Inside the Fight to Repeal Massachusetts’ Gestational Ban

I'm especially not a fan because when I record the podcast, I have to close all my windows so you don't hear anything that's happening outside. And I have to turn off my AC so that you can't hear the fan running if it runs off. And that means I just sit here and roast.

There's a sunlight, well, depending on the time of day, but today when I was recording, there was like sunlight directly where I was sitting. So it was just like slowly getting hotter and hotter as we were having this conversation and it was making it a little hard to focus, but that's okay. It was still a great conversation. Don't worry, y'all.

I made sure that we had a good conversation, but yeah, not a fan. And adding on top of that, as it has gotten warm, for some reason, all of a Like, hey, I need to snuggle with your arm while you're working.

And I know you're hot and sticky and gross, but I'm just going to lay my entire kitty body all down the length of your arm and use your hand for a pillow. Thanks. So not a fan. She's lucky. She's cute. But yeah, I don't need kitty snuggles while I'm working and while I'm hot.

Like, thanks, Luna. Otherwise, I feel like there's just so much happening and so many terrible things to keep track of, whether that is the reconciliation bill or this new rescissions package, which is looking to claw back a bunch of money from foreign assistance, particularly from global health and public broadcasting and. Yeah, just a lot.

And there is the what is happening in Los Angeles. There are many ICE raids that have been feel like they've been going on for forever. And there's just so many terrible things. And I'm recording this on Wednesday, June 11th. So before that. the big military parade in DC this weekend. Uh, so the got that to look forward to.

And by that, I mean, I am staying in my condo all day and not going outside. I don't want anything to do with it. I don't want to be near it. I don't want to deal with it. I'm sure I'll hear all of the helicopters and if there's planes and stuff flying over overhead, but yeah, I just, I don't want anything to do with any of it.

And, um, There's just, I feel like it's back to that time where I've been trying to be really good about not being on social media a lot to not get caught up in what the new latest outrage is. But there are so many like legit, terrible things happening that it's hard to keep up and it's overwhelming. And I know that's the point, right?

Is to have so many things happening that you can't focus on any one of them and it makes it harder to push back. The point is to overwhelm us.

And unfortunately for me, I the moment it seems to be working like I'm losing my outrage capacity at the moment like I still have like that flash like right when it happens but I can't stay focused on it because there's like the new outrage like 10 minutes later so I'm trying to find my peace again so that way I can more effectively fight back in the many

ways that I try to fight back so I'm Yeah, I'm just feeling a little overwhelmed right now by all of the things. And like I said, there's just so much happening that it is making it hard to focus on any one of them. Yeah, sorry to be a little bit of a bummer today, y'all. Let's go back to kitties, right?

Let's go back to luna deciding it is okay to need to snuggle with my arm when it is 90 degrees and I am hot and gross. Okay, actually, let's just turn to this week's interview.

I feel like there's a lot going on and i could talk about any number of them but again my brain is like scattered and having a hard time focusing on any one of the terribles so let's just talk about about this week's episode instead. I'm excited. This is the next in our series on abortion later in pregnancy.

I am so very grateful to Patient Forward for helping me put this series together, in particular, Bonyen, who has been so helpful in helping me outline the series and find guests and really helping put this all together. I am very excited for this whole series.

If you haven't heard the first two episodes, we'll make sure to link them in our show notes so that way you can listen to all parts of it because I think it's a really important conversation and today we're going to talk about again abortions later in pregnancy but we're also going to be talking about an effort in Massachusetts to try and repeal their state's

gestational ban and joining me I am very excited to have Kate Dineen a patient advocate and a reproductive equity now board member in Massachusetts who's working to repeal that viability ban and Jeanette Kincaid who's the associate director of care coordination at the DuPont Clinic. I am really excited for our conversation.

So let's go to my interview with Jeanette and Kate. Hi, Kate and Jeanette. Thank you so much for being here today. Hello. Hi, thanks for having us. So before we get into our conversation, why don't I have you all introduce yourselves? Jeanette, would you like to go first?

And I’m excited ‘cause this is a little bit of a good-news episode, which is fun. I feel like I don’t get to do those a ton, to hear about some new fights that are happening. So, but before we get there, Kate, let’s hear about how you got involved in this work. I think it’s always helpful to hear people’s personal stories for people to understand what’s at stake when we’re talking about abortion later in pregnancy.

And the ultrasound tech detected something called ventriculomegaly in my son Teddy's brain. And that led to a whole series of, you know, completely devastating and unexpected next steps. I had a fetal MRI right after that ultrasound. And The MRI detected that my son had suffered a catastrophic stroke in utero.

And he would either die in utero or survive with a spectrum of potentially devastating outcomes. The pediatric neurologist couldn't fully explain what those outcomes would be. So , it's often described as a gray diagnosis, but the prognosis for me and my husband was so devastating that I immediately asked, what are my options?

And I was standing in my kitchen in Boston on a Zoom because this was during the pandemic, and I will never forget the response. I was told, you may still be able to explore termination if you're able to travel. So in that moment, I was just so shocked and confused. You know, obviously still processing the very unexpected and devastating fetal diagnosis.

But I thought to myself, travel where? I live in Boston, which up until then I had thought to be this bastion of reproductive justice. I've always been very pro-choice and supportive of the statutory framework that would allow access to abortion care.

So I thought I understood what our state law was and the kind of care that someone in a situation like mine might be able to access. So, you know, just Florida on a personal level, but also on a policy level. And I talked to my providers and

they were very supportive of the decision that I very quickly made, really without much hesitation. But they couldn’t help me. They explained very empathetically that their hands were tied by our state law, but they would help me get care out of state. Interestingly enough, they found me an appointment at the Dupont clinic in D.C. and it was several days out. And I was so anxious to secure this vital care that I found myself an appointment just a few days earlier at

another clinic in the Metro DC area called the Care Clinic, where I got incredibly compassionate care from the late Dr. Leroy Carhart. And so it was just an incredibly disorienting and raging process to learn that your child had been consigned to either death or a fate far worse than death, in my opinion, and then to be turned away

by your doctors and told that, “We can’t help you. Even though we want to help you, we can’t help you. You’re going to have to travel.” So, I was in the best possible position to seek care out of state: I have a wonderful partner; we have family nearby; we were able to leave our toddler with family; we have a car; we have access to savings. And we dropped everything and drove 500 miles from Boston to Bethesda, Maryland to obtain that abortion care that my own doctors in one of the leading hospitals

in the country, if not the world, could not provide me because of the constraints of our state law. And I learned a lot about the decision-making process along the way. My hospital, after the fact, told me that they had a panel in place to determine which terminations after 24 weeks could be performed in-house.

And despite the fact that my son's diagnosis was dismal and likely fatal, it did not meet the hospital's definition of a, quote, lethal fetal anomaly, which... amounts to a staggeringly short list of qualifying diagnoses.

And at the end of the day, I am immensely grateful for the diagnostic care that I received in Boston and for the compassionate abortion care I received out of state in Maryland.

And I'm just incredibly fortunate that I had the financial resources and the support system to travel out of state to pay upwards of $10,000 out of pocket for medical expenses and travel costs. And many other patients simply don't have So when I came back from D.C., I started to share my story publicly here in Boston.

I started to work with organizations like Reproductive Equity Now and lawmakers who were really surprised that patients were still being denied care in Massachusetts. I kind of got this overwhelming response of like, whoa, we thought we fixed this in 2020 with the Roe Act on the state level, which was really designed to codify Roe in the state context.

But we all learn together that a ban with exceptions often just functions as a ban. And in 2022, after the Dobbs leak, I had the opportunity to work with advocates and lawmakers here in Massachusetts to revisit the statutory language of the Roe Act and to try and clarify some of that exceptions framework.

It was clear to me at the time that we didn't have a real shot at doing away with the gestational ban altogether. So, we were really forced to kind of tinker around the margins and expand the exceptions framework. and ended up with some compromise language that does represent important progress toward realizing a future without forced travel or forced birth.

And I'm really grateful for the leadership of the House and the Senate in Massachusetts to try and make some clarifying changes to our state law in 2022. We still have, fast forward to 2025, we still have a 24-week ban on the books, now with more expansive exceptions.

So in addition to the lethal fetal anomaly provision that my son's case did not qualify for, there is now a grave fetal diagnosis provision. And we do know that is allowing certain patients to receive care in state who would have previously been forced to travel. However, we know that patients are still being denied care and forced to attempt to travel out of state.

Now, during, of course, a time of a lot of legal uncertainty, a time of scarce resources where our abortion funds that often provide resources for folks traveling out of state are strained, where incredible all-trimester clinics like the DuPont clinic have constraints and, you know, obviously limited openings.

And what we're trying to do now here in Massachusetts is to revisit our state law again and to try and do away with that 24-week gestational ban altogether so that we can untie the hands of our world-class medical providers here in Massachusetts and allow them to provide the compassionate care to their patients that by and large they want to provide so that patients

are able to get care in state. They're not forced to attempt to travel, which we know many people just cannot travel for many reasons.

And you know, from my perspective as a later abortion patient who was forced to travel, I think that we in Massachusetts have a real moral imperative right now to expand access to abortion care throughout pregnancy and stop straining this very fragile network of abortion funds and this vital network of all trimester clinics and really commit to being a bastion for

reproductive justice and commit to changing our state law so that the decision around moving forward with a pregnancy is one between the patient and their provider.

kind of like Kate was saying, they're not incredibly clear even when you do have the opportunity to go back and add to these exceptions or rework these exceptions.

The wording of exceptions may create confusion among providers and patients who are concerned about violating the law, which does have a chilling effect on patients' ability to seek abortions as well as providers' ability to to provide abortion care to these patients.

We see patients who come from out of state, including Massachusetts, who are terminating a pregnancy and they did not qualify for an exception or were not able to get an exception. And we can see that in some ways, the decision-making as to who is able to get an exception can be subjective, again, just due to this vaguely worded statutory language.

Abortion seekers may think that they do need to carry a pregnancy to term because they don't know that they have any options. They may have a provider who is not able to give them those options or not willing to give them those options, which is something that we do see, unfortunately. Another factor is that exceptions cause delays to care.

Applying for and being granted an exception can take time. It can take weeks. And at that point, the pregnancy is further along. Patients are at a higher gestational age by the time they are able to get a procedure, even if they are granted an exception.

And one of the things that we do see is the potential for increased risk for patients with a complex medical history if they are at a higher gestational age. Like Kate was saying, there are abortion seekers who are forced to travel out of state for care because they are not granted these exceptions.

We see an increased procedure cost as a patient is further along in their pregnancy, as well as increased logistical barriers. So procedures can be anywhere from one to four days, depending on the clinic and depending on gestational age. Logistically, this means that a patient who is seeking an abortion needs to find childcare for multiple days.

They need to take off from work for multiple days or take time off from school for multiple days. And this can have a serious effect on their life. They may have to deal with lost wages. They may have to reach out to family or friends who are unsupportive for childcare. And in that, we see a lot of inequity and disparity in access.

Exceptions disproportionately, overwhelmingly affect marginalized communities who may already have limited access to healthcare.

And they contribute to preexisting healthcare inequities because abortion care is healthcare and individuals have a right to seek that care without worrying about gestational age limits or having to apply for an exception and having to speak with a panel of doctors or a single doctor who makes the decision as to whether or not that pregnancy is harmful to their physical

or mental health, whether a fetal anomaly is grave enough to warrant an abortion over 24 weeks in gestation, whether the fetal anomaly is lethal. We see a lot of exceptions in red states, but they can happen in blue states like Massachusetts as well.

The goal is to, like Kate is doing, like people Kate is working with are doing, the goal is to improve access, increase access for patients all over the state and for patients in neighboring states who may want to travel to Massachusetts for abortion care.

reasons people may need an abortion later in pregnancy. They don't think about being in that position and needing access to the health care and not being able to get it until they are in that position. Okay, Kate, do you want to tell us a little bit about the campaign that is going on in Massachusetts right now to try and get rid of their gestational ban?

And I just really reflect upon the fact that I am one of the lucky ones. I had the resources and wherewithal to travel and to seek care out of state. And the alternative for me was one of just frankly, government mandated forced birth, right, in Massachusetts, really, really plainly stated.

And so, you know, I just continue to think about the patients who may not be able to to travel may not know what options exist for them. So just thank you for all that you're doing to make people aware that there are still options out there for them, regardless of where they live. So just thank you.

But I would be delighted to talk more about what we're doing right now in Massachusetts to try and expand access to care throughout pregnancy.

So working in partnership with some leaders in both the State Senate and the House, we are advocating for a piece of legislation called called the prioritizing patient access to care act that is being sponsored by state senator robin kennedy and state reps christine barber and lindsey sabadosa here in massachusetts they are all champions true champions for reproductive justice

and you really understand what's at stake if we are not able to act, and we really just maintain the status quo. So what this bill would do is to expand access after 24 weeks of pregnancy when in the best professional judgment of a licensed physician.

And this bill is loosely modeled after legislation that passed in Maine just in 2023, which is kind of an interesting model and an interesting test case politically in terms of red states, blue states, and purple states.

Really, Maine was able to to make some substantial progress back in 2023 and I think we want to kind of learn from that as a state and really upend the current status quo which of course is a ban with now more expansive exceptions and the intent is really simple.

The goal is to enable doctors to give their patients the best medical care possible without government interference and I often think that when we talk about you know good abortions versus bad abortions or number of weeks of gestation or the specifics of qualifying diagnoses we really over complicate the issue it's really about who decides is it the government?

Is it a politician or is it the patient and their healthcare provider? And so our goal here is really to remove politics from the exam room. And at no point in pregnancy is a politician who writes a law more qualified to make decisions about abortion than a patient and their doctor.

So it's really that simple, just framing it as a healthcare decision that should be guided by medicine and science and not by political opinion or really arbitrary statutes and arbitrary viability or gestational cutoffs. And we really just firmly believe that no patient should have to leave Massachusetts for care.

And we know that that is still happening with some degree of regularity. I am personally aware of several cases just in the past month or so, having connected with patients who went through very similar experiences that I did.

And just knowing that they have lived through the same trauma that I have is really heartbreaking and it's also really profoundly motivating to try and change the way that our state law is structured here in Massachusetts. There are some encouraging trends in public opinion polling, including polls that have been conducted here recently in Massachusetts.

You know, what we're seeing is that expanding access to abortion is popular. Massachusetts residents are really demanding that our Commonwealth continue to be a beacon for care. And especially as now we have with Trump in office and tremendous amount of uncertainty about what's happening at the federal level.

So according to some recent polling conducted by Reaper Productive Equity Now's foundation and EMC research, two out of three Massachusetts voters support expanding access to abortion later in pregnancy based on the professional judgment of a physician. So those are really encouraging polling results. Again, we don't think policy should be directly influenced by public opinion.

However, that public opinion trajectory is really encouraging that people are are starting to understand that it's really not about number of weeks. It's not about specific fetal diagnosis or specific life circumstance to sort out what abortions are good or bad. It's about who decides, the patient or the politician.

And I think Americans across the country, not just here in Massachusetts, are becoming increasingly wary of government interference. And our hope here is that we can really leverage that to make some smart, common sense changes to our own state law here.

And, you know, in doing that, we're trying to sort through some of the stigma and some of the misinformation that's out there. We are trying to reinforce that abortion later in pregnancy is not done for convenience. I think that is a common talking point of the antis.

And we even saw that trotted out on the presidential debate stage when we have politicians talking about so-called late-term abortion or so-called partial birth abortion or infanticide. The reality is abortions later in pregnancy are not done for convenience. They're serious medical procedures, in my case, often necessary due to unexpected complications.

But also due to changing life circumstances, right? So it's not just about stories like mine where it was a devastating fetal diagnosis identified later in pregnancy. There are a variety of reasons why someone may need to or want to pursue an abortion later in pregnancy.

And I would argue that those reasons are all deeply personal, not the government's business, and they're all valid.

So... Our hope is to expand access to care throughout pregnancy and really ensure that patients and doctors Who are the ones carefully considering these decisions can prioritize health, safety, and really lead with compassion for patients who are grappling with really challenging circumstances across the board.

So something that you said earlier really resonated with me around good versus bad abortions. And for me, as a later abortion patient, when I tell my story, I really wrestle with that because I find that most people hear a story like mine, a sad story of a mom trying to have another baby and really being confronted with this unexpected, devastating fetal diagnosis.

I think my story is often met by a tremendous amount of empathy.

And people say, oh, yes, well, your case is sad enough you should have been able to qualify for an exception but that's not what this is all about right it's not about carving out more exceptions it's not about tinkering around the edges of statutory language it's really about protecting healthcare decisions and keeping politicians out of our exam rooms and allowing

patients and providers to make informed decisions together without government interference. And so that stigma is very much still with us, even, I think, in the pro-choice movement.

And so it's something, you know, as a storyteller who has an arguably sad story, I think it's really important for people like me to affirm that you shouldn't need a sad story to be able to access abortion later in pregnancy.

at what point in a person's pregnancy is the state more qualified to make a decision about your pregnancy than you are with your doctor? And that's the bottom line, right? There is no point where the state could ever institute enough exceptions to take into account people's reality or the world they live in to ensure that everybody who needs an abortion can get one.

And it is, again, just ensuring access to basic healthcare no matter someone's circumstance, to ensure that they are able to get the care that they need.

Jeanette, you started to kind of allude to this when you were talking earlier, but what would it mean to get rid of that gestational ban in Massachusetts for access to care, not only in Massachusetts, but for the region?

And again, we see how this disproportionately affects marginalized communities that may already be dealing with systemic oppression, systemic racism, and may not have the same resources that other individuals do. And Kate really touched on this.

And Kate, I appreciate you acknowledging that you were able to cover the cost of a procedure and travel because there are a lot of individuals who aren't able to do that, which again, I appreciate you acknowledging that. Absolutely. Right now, abortion funds and practical support organizations are really the backbone of all trimester care.

They are making sure that individuals are able to pay for procedures. They're making sure that individuals are able to get to appointments. But there is a finite amount of resources. If individuals are able to get care closer to home, then it's going to be less costly for these organizations.

They're going to be able to help more people rather than just one person at a higher gestational age with a larger procedure cost. And one last thing that I wanted to say is that patients don't owe us their stories. It is not our decision as to whether or not a patient deserves abortion care. We never ask a patient their reason.

Sometimes patients disclose and that is fine. But it's not necessary that a patient discloses why they are getting an abortion. There is no wrong reason to get an abortion.

I know there are so few all-trimester clinics that getting an appointment can sometimes be a little complicated, so more clinics or more places where people can get access to the care helps alleviate the burden on the overall system to ensure that as many people as possible are able to access the care they need.

Okay, I always like to end our conversations thinking about how the audience can get involved and what the audience can do. So let's go to Kate first. Kate, what are your thoughts of how our audience can get involved in this?

And there's an overview there of our broader 2025-2026 Massachusetts legislative agenda. And there is a take action page where you can click learn more and take action on the bill called expanding abortion access throughout pregnancy. And there's some really great data points and fact sheets.

And you can click through the website to find Take action by writing to your legislator. You can take action by sharing your own story in any way you feel comfortable. Posting to social media, writing a letter to the editor, signing up for volunteer trainings.

And if you are from an organization that is either... based in Massachusetts or New England or nationally, and you might be interested in offering your endorsement of this legislative approach, you can find information about that on the website as well.

There's this stigma surrounding second and third trimester abortion care and people are very quiet when it comes to that type of care. So please continue to discuss it, help eliminate that stigma.

Volunteer at your local clinic or your local abortion fund or practical support organization and absolutely donate to national and local abortion funds and practical support organizations. Many of these organizations are also involved in policy work and grassroots organizing.

They are Frequently, the first people that patients talk to, and they do have a very good understanding of the general climate and the way that patients are approaching getting abortions and any concerns that the patients may have.

Specifically for Massachusetts, just to plug them, Abortion Rights Fund of Western Massachusetts funds Eastern Massachusetts Abortion Fund, and Tides for Reproductive Freedom. Those are all amazing organizations that we work with at DuPont Clinic and that are able and are helping multiple individuals who are from Massachusetts and have to travel outside Massachusetts for care.

And if you go to the link we'll have in our show notes, but it's reportcard.reprosfightback.com, you'll see the overall grade map, but there are toggles on the side and you can click on abortion restrictions and you can see which restrictions your state has. and included in that as gestational bans.

You may be surprised in some of the states like Massachusetts where you assume there wouldn't be those gestational bans that your state may have one. So it's a really great resource to see how your state is faring when it comes to a whole slew of issues, but related to today, gestational bans.

to question their own assumptions about abortion later in pregnancy and try to confront any internal stigma you have. And there are some really great resources out there. One that I find indispensable is a website called WhoNotWhen.com. And it’s a project by Patient Forward, an incredible organization. And the website it really helpful in breaking down: what do we mean by abortion later in pregnancy? Why would people need abortion care later in pregnancy?

Why are gestational bans harmful and to whom? What is this legal construct of fetal viability that was codified in Roe, and why is that a bad legal construct? So, there are wonderful resources out there.

So if you want to learn more about why people seek care later in pregnancy and why gestational or viability matters, bans are so deeply harmful and do not result in people being able to access care. Please check out WhoNotWhen.com. There are other great resources linked on there too.

And I think there is a misconception out there held by a lot of folks, including a lot of pro-choice or even pro-abortion people that say, this construct of a 24-week ban with exceptions is a reasonable compromise, is a moderate compromise. And I would just encourage people to sit with the reality of that ban and exception construct.

That really means that if you're a pregnant person in Massachusetts and your pregnancy crosses this arbitrary point of pregnancy, quote, fetal viability at 24 weeks, then you are, in most cases, a government-mandated incubator.

You cannot legally get care in Massachusetts, and you are on your own to try and find care out of state if you can do it, if you can figure out those logistics, if you can cobble together the money and the wherewithal to travel to 500 miles out of state with litter or no support. Godspeed. That's the reality in many of these blue states.

And it's a very uncomfortable reality. I think that some people are uncomfortable with the concept of an abortion later in pregnancy. And I would challenge people to also acknowledge how deeply uncomfortable and I would say unjust this current statutory framework is of forced birth. And in the best case scenario, forced travel, right?

Again, I'm so lucky at the end of the day to have been able to seek care out of state. And the alternatives for me would have been dire, both to my physical and mental health and overall to my self-determination as a person who should be able to decide what to do with my body and my healthcare and my family at any point.

So to go back to Dr. Horvath's own words, you know: at what point in pregnancy is a politician or the state or the government better able to make a decision? I think we would say never. So just, you know, thank you for digging into this topic that I think is often neglected and is often one people would rather not think about.

But it is, I think, increasingly important in a national landscape where we know, as Jeanette said earlier, that bans at any point are forcing people later and later in pregnancy. Bans at any point are forcing people to seek care later and later in pregnancy.

So we're going to be, and I think we already are seeing more and more cases of second and third trimester abortions because folks may not have had the ability to get an abortion earlier in pregnancy too.

I had a lot to work through, and I'm sure there are still parts that I am still trying to root out. But it is important to recognize where it exists in the way you are thinking about these things and to try and challenge it and get rid of it. So I appreciate you bringing that up.

You can reach me at Jennie, J-E-N-N-I-E at reprosfightback.com or you can find us on social media. We're rePROs Fight Back on Facebook and Twitter or @Repros FB on Instagram. If you love our podcast and want to make sure more people find it, take the time to rate and review us on your favorite podcast platform.

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