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In Tennessee, Abortion Providers Challenge Two-Day Wait for Procedure

Before the National Memorial for the Unborn became a place designed for mourning abortions women and their partners later regretted, it was the site of Chattanooga’s last abortion clinic.

CHATTANOOGA, Tenn. (CN) – Before the National Memorial for the Unborn became a place designed for mourning abortions women and their partners later regretted, it was the site of Chattanooga’s last abortion clinic.

A cross wrapped in white roses stands before a wall of small plaques and names. Stuffed bears and rabbits crowd a shelf that also holds yellowed notes, wrinkled at the corners, and fresh ones placed this July.

After anti-abortion activists bought the building in a bankruptcy sale and shut the clinic down in 1993, they demolished a portion of the building where abortions were performed and, inspired by an account in the Old Testament, placed a limestone boulder – an Ebenezer stone – to commemorate a victory they believe came about only with God’s assistance.

Today, if a woman in Chattanooga seeks an abortion, she must drive about two hours to Knoxville or Nashville, Atlanta, Georgia or Huntsville, Alabama.

Chattanooga is one of 27 cities in the country termed an “abortion desert” by a 2018 study published in the Journal of Medical Internet Research, a city where a woman seeking to terminate a pregnancy has to drive more than 100 miles to the nearest abortion clinic.

The distance some women have to drive for an abortion is the reason why abortion clinics in the state are challenging a Tennessee law in federal court requiring women to wait 48-hours between an initial, in-person consultation with an abortion provider and the actual procedure.

It’s a law that could delay any Tennessee woman’s abortion for weeks, said Aimee Lewis, vice president of external affairs for Planned Parenthood of Tennessee and North Mississippi.

“For patients who have low income or inflexible work schedules, or live in rural areas that are far away from the health centers, they have to miss work, they have to lose wages, they have to pay for additional travel and childcare, just to access the care,” Lewis said. “It's especially onerous for patients who have to travel.”

Lewis added the law demonstrated lawmakers’ distrust in women’s decision making abilities.

The National Bureau of Economic Research, a non-partisan organization, said the effects of mandatory waiting periods for abortions have changed as now 27 states mandate some kind of waiting period before obtaining an abortion, even as the number of abortion clinics decline. The research organization published a working paper examining Tennessee’s 48-hour waiting period this month.

Advising readers to view the results with “some caution because of limited statistical power,” the study estimated that the 48-hour waiting period in Tennessee increased the number of second-trimester abortions by 38% while reducing the number of overall abortions by 6%.

“In total, the mandatory waiting period could increase the monetary cost of obtaining an abortion by a total of over $900 when accounting for fees, transportation costs, lost wages, and childcare,” the study found.

On Monday, the lawsuit brought by Tennessee abortion providers such as Planned Parenthood heads to a bench trial in a federal courtroom in Nashville. Among their arguments, the abortion providers argue a 48-hour wait for an abortion violates the Equal Protection Clause of the Constitution because it treats women and their decision making differently.


Autumn Katz, senior counsel for the Center for Reproductive Rights – which is helping represent the abortion providers – said the abortion clinics will focus their arguments on the facts on the ground and the real-world impacts of Tennessee women. To that end, they lined up eight witnesses to testify during the trial.

The Supreme Court’s 2016 decision Whole Woman’s Health v Hellerstedt, according to Katz, directs courts judging an abortion restriction “to weigh the evidence and look at the benefits and the burdens of the law. And if the burdens outweigh the benefits, then the law should be struck down as unconstitutional.”

Matthew Cloutier, from the Tennessee Attorney General’s office responded to the abortion clinic’s pretrial brief by saying the state has an interest in fetal life and maternal health.

“Recognizing the unique status of abortion, the Supreme Court has upheld reasonable regulations—including waiting periods—even where these regulations have made abortions more inconvenient and expensive,” Cloutier wrote.

The Tennessee Legislature passed the law mandating a 48-hour waiting period in 2015, around the time voters amended the state constitution to specify it did not recognize the right to an abortion.

The trial comes at a time when several neighboring states such as Georgia and Alabama have passed laws (quickly challenged in court) restricting abortions to the first six weeks of pregnancy or even outright banned the procedure.

Over the summer, earlier in the summer, Tennessee senators held a hearing, considering a ban on abortion that will be taken up in the next legislative session starting in January.

Meanwhile, one of the closest abortion clinics to Chattanooga, the Knoxville Center for Reproductive Health, performs about 1,400 abortions annually. Since lawmakers passed the 48-hour waiting period, the clinic along with others across the state have seen a slow decline in the number of abortions, something Corinne Rovetti, nurse practitioner and co-director at the clinic, said was due to women seeking services out of state.

Rovetti added the lack of an abortion clinic near Chattanooga is a sign of a lack of other services for women’s health.

“Chattanooga has also then been denied an affordable, accessible, family planning and birth control and basic women's healthcare in a clinic setting, in a more accessible way, other than in a private doctor's office,” Rovetti said.

Michele Cheresnick, a director of client services at Choices Chattanooga, a crisis pregnancy center that moved next door to the National Memorial for the Unborn, said the 48-hour waiting period is not unlike the time it takes to undergo any other medical procedure.

“I think it empowers women to not respond emotionally but to respond logically,” Cheresnick said. “Anytime you're in a situation where you think you've got to make a decision right now, you race to the end of that decision rather than take a step back and say 'What really is what's best for me?'"

About 576 people turned to the crisis pregnancy center last month, seeking services such as pregnancy tests and parenting classes.

Mike Jennings, a Chattanooga-based attorney that has dealt with adoption law for about 30 years and helped buy the building belonging to Chattanooga’s former abortion clinic, downplayed Chattanooga’s proximity to an abortion clinic saying it’s common for Chattanoogans to drive to nearby cities to catch sporting events, and women could seek abortion in Georgia, where they can receive an initial consultation by phone, wait 24 hours and receive an abortion in Atlanta.

“It's a high-volume, high-dollar kind of medical practice,” Jennings said.” If you can get a woman in one time, and do everything you need to do, and get her out and collect your money, that's more profitable than having to talk to her twice.”

According to the Guttmacher Institute, a nonpartisan organization researching reproductive health policy once affiliated with Planned Parenthood, there are six states that require 72-hour wait periods.

While abortion rights advocates say striking down Tennessee’s law would increase abortion access for women in the state, anti-abortion advocates such as Jennings worry Tennessee might become a destination for out-of-state women seeking to terminate their pregnancies.

The fate of that law has been assigned to Senior Judge Bernard Friedman. The judge, appointed by President Ronald Reagan, ruled Michigan’s ban on same-sex marriage ran contrary to federal law in 2014 and  struck down the federal government’s ban on female genital mutilation last year.

The trial is expected to last a week.

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