In 2017, Delaware lawmakers codified women’s access to abortion, ensuring the right to choose in the First State. It proved to be a prescient move.
Within five years, the U.S. Supreme Court would overturn Roe v. Wade, returning abortion law to the states. To date, our state is one of only 16 to codify reproductive rights.
With more than 20 U.S. states banning or severely restricting access to abortion—and more expected to follow suit—Delaware is positioned as a safe haven for reproductive rights. In June, Gov. John Carney signed a bill allowing nurse practitioners, physician assistants and midwives to prescribe medications that induce abortions. The bill also protects out-of-state women seeking the procedure in Delaware.
To accommodate an influx of women from other states, Planned Parenthood of Delaware is exploring ways to expand services, says CEO Ruth Lytle-Barnaby.
“We are anticipating that folks from hundreds of miles away will come to us for abortion care and we are looking at plans for how we might increase our services by doubling what we have right now,” Lytle-Barnaby says.
Delaware already offers far greater access to abortion than other states. Planned Parenthood currently operates centers in Wilmington, Newark, Dover and Seaford. Compare that to Wyoming. Both states have a population of under 1 million, but Delaware is less than 3,000 square miles in size. Wyoming is 98,000 square miles and has only one abortion center, open temporarily under a court order while legislators work to enact an abortion ban.
It’s likely that some women from states where abortion is illegal will turn to Delaware for services via telehealth without ever traveling here. Currently, 65% of abortions in Delaware are medication abortions, also known as pill abortions. Nationally, 54% of abortions are via medication, a rate expected to climb to 70% by 2023, according to the Guttmacher Institute, a reproductive health research organization.
Medication abortion is an alternative to surgical abortion, such as vacuum aspiration or dilation and curettage, and has rapidly become the de facto option for terminating pregnancies of 10 weeks or less. The procedure works through a combination of two prescription drugs: The first pill is mifepristone, which blocks progesterone, a hormone the body needs for a pregnancy to continue developing. The second, misoprostol, is taken 24 to 48 hours later, and causes cramping that expels the contents of the uterus.
Women, essentially, self-manage the process. Sometimes, the first pill is taken at a clinic and the second pill is taken at home or another location chosen by the woman. In many cases, the pills are delivered directly to women via mail.
Still, medication abortion comes with its own set of challenges. Lytle-Barnaby notes that ultrasounds are needed to detect ectopic pregnancies, a rare complication that can be fatal, yet not all abortion providers require them. If the pills are taken to abort pregnancies of more than 10 weeks, the risk of complications such as bleeding and incomplete abortion increases.
Rep. Melissa Minor-Brown, D-New Castle, is the primary sponsor of Delaware’s new law expanding abortion access. A nurse who began her career at Planned Parenthood, Minor-Brown notes the law includes protections for providers of abortion services, and for the women who receive the services.
“Delaware is a small state, but our impact is mighty as a champion for people’s rights,” says Kori Beaman Cheatham, a board member of the recently formed First State Abortion Fund.
The nonprofit provides financial aid for women who are Delaware residents and who need assistance in obtaining abortion services, including expenses like transportation costs, child care and meals. Currently, state government pays for abortions only in cases of rape, incest or when the mother’s life is in danger.
“We have our finger on the pulse of how things are unfolding,” Beamon Cheatham says. “When things change, we can react quickly.”
The Delaware Pro-Life Coalition is in favor of restricting abortion, says Bess McAneny, president of the antiabortion group. She views the overturn of Roe v. Wade as the beginning of a growing movement to ban abortion. In Seaford, the city council enacted an ordinance requiring aborted fetuses to be buried or cremated. The move was overturned in court because it conflicts with state law.
Access to mental health support is an important aspect of reproductive rights. Women who have experienced abortion often need behavioral health care, but the overwhelming majority don’t know where to turn, explains Janine Marrone, a former MBNA executive and Greenville resident who is a founder of Support After Abortion.
The nationwide nonprofit group has established a model that provides specialized counseling for men and women who suffer emotionally after abortion. The model is secular rather than faith-based; participants can remain anonymous via online programs.
“Our research tells us that many people are hurting and in need of healing, sometimes years after an abortion,” Marrone says. “Our whole purpose is to provide them with help so they can heal and go on to lead happy, productive lives.”
Beamon Cheatham concurs that counseling for women who suffer emotional and spiritual pain after abortion deserves a higher profile and greater accessibility. She says counseling is a service the First State Abortion Fund hopes to support.
“Abortion care doesn’t stop at the medical procedure or the medication,” she explains. “Mental health care is an important part of that. This is a tough decision, and we want to support women in every aspect, whether that is before or after.”
Related: Nurses in Delaware Can Now Open Primary Care Clinics