Abortion clinics were forced to turn patients away following a decision by federal court to enact Georgia House Bill 481 without a grace period.

U.S. Court of Appeals for the 11th Circuit said Monday it will hold off ruling on Georgia’s anti-abortion litigation until the nation’s highest court settles a case that could have implications for Georgia’s 2019 law.

The decision by the 11th U.S. Circuit Court of Appeals to immediately enact Georgia's strict abortion law has forced abortion providers to swiftly pivot.

Credit: John McCosh/Georgia Recorder

A federal court ruling on Wednesday immediately set Georgia’s strict abortion ban into motion. It’s taken abortion providers by surprise.

They thought they would have about a month to prepare before House Bill 481 was enacted as the ruling made its way back through lower courts.

Lauren Frazier works for Planned Parenthood Southeast. She called the decision by the 11th U.S. Circuit Court of Appeals to issue an immediate stay on the injunction on the law “unorthodox.” 

“Those folks who were beyond six weeks will now have to have their appointments canceled,” Frazier said. “And so those are the conversations that we are having today and over the next couple of days.” 

Three clinics in the metro Atlanta area are the last stronghold for Planned Parenthood Southeast’s abortion services, since neighboring Mississippi and Alabama implemented total bans last month. Clinics in those states have shifted to providing basic health services, such as offering STD and pregnancy testing and contraception. 

Frazier said although patients are being turned away, Planned Parenthood Southeast can still provide financial assistance for travel and child care, funded by grants and donations. The nearest states with better abortion access are Florida and North Carolina. 

“It's an impossible situation that we found ourselves in and where we're trying our best to serve our community in the way we know how,” said Kwajelyn Jackson, director of the Feminist Women’s Health Center in Atlanta. “But the constraints that have been put upon us are extremely detrimental to many, many people.”

Jackson’s clinic also had to cancel patient appointments Wednesday. She said the majority of those patients are people of color. In 2021, 67% of abortions in Georgia were had by Black women. 

While HB 481 doesn’t ban abortions outright, it does make them extremely difficult to get. That’s because historically, more than half of abortions in Georgia happen after the six week gestational period, when it’s still too early for most people to know they’re pregnant. 

READ MORE: Federal appeals court rules Georgia abortion ban can immediately take effect


Abortion providers in legal limbo

The abortion ban prohibits procedures “after detected human heartbeat” with exceptions for pregnancy caused by rape or incest if a police report is filed. Cardiac activity usually shows up on an ultrasound at about six weeks of pregnancy, but health care professionals warn the term “fetal heartbeat” is medically inaccurate

“Often times, health care providers are forced to interpret and apply a medical definition to a political phrase,” Jackson said. “We don't call it a heartbeat in any of our paperwork or language. We do reference cardiac activity or fetal heart tones.”

While other parts of the law remain vaguely explained, such as when exactly providers can classify a pregnancy as “medically futile,” Jackson said her clinic will continue to work with legal counsel to help interpret HB 481. 

For those who can get an abortion in Georgia, it will either be medicated — using two drugs that induce termination of a pregnancy — or surgical. Planned Parenthood Southeast is only providing medicated abortions but other clinics in the state offer both methods. 

While a telehealth visit is still technically legal as a means of being prescribed an abortion pill, it’s not being offered regularly in Georgia because detected cardiac activity is used as an indicator. Without an ultrasound report, physicians prescribing a medicated abortion could be prosecuted. 

Jackson also warns that even if people get access to an abortion pill outside of a clinic, they could face “aditional legal risks” under HB 481’s fetal personhood language, which classifies “unborn humans in the womb at any stage of development” as people with legal protections. 

That’s why the Feminist Women’s Health Center provides only provides medicated abortions in-clinic.  

With all the additional barriers set on abortion providers, Frazier isn’t optimistic about the long-term effects on health care capacity. 

“I wouldn't be surprised to see more providers looking elsewhere to work,” Frazier said. “And that's going to be difficult, because I think we're already facing such a huge provider shortage.”