Gov. Brian Kemp signed Georgia's House Bill 481 into law in 2019.

The abortion legislation remains tied up in federal courts, but in the wake of the Supreme Court's overturning of Roe v. Wade, HB 481's ban after six weeks of gestation has abortion providers — and women from Georgia and neighboring states — bracing for a new plan of care.


The first hurdle? Even knowing you’re pregnant

Six weeks is a difficult time frame in which to pinpoint the length of a pregnancy.

"Most women are not going to know that they are pregnant at the time of conception," Haben Debbessai said.

Debessai is a resident physician in obstetrics and gynecology in Atlanta. She said pregnant people usually don’t know they’re pregnant until four weeks later, or around the time that people with a regular menstrual cycle notice a missed period.

Some early-detection pregnancy tests can provide results around a week earlier, but that is not realistic for many women, Debessai said.

"Unless you’re kind of habitually taking pregnancy tests, it might be really difficult for you to get to know that you're pregnant with enough time to make that decision if that ban were to go into effect," Debessai said. 

Realistically, a pregnant person would have two weeks to make an appointment with an abortion provider. Compare that to close to three months under current law which allows for abortions up to 22 weeks of pregnancy. 

The most recent tally of abortion providers in Georgia is 26, but it's from 2017. Closures or changes in specialty care since then puts that number closer to 12, said Kwajelyn Jackson, director of a clinic in Atlanta.   

"And again, I think not all of those are currently providing abortion care," Jackson said. "That is the also sort of, like, the thing that remains in flux."

The remaining clinics aren’t spread evenly across the map, either. People might have to drive hours for an appointment, something public health data suggests might influence them not to make the appointment at all. 

Jackson’s clinic, the Feminist Women's Health Center, is already seeing an influx of patients from states that have banned or severely restricted abortion on top of the patients she already has scheduled. She said while her staff isn’t turning people away, it's a difficult matter.

"We have been trying to very carefully manage how we absorb additional patients because we really sincerely don't want to overload our staff," Jackson said. 

That’s already with Georgia’s current 22-week limit on access. 


When you get an appointment, what comes next? 

Since 2005, Georgia law mandates abortion counseling before an abortion procedure. Only the team performing the abortion can offer counseling, but it doesn’t have to be done in person. 

Almost every person seeking abortions in Georgia between 2006 and 2021 got counseling over the phone. Diane Derzis,  who owns the Columbus Women’s Health Organization clinic, said the counseling is easy. 

"It only takes a minute to read all of that stuff," Derzis said. "It should be called the relay of information."

That's information offered under the state’s “Women’s Right To Know” law, which also mandates people sit with the information for at least 24 hours. 

And, Jackson said, that waiting period could mean a lot. 

"If you are outside the window by a day, then you have to go somewhere else and essentially start that clock over based on the parameters and obstacles that might exist in the state that you're traveling to," Jackson said. 

Emory University’s Elizabeth Mosely said the new hurdles imposed by HB 481, if it goes into effect, won’t technically make abortions impossible, but they will pile on challenges for people in what was already a tough system to navigate. 

"We know that people who are living on lower incomes, people with disabilities, people in rural areas and people of color are more likely to face those challenges," Mosely said. 

Plus, typically more than half of Georgia abortions happen after the six-week gestational period. 

"I think it's safe to say that a six-week ban is outlawing most abortion in Georgia," Mosely said.