of New York to help people who need funding support to pay for abortion services. So something like that is a very basic lift.

If we can just simply have that as a box on your tax return to check off. It seems like it would be a win-win. We also inform our supporters of other abortion access funds across the country. We've even done campaigning or fundraising locally to help support many of those access funds in Texas, since the checks in patients are having the biggest struggle or threat right now. So, you know, fundraising as we are able to help Texas and other states, other hostile states since we're using that word elect. And education again and advocacy, those are some of the big things that we're taking on patient advocacy.

Dr. Palermo: Thank you for that you've given us so much to think about today. I wonder. Before we wrap up, is there anything that either of you would like to add, maybe starting with Professor Finley?

Professor Finley: I think I want to underscore something that I just said that I think don't think most people really realize how the right to a safe, legal abortion is under threat to a far greater extent in this country than it's ever been since Roe versus Wade. That is, as I said, when you ask, what did I think was going to happen in the Supreme Court, I think that, you know, by the end of by mid-summer 2020 to the U.S. Supreme Court is highly likely to have said either that Roe is completely wrong or that as long as they,

you know, safeguard women's health, states can ban abortion almost at any time. And I think I particularly want younger women to think about this, what this would mean for them because younger women never lived in the pre Roe world.

They don't know women like I do that or like my mother, you know, who had to go and get illegal abortions and what it was like and how degrading it was and humiliating and dangerous it was. And you know, just what a sort of basic aspect of your humanity gets taken away from you when the government says, you know, basically, we can conscript your body and force you to bear a child that you feel at this stage of your life you can't properly care for or support or to have would risk, you know, the safety of you and your other children because you're in an abusive environment. So I I just want to echo Deborah's call for saying, you know, education and advocacy.

If the Supreme Court overrules Roe, abortion will probably become one of the hottest issues in electoral politics at the state and the federal level, and it's going to take sustained commitment and activism from from people who who care about women's fundamental humanity and dignity and right to make their own decisions to to fight for it. And in the states that are currently restrictive to elect people who do respect women's dignity and humanity and right to make their own decisions.

Dr. Palermo: You raise some really important points there about how how common abortion is now and how we take for granted that abortion is health care and it hasn't always been that way in the US. And as Deborah told us at the beginning of the episode, one in four U.S. women will have an abortion by the age of forty five. So it's very common and it's a very safe procedure, and that's something that we kind of take for granted now. But it's something that hasn't always been that way and may not always be that way. But still a very common procedure that women will continue to need in the future. Deborah, are there any final comments that you'd like to leave us with today?

Deborah McDowell Hernandez: The only other thing I'd say is we're very grateful for the support that we receive from the faith community.

Planned Parenthood Empire State acts has a Concerned Clergy for Choice Group, which is a group made up of supportive clergy members from across different faith sectors, and they join Planned Parenthood and other community coalition members in advocating for sexual and reproductive health and safe and legal abortion. So I think it's pretty powerful when you're able to have a reverend, a rabbi and minister joining you during a legislative visit with an assembly person or a senator to explain why they want the people in their congregations to be able to make the decision and not have it be made for them by a politician.

Dr. Palermo: So thank you both again to Professor Lucinda Finley and to Deborah McDowell Hernandez for being with Buffalo help cast today. Really appreciate your time and all of your insights on this important issue.

Thank you so much for being with me today. Thank you.

Professor Finley: Thank you. Yes, thank you for having me and for bringing attention to this very important issue.

Buffalo HealthCast

Abortion Access, with Debora McDell-Hernandez & Prof. Lucinda Finley

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