By Peter Slevin
Washington Post Staff Writer
Monday, June 8, 2009
JACKSON, Miss. -- Twelve women sat gloomily in a windowless conference room as Joseph Booker, M.D., recited the instructions required by the state of Mississippi before he can perform an abortion.
"Try to bear with us," Booker began. "This is something we have to do."
Prenatal benefits may be available, prospective fathers are legally liable for support and a list of adoption agencies can be provided, he said, ticking through a list worn into his memory. He offered the women a packet that included a brochure containing color photos of tiny fetuses inside the womb.
No one took the packet. Each woman silently signed the consent form in her lap and filed out. They passed a line of singing and praying antiabortion protesters -- "Do you have time for a 15-second prayer?" "Ma'am, killing your baby isn't going to help" -- to wait the 24 hours mandated by Mississippi legislators.
Booker's clinic is the only place left in Mississippi to obtain a legal abortion. Access is no longer simple at a time when the biggest battles over reproductive rights are taking place not in Washington but in Jackson and Bismarck, Little Rock and Helena. In 2008 alone, state legislatures nationwide considered about 400 measures to restrict abortion.
Recognizing that strong Democratic majorities and the election of Barack Obama as president make it increasingly unlikely that federal laws will be tightened or Roe v. Wade overturned, opponents are pressing legislators to make abortion more difficult to obtain and, they hope, harder to accept.
Rules requiring that a woman be offered the chance to view a sonogram are designed to make her think again. Laws imposing a waiting period after a first visit to a provider have the added effect of raising the obstacles and the costs, especially for poor and working-class women, who are the ones most likely to have an unintended pregnancy.
In states from South Dakota to Texas where the fights are waged, supporters of a woman's right to abortion feel increasingly embattled. Some doctors and clinic personnel feel threatened, particularly since last week's slaying in Kansas of physician George Tiller, the nation's best-known abortion provider. Others say they simply feel beleaguered.
"The states are the battlegrounds and certainly the testing grounds of new kinds of restrictions," said Gretchen Borchelt, senior counsel at the National Women's Law Center, which defends abortion rights. "State legislatures can be more creative in what they're trying to push and see what works."
"We tried every which way, and we were successful in the state way," said Terri Herring, head of Mississippi's Pro-Life America Network. She calls ever-stricter regulations a matter of common sense and creative strategy.
"All-or-nothing means nothing," Herring said. "Incremental means something."
What it means in Mississippi, one of the most restrictive states in the country and a model for antiabortion forces elsewhere, is that a woman seeking an abortion must go twice to the clinic, at least 24 hours apart. A girl younger than 18 requires the consent of both parents or a judge's signature. Public money is available for very few abortions.
Such rules are known as TRAP laws, for Targeted Regulation of Abortion Providers.
"We've got a glut of bills we fight every year," said Felicia Brown-Williams, a Planned Parenthood staffer in Hattiesburg. "We spend the first two months in sheer and utter panic that one of these bills is going to get past us."
Planned Parenthood, which provides abortions in clinics across the country, does not provide them in Mississippi. The reason, said a spokesman, is "the amount of regulations and the cost." Five other clinics have closed, leaving only the Jackson Women's Health Organization, founded by clinic operator Susan Hill.
"We've got rules like crazy," Hill said.
Herring and her colleagues are pleased but not satisfied.
"Mississippi clearly has done all that we can within our current legal culture to end abortion here," Herring said, "and yet we have one remaining abortion clinic."
Booker, 65, remembers when there were six. He worked at another Mississippi clinic from 1989 to 2003, then moved to this one. Opponents have picketed his home in a nearby town, he said, and knocked on his neighbors' doors to denounce him as a "baby killer."
One of the regular clinic protesters, C. Roy McMillan, was a signer of the Defensive Action Statement, which asserts that killing an abortion doctor is justifiable homicide because it saves the lives of the unborn. Scott Roeder, accused of killing Tiller, told friends he agreed.
For 18 months between 1994 and 1996, Booker was under the protection of U.S. marshals, who moved him from place to place for his safety. Years later, he often wears a bulletproof vest.
"After Dr. Tiller died, I started thinking, 'What's the use?' They'll just shoot me in the head," Booker said. Although deputy marshals met with clinic staff members in Jackson last week to consider providing protection, he said he intends to continue living at home and following his routine.
"I'm older now," Booker said. "I'm not going to let them paralyze my life for how I think. That's what they try to do, bully everybody out for doing abortions."
Booker, who performs about 60 abortions a week, said he is careful to follow state law. But, citing medical research, he refuses to comply with the legislative mandate to tell women that abortion increases the risks of breast cancer and infertility. During one counseling session last week, he called them "two things definitely not associated with having an abortion."
He then explained how to complete the consent forms.
"Signature, date and time. Full name. No initials," Booker said. "Today's date is six four oh nine. Our time's going to be 10:25 a.m."
The time is important. Booker, determined to give his critics no cause to shut the clinic, wants no exceptions and no mistakes.
"If they come 20 minutes early," Booker said, "they won't be seen before the 24 hours is up."
For all of the talking he does, Booker and counselor Betty Thompson said they see few women express interest in what he is saying. They also say the requirement to come twice to the clinic is an economic and personal hardship, especially on the state's poorest residents, some of whom live as many as three hours away.
A woman named Temeka said her mind was made up before she took a day off from work to visit the clinic. Six weeks pregnant with twins, she decided that giving birth and raising the children would be too much -- on top of her marriage, her mothering of a 1-year-old, her full-time job at a sandwich shop and her studies at a junior college.
"I have doubts, but I know what I've got to accomplish," said Temeka, 26, who asked that only her first name be used. "I already asked God for forgiveness."
Counseling completed, Temeka walked the line of the beseeching protesters, headed for her car and an 80-minute drive home. She wished she could have an abortion without the waiting period, in a private clinic.
"You've got to face the protesters and all the things they're telling you," she said just before leaving the clinic to walk to her car. "I'd just rather get it done and go away and put it behind me."
As she left, protesters on the other side of a fence scrambled to walk alongside her, barely three feet away. "Prayer? Prayer?" one woman called. Another asked, "Can we do anything for you, sweetie?"
Temeka walked straight ahead, past the boy and girl whose signs said in bold black letters, "WE CAN HELP." Past a man who began to pray in a loud voice, "Let these women who think they don't have a choice know that they have a choice. Their babies do not have to be destroyed."
Herring has worked on more than a dozen pieces of legislation with the Chicago-based Americans United for Life, which takes credit for "helping state after state become more pro-life every year." Her next goal is a law requiring clinic staff members to report the identities of the sexual partners of pregnant underage girls. She is also working on a school curriculum.
"We have helped build a legal fence that helps protect women," Herring said. "The greater goal, even in legislation, is to influence the culture. This is a major culture war that isn't going away."