By Rose Hoban and Anne Blythe
Before the North Carolina state Senate joined the state House of Representatives in adoption of a bill to restrict abortion after 12 weeks of gestation, Senate Democrats asked a series of questions and offered pointed comments that could be useful to anyone filing a legal challenge against the legislation.
In a session that started shortly after 10:30 a.m. Thursday and lasted until 5 p.m., with an hour break at lunchtime, the complaints lodged against Senate Bill 20 centered on multiple themes including that:
- The legislative process was flawed and did not comply with typical bill-making procedures.
- New restrictions would have disparate impacts particularly on low-income, Black and rural women.
Democrats cited sometimes arcane rules in exchanges over procedures and protocols as they fruitlessly maneuvered to block SB 20. The legislation was rolled out Tuesday night by Republican leaders, passed through the House of Representatives late Wednesday on a party line vote, then landed on the Senate floor Thursday morning for what became a marathon debate — the likes of which some said had not been seen in a decade.
The Senate approved the bill along party lines, too, with 29 Republicans supporting the new abortion restrictions and 20 Democrats opposed to them.
The next stop is the desk of Gov. Roy Cooper, a Democrat who has vetoed all previous attempts to restrict abortion beyond the 20-week limit currently in place.
Cooper issued a tweet on Wednesday, with his signature RC at the end, saying: “I will veto this extreme demand and need everyone’s help to hold it.”
Based on numbers alone, that could be a tough ask. Republicans have enough members in each chamber to override any veto.
Bill imposes wide-ranging restrictions
The debate began Thursday with Republican women lauding their negotiations between the House and the Senate — chambers with wide-ranging ideas about what kinds of abortion limitations would be added into North Carolina law now that Republicans have supermajorities in the Senate and House.
Primary sponsor Joyce Krawiec (R-Winston-Salem) started the drawn-out session by introducing what she called “mainstream common-sense legislation,” before noting that she had only read the full bill for the first time on Wednesday.
“This is a 46-page bill,” Krawiec said in response to a series of questions from Sen. Jay Chaudhuri, a Democrat from Raleigh. “I read it yesterday, as you did, and I don’t remember all parts of it.”
While the bill does not completely ban abortion after 12 weeks, it does set up significant hurdles to obtaining care after that point. People seeking abortion care must meet face-to-face with a doctor to receive information, get an ultrasound and give informed consent. Three days later, the pregnant person then needs to take abortion pills in the presence of the same provider. Finally, the patient needs to return within the subsequent two weeks for a follow-up visit.
Krawiec argued that a 12-week restriction is in line with standards in many European countries.
But Temple University law professor Patty Skuster, who studies global abortion issues, said that Krawiec’s statement lacks the context that makes European abortion restrictions different.
“Some countries do have limits early for abortion on request, however, most of those laws also allow later access in pregnancy, including in many cases, health grounds, and don’t contain the onerous restrictions,” Skuster said.
Many European countries have publicly funded health care and in many cases, abortions are paid for by those health systems, she said. Those countries also offer social services, parental leave and child care.
Under SB 20, people seeking an abortion after that point will be compelled to receive care in a hospital, surgery center or clinic that meets surgical standards. Those sites are often more expensive to access than the state’s 14 abortion clinics, which often have sliding scale fee schedules.
“Abortions are very serious medical procedures, and they should be performed in the safest place possible and regulated just as any other procedures are done,” Krawiec argued. The bill requires that any facilities meet the same health standards as ambulatory surgical centers, but it leaves creation of standards up to the state Medical Care Commission.
Those exact parameters are not fully known.
“We are still reviewing SB 20 and are not yet able to determine if any existing health care settings who perform abortions will be able to do so if this legislation becomes law,” Patsy O’Donnell, a spokeswoman for the state Department of Health and Human Services wrote in an email. “The same rules and regulations apply to facilities whether they are performing surgical abortions or medication abortions.”
Fighting ‘a myth’
Sen. Amy Galey (R-Burlington) recounted her evolution from a young pro-choice law student in a Democratic family, where her father believed that “Jimmy Carter hung the moon,” to a Republican who is a “passionate advocate for the sanctity of life.”
With a voice that sometimes quivered with emotion, Galey took Democrats to task for advocating for abortion throughout pregnancy, including into the third trimester.
“I ask my fellow senators who are Democrats will one of you — any of you — stand up and tell this body that it is not OK to abort a healthy child in the 39th week of a pregnancy? What about the 37th or the 36th?” Galey asked.
No one in the chamber answered her question. But physicians say that procedures in the third trimester are virtually nonexistent.
“Third trimester abortions are a myth,” said Duke Health OB-GYN Beverly Gray in a webinar with reporters Thursday afternoon. “I’ve been in medicine [for] over a decade. I’ve been working in OB-GYN, and that’s not something we need to legislate against because it is not something that happens.
Statistics from the Centers for Disease Control and Prevention show that in 2020, the most recent year with complete data, only 48 out of 29,636 abortions in North Carolina that year took place after 21 weeks.
Fearing wider inequities
As the afternoon wore on, each of the chamber’s 20 Democrats stood to use their allotted 10 minutes of debate time with little rebuttal from Republicans in the majority. Many Republicans left the chamber while Democrats were trying to make their case.
But Sen. Vickie Sawyer, a Republican from Cornelius, repeatedly reprimanded Democrats who referred to the provisions in the new law as a “ban.”
“There’s no such language in this bill, because this bill does not ban abortion,” Sawyer said more than once. Democrats responded that the regulations both before and after the 12-week cutoff were onerous enough that for many women, they effectively would be a ban.
“These restrictions disproportionately affect … vulnerable communities, including low-income individuals, people of color and rural residents, who often lack access to affordable health care and support systems,” said Sen. Julie Mayfield (D-Asheville). “Denying them access to safe and legal abortion only exacerbates the inequalities they already face and puts them at greater risk for mental health issues.”
Those issues were a theme for many of the Black Democratic senators who spoke about the poor maternal and infant health outcomes in their communities.
“It’s Black women who suffer under most abortion bans,” said Sen. Kandie Smith (D-Greenville). “The history of reproductive oppression in the United States has disproportionately affected communities of color, particularly Black women.”
Sen. Natalie Murdock, a Durham Democrat who has introduced legislation several times to bolster services for Black women, echoed Smith’s concerns.
“Black maternal health rates and all maternal health rates continue to go in the wrong direction, jumping up again in 2022,” Murdock said, citing the fact that Black women have the highest maternal mortality rates in the U.S. — 53.3 out of every 100,000 live births.
“Black women were two to nine times more likely to die from a pregnancy-related issue than white women,” Murdock said. “Let’s touch on pregnancy complications. They are the sixth leading cause of death among Black women ages 20 to 44, while pregnancy complications do not rank in the top 10 causes of death for any group of white women.”
Murdock went on to tell her colleagues that once this bill becomes law, she fears becoming pregnant in North Carolina. She said she had already consulted a OB-GYN friend in Virginia to help her should she decide to have a baby.
“Love this state. North Carolina native,” Murdock said, tearing up. “But I’m absolutely horrified, horrified at the prospect of having a child in my home state. I’m horrified.”
Shortcut subverted discussion
As each Democrat completed speaking and the afternoon drew to a close — almost six hours after they started discussing the bill — Minority Leader Dan Blue (D-Raleigh) compared the Senate to a family.
“As lawmakers, a big portion of the family that should have been included in the discussion [about the bill] but was intentionally excluded,” Blue said. “And the value of having talked to all the family is immeasurable. I think a lot of the things that you heard on the floor would have been heard in committee, and you could have done something about them.”
Then Blue moved to file a constitutional protest against the proceedings and the bill, something done by House Democrats on Wednesday night.
As Blue walked to the dais to hand up his written protest, Sen. Gladys Robinson (D-Greensboro) rose to do the same thing. As she walked to the front of the chamber, Senate Leader Phil Berger, cut off further comment. Democrats continued to walk toward Berger at the podium, one by one, to file their written protests.
Berger called for the vote. With that, protesters in the gallery erupted into chants before being led out of the chamber. The debate inside the chamber had ended.
Correction: A previous version of this article incorrectly identified the party with which Sen. Julie Mayfield is registered. She is a Democrat.
Tell us your story about abortion access
NC Health News will be continuing to cover the effects of increased abortion restrictions in the months ahead and the best way for us to do that is with your help — hearing concrete examples of how you are navigating the new law. Have you been affected by new abortion restrictions as a medical professional or a patient? NC Health News is interested in hearing your experience.
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