A post-‘Roe’ world in Georgia will mean more restrictions — and more political battles

Jerisha Morton didn't realize she was pregnant until about six weeks into her pregnancy. She soon started feeling waves of intense nausea.

"I can’t smell anything. You’re so weak that you have to lay down all the time. It's rough," Morton, 27, said recently as she sat in a Planned Parenthood clinic in Atlanta.

Morton was diagnosed with hyperemesis gravidarum, or severe nausea during pregnancy. She thought she couldn't handle nine months of being sick, she said, so she chose to have an abortion.

At the clinic, as she picked up the pills for her medication abortion, Morton estimated she was eight weeks into her pregnancy. A Georgia law currently on hold — but likely to take effect soon — outlaws the procedure at about six weeks, with few exceptions.

"It's making people not have a choice. It’s taking their choice away before they even find out," Morton said.

Women in Georgia, like those in many other parts of the country, could soon have less access to abortion now that the U.S. Supreme Court has released its decision in Dobbs v. Jackson Women's Health Organization. Like the draft ruling leaked in May, it strikes down the abortion protections laid out in the landmark 1973 Roe v. Wade case and gives states the authority to regulate the procedure.

Patients and providers will have to figure out how to navigate the new legal landscape. Changes to the laws in Georgia will be felt across the region, because the state has served as a destination for people seeking an abortion.

In 2019, more abortions were performed for out-of-state residents in Georgia than in any other Southern state — and in nearly every other state in the country, according to data from the Centers for Disease Control and Prevention. That year, 6,500 abortions performed in Georgia were obtained by people who didn't live there.

Abortion access is already a campaign issue in Georgia. And it's one of many states where the Dobbs decision will set in motion a cascade of legal and legislative action restricting abortion access, said Elizabeth Nash, a policy analyst with the Guttmacher Institute, a research organization that supports abortion rights.

The state's conservative political leadership has made abortion a target. In 2019, Georgia legislators passed a bill that bans most abortions after embryonic or fetal cardiac activity can be detected in the womb, which can be as early as six weeks into a pregnancy. The law also includes so-called "personhood" language, which gives embryos legal status when cardiac activity can be detected. That language could have broad implications, Nash said, and could affect every part of Georgia's legal code about a person's rights.

"We don’t know how far states will go, but it's clear that they're not stopping with abortion," said Nash.

A legal challenge has kept the law from taking effect. Late last year, a federal appeals court paused its review of the case while it waited for a ruling in Dobbs.

Some states have established protections for abortion rights. But, according to a Guttmacher analysis, in several states, such as Kentucky, abortion will be outlawed immediately, with few exceptions, as so-called trigger bans take effect. These measures, passed in advance of the Dobbs decision, severely limit access to abortion if Roe no longer applies. In other states, such as Tennessee, such bans will take effect after 30 days.

"A big problem is that patients may see a decision has been issued by the Supreme Court and automatically assume that abortion is banned," said Nash.

Even though people seeking abortions may still have access, she said, they will likely have a hard time understanding what laws are in place. That could limit the number of procedures performed.

The decision could also motivate abortion opponents, Nash said, who plan to seek even further restrictions on the procedure and other kinds of reproductive care.

Abortion will come up in many races for statewide and local office, said Andra Gillespie, an associate professor of political science at Emory University.

Democrats are using the issue to mobilize their base voters, Gillespie said, to try to counteract some of the headwinds they face in the midterm elections, when the party in control of the White House generally experiences losses. Republicans, she said, may have to find new causes to motivate single-issue anti-abortion voters now that Roe has been overturned.

Georgia's shifting politics and demographics raise questions about what voters will want abortion policy to look like.

A majority of Georgia voters support access to abortion, according to a January 2022 poll from the Atlanta Journal-Constitution and the University of Georgia's School of Public and International Affairs. Roughly two-thirds of respondents said they did not want to see the U.S. Supreme Court overturn the abortion protections laid out in Roe.

Democratic gubernatorial candidate Stacey Abrams has said she plans to make abortion a leading issue in her campaign. Shortly after the Dobbs draft opinion was leaked, she asked potential donors to give money to reproductive rights groups, instead of her campaign. In a video posted to Twitter on Friday, Abrams said she was "appalled" by the Dobbs ruling. "As Georgia’s governor, I will work every day to ensure access to affordable and safe health care for all, including access to abortion," she said.

Her opponent, incumbent Republican Brian Kemp, has continued to voice his support for Georgia's current abortion law. In a statement on Twitter, he called Friday's decision in Dobbs "a historic victory for life" and said he looks forward to its impact on the legal proceedings surrounding Georgia's six-week ban. Passing the law was one of Kemp's first legislative priorities after he took office in 2019.

With a ruling in Dobbs, the law could be in place within weeks or months, said Ron Carlson, an emeritus professor at the University of Georgia School of Law. The federal appeals court reviewing the measure could allow the law to take effect or send the case back to a lower court that would likely make the same decision, he said. "As legal time goes, it will be relatively short," he said. "They'll move in a fairly prompt manner."

The Feminist Women's Health Center, a clinic in Atlanta, wants to take advantage of what little time it may have to provide abortions, said executive director Kwajelyn Jackson.

Jackson said she has been in conversation with other clinics across the South in hopes of taking on their patients. "One reality that we are trying to prepare for is how we might be able to realistically and thoughtfully absorb some of the need from neighboring states," Jackson said. Her clinic already serves patients from rural parts of Georgia, Jackson said, as well as those from Texas, Mississippi, Alabama, and Tennessee.

Distance is only one factor that influences where patients decide to seek care, said Lauren Frazier with Planned Parenthood Southeast, which runs clinics in Alabama, Georgia, and Mississippi. Price, appointment availability, and social networks also play roles, she said. "For folks who may have family support systems somewhere in New York or California, it will make more sense for them to go where they have the level of support that they need," Frazier said.

Meanwhile, some anti-abortion activists see the decision as a chance to make accessing abortion harder for people in Georgia. "Our work really is just going to start," said Zemmie Fleck, executive director of Georgia Right to Life.

Georgia's abortion law doesn't go far enough, Fleck said, because her group opposes abortion at any point, with no exceptions. She said she would like to see the "personhood" language in the law enshrined in the state constitution, effectively outlawing abortion.

Mike Griffin, a public affairs representative with the Georgia Baptist Mission Board, said his group, an organization of Baptist churches in the state, wants to restrict the distribution of abortion medication and require in-person consultations for people considering abortion.

Doctors, meanwhile, continue to weigh what care they'll be able to give patients.

Dr. Joy Baker, an OB-GYN in LaGrange, Georgia, expressed concerns about the decision limiting the scope of her practice and ultimately cutting off more people from care — especially if doctors start to face legal consequences.

Baker pointed to the dozens of counties in Georgia that don't have OB-GYNs, mirroring a national shortage.

"If they just decide to lock us all up, who’s going to take care of the patients?" Baker asked.

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.