What girls and women can do to cope

Because I’m interested in reproductive rights, I did some research to find out how a young woman (or girl) who doesn’t want children can navigate this new legal landscape.

Timothy Olson
| Guest columnist

Dr. Timothy Olson is a psychiatrist who practices in Des Moines and has lived in Iowa his entire life.

The Iowa Supreme Court ruled June 28 that the state can take a woman’s body if there is a reason to do so (“rational basis”). That means the “fetal heartbeat” law, passed last year by the Republican-controlled Legislature and signed by the governor, could soon go into effect.

The law is intended to force a woman (or girl) to bear a child. Pregnancy and childbirth are a threat to the woman’s health. In about 30% of cases, she has to undergo a caesarean section, among other things. The law is intended for religious groups that consider life in the womb as spiritually equal to a woman.

The “fetal heartbeat” can be detected by Doppler ultrasound at 6 weeks, before many women know they are pregnant. At this stage, the embryo—not yet a fetus—is about the size and shape of a pea. It is life, but not what most people would call a child.

More: As Iowa’s ‘fetal heartbeat’ abortion ban looms, clinics brace for uncertain future

The law is backward and cruel, but it is the law. I am a physician with a specialty in psychiatry, not obstetrics. But with an interest in reproductive rights, I did some research to find out how a young woman (or girl) who is not planning to have a child can navigate this new legal landscape.

The most important thing is to avoid getting pregnant. Intrauterine devices and long-term implants are nearly 100% effective, but they are not for everyone. Other methods often fail due to imperfect use. With condoms, for example, the real-world pregnancy rate approaches 20% per year. Aim for perfection.

Consider the morning-after pill if you have contraceptive problems. Generic levonorgestrel, 1.5 mg, is widely available for about $6. It should be used as soon as possible after sex, generally within 72 hours.

Detect pregnancy as early as possible. On the first day of your missed period, you are already four weeks pregnant (from your last menstrual period), leaving only two weeks to get an abortion at an Iowa provider. Monitor your period and test regularly. Pregnancy test strips are available in bulk for about 30 cents each.

There are other good reasons to diagnose a pregnancy early:

An early abortion is less traumatic, both physically and emotionally.
For the 15% of women who are Rh negative, the risk of incompatibility increases later in pregnancy.
An early medical abortion has a greater chance of success.
If an early medical abortion fails, there is still time to repeat it.

If you miss the six-week deadline in Iowa, you can still get an abortion at a clinic in Illinois (24 weeks), Minnesota (24 weeks), Kansas (22 weeks), Wisconsin (22 weeks), or Nebraska (12 weeks). A clinic abortion can be expensive, but financial assistance is often available.

Desperate women may be attracted to online clinics or pharmacies for a medication abortion, from about 10 to 13 weeks. The clinics violate Iowa law and offer limited medical support. The pharmacies sometimes provide pills that are counterfeit or expired. As a physician in Iowa, I cannot recommend these options.

While the fetal heartbeat law doesn’t impose any penalties on women, there are still legal risks. But if you have an illegal abortion and are having problems, don’t hesitate to consult a medical provider. Simply say that you think you’re having a miscarriage and ask the provider to avoid sensitive topics unless medically necessary.

If for any reason you wish to keep your abortion a secret:

Tell a minimum number of people about your pregnancy and your plans.
Avoid mentioning your situation in text, email or social media. Immediately delete all revealing content from all folders, including the trash.
Keep your abortion research private. Put your browser in incognito mode and use the DuckDuckGo search engine.

So, women of Iowa, you can still control your own bodies. You can still choose whether or not to have a child. You can still live according to your own religious beliefs. Just don’t expect help from your state government.

Dr. Timothy Olson is a psychiatrist who practices in Des Moines and has lived in Iowa his entire life.