The state legislature is to vote on a bill banning terminations after six weeks but so-called Trap laws have already severely restricted access

Kathaleen Pittman still remembers the first time she had to turn away a patient because of new intrusive anti-abortion laws in Louisiana.

“We had the patient already prepped and ready to go – medicated and everything. Then we got a call from our attorney saying that the governor had just signed the 24-hour waiting period into law,” said Pittman, who has worked on staff at the Hope Medical Group For Women in Shreveport for more than 26 years.

She recalls telling the patient that she’d have to go home for now. “The governor doesn’t think you’ve thought about this sufficiently,” Pittman told her.

The woman’s face scrunched in utter confusion. That same day, staff began huddling and figuring out how to make sure they were compliant in patient care.

Pittman continued: “I remember telling our administrator at the time: ‘Well, if this is the worst they throw at us I guess we can deal.’ Then she got this really weird expression on her face and she says: ‘Oh, no, no, no no. This is just the beginning.’ And boy, was that prophetic.”

Louisiana senate passes anti-abortion bill in latest attack on women's rights Read more

It has been more than 20 years since that round of regulatory onslaught, and anti-choice lawmakers haven’t let up. On Wednesday Louisiana looks set to vote on making abortion illegal beyond the sixth week of pregnancy – following a slew of other states who have passed similar laws. The law is described inaccurately by its supporters as banning abortion after a “fetal heartbeat” is detected, but experts have pointed out that this terminology is wrong on both accounts.

But even without the new law abortion has been prohibitively difficult in the state for decades. Lousiana’s lawbooks hold more than 1,000 medically unnecessary requirements regarding abortion, according to the ACLU. These include laws requiring not just waiting periods, but the reading of counseling scripts, mandatory ultrasounds, and what choice advocates call “Trap” laws, or Targeted Regulations of Abortion Providers.

Unlike the recent onslaught of unconstitutional anti-choice legislation in states like Alabama, Ohio and Georgia, most of these laws do not depend on a future landmark supreme court decision to go into effect, and are already curbing women’s access to reproductive healthcare. Thanks to those regulations Louisiana, which had 17 abortion clinics in the early 1990s, has just three today. Additional pending Trap legislation could make it difficult for all but one to remain open.

“There’s a slew of burdens that abortion providers are required to meet, that other medical providers are not,” said Katie Caldwell, the clinic coordinator for the Women’s Healthcare Center in Baton Rouge. “If they were meant to actually provide more competent healthcare then they would be implemented across the board.”

A common form of Trap language are laws that hold abortion clinics to the same building code standards as hospitals and ambulatory surgery centers, and laws which require doctors who perform abortions to have admitting privileges at a nearby hospital.

Many of the laws impose catch-22 scenarios that are nearly impossible to square – some would argue intentionally so. For example, many hospitals set a minimum number of admissions a physician must make every year before they can be granted admitting privileges. The catch here for abortion providers is that, given how relatively safe the procedure is, they will generally be unable to reach that threshold. Critics of these laws point out that many procedures, from dental surgery to colonoscopies carry a much greater probability of a serious adverse reaction, but providers have not been required to jump through the same regulatory hoops.

More Trap laws are winding their way through the Louisiana state legislature and likely to become law this year, including one that would require those seeking medication abortions to visit one of the state’s three remaining abortion clinics. Currently, those patients can obtain the medication during a visit to a gynecologist’s office.

Critics say the law, like many abortion regulations, serves no medical purpose. “Leading medical experts agree that there is no improvement to patient health and safety by requiring medication abortions to be performed in any particular type of location,” said Ellie Schilling, an attorney who has represented all three of Louisiana’s remaining abortion providers in recent years.

Dr Kiersta Kurtz-Burke sees the impact of the laws from the vantage point of both a healthcare provider and a patient.

In 2007 Kurtz-Burke had a medication abortion for a non-viable pregnancy. She said that being able to undergo the process with a gynecologist she had been seeing for years, and trusted, made the difficult experience less traumatizing.

The ability to have a medication, rather than surgical, abortion in this setting was also important. “I wanted to be with my husband, I wanted to be with my friends. And that was really paramount, I think, to my mental health,” Kurtz-Burke said.

As a physician, Kurtz-Burke also sees the regulations as insulting to the women’s health professionals who undergo years of training related to pregnancy. “To take this out of the hands of people who’ve trained to do this their whole life and take it out of that established doctor-patient relationship is really insulting not just to women, but to physicians as well,” Kurtz-Burke said. “It really is the height of hypocrisy, and there is no way to read this, other than control of women’s bodies.”

Kurtz-Burke also worries about the effect on poor women, calling the legislation classist. She notes that, as someone earning a professional salary, she could afford to travel to a clinic if there wasn’t one nearby, and stay overnight for a night or two. That’s a much heavier lift for women in poverty, especially those who live in rural areas, far from one of the state’s three clinics. “That means that essentially, you’re setting up a situation where you’re forcing people to give birth,” Kurtz-Burke said.

Of course, the concerns about clinic access and how it affects poor women are only new to the conversation around medication abortion. For patients who need surgical abortions, those barriers have long been in place.

“It’s cruel, it’s wrong. I don’t know any other way to describe it,” Pittman said.