Read from two Montgomery County women who share their own perspectives in “Montgomery County faces of the abortion debate.”
It was a dollar store test kit she took this past August that confirmed 15-year-old Cara’s pregnancy. But with the stakes so high, her grandma decided it was worth splurging on a $7 test from the drugstore just to be sure—even though it would mean $7 less for the family’s monthly expenses until her grandpa’s next disability check arrived.
When the second test came back positive, Cara—who asked that her real name not be used—panicked. If she kept the baby, the child would be repeating the same cycle that she had lived: being born to an unwed teenager unready to be a parent.
Cara’s grandparents had raised her—and they also supported her mother on their limited means. Would they be stuck raising their great-grandchild, too? Her grandparents told Cara it was her decision. And her 17-year-old boyfriend said he’d back her no matter what, but his financial situation was no better than hers. “I don’t want to bring a baby into this world just to give it a hard life,” Cara says.
Even carrying the pregnancy to term—whether she gave up the baby for adoption or not—would mean folks in their small Tennessee town would soon learn of Cara’s indiscretion. “If they all knew, you know, they would look at me different,” she says.
Not sure how to proceed, Cara waffled. Then, less than two weeks after learning she was pregnant, she started to bleed, with cramps that made her double over in pain. Her grandparents raced her to the emergency room, where a sonogram revealed significant cervical hemorrhaging—and a beating heart. Doctors told Cara her pregnancy was seven weeks along.
The doctors sent her home, still pregnant and more confused than ever. “There could [be] something wrong with the baby already,” and it’s still too early to know, she recalls thinking.
A week later, the bleeding had stopped, but Cara decided to get an abortion. By then, though, a “trigger” law banning abortion had gone into effect in Tennessee, making the situation much more complicated and costly than before. Cara and her grandparents figured they would have to travel at least a day’s distance and scrounge together money for gas and lodging. Not to mention the medical costs and Cara’s lost school days.
Her grandma’s friend in Maryland offered to let them stay for free if they wanted to drive up for the procedure, which was legal in Maryland. And the friend’s home wasn’t far from the Potomac Family Planning Center in Rockville. When they called, a staff member said she could get them in quickly, so Cara and her grandparents drove through the night. The clinic also put Cara and her family in touch with an abortion-rights group that ultimately covered the cost of the $520 abortion.
The surgery went well—but days later, Cara and her family were still stranded in Maryland, lacking enough money for the long drive home. The clinic gave Cara’s family $100 for expenses, and several organizations offered financial assistance for bus tickets. But none said they could provide the family with gas cards or cash, Cara’s grandma says.
While Cara rested, her grandparents spent the next few days visiting friends and family, asking for $5 or $10, anything they could put toward returning home. And the clock was ticking. After three days of missed school, Cara would need a doctor’s note, which she refused to get because people would then learn of her situation. “Ninety-nine percent of these people don’t even know why we are here,” Cara’s grandma says. “They think we just up and came for a visit.”
This past June, the U.S. Supreme Court released its ruling in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade, the landmark 1973 case that rendered abortion a constitutional right for the past half-century. The Dobbs decision turned the abortion issue over to the states.
Since the ruling, more than a dozen states—most in the South and Midwest—have banned or restricted abortion access, according to the Guttmacher Institute, a reproductive rights think tank based in New York. Guttmacher has reported that up to 26 states in all were likely to heighten restrictions or implement bans in the wake of the ruling.
As one of the nation’s deepest blue states, Maryland isn’t one of them. No new restrictions are being added to the state’s abortion laws in the wake of the Dobbs decision. And yet the abortion landscape is shifting in ways that affect both Montgomery County and the state more broadly.
All 32 state legislators representing Montgomery County supported the Abortion Care Access Act (ACAA), which survived a veto by Republican Gov. Larry Hogan and took effect
July 1. Del. Ariana Kelly, a Bethesda Democrat, was the bill’s sponsor and says the ACAA is the most comprehensive abortion access law in the nation.
The law makes abortion accessible to more low-income Maryland residents by increasing abortion coverage through Medicaid and private insurance, with no copay. It also requires the allocation of $3.5 million in annual funding to provide customized training for practitioners who want to start offering surgical abortions, as well as funding for programs to instruct physicians, midwives, nurse practitioners and physician assistants interested in providing medication abortions.
Medication abortions involve taking two prescription pills early in a pregnancy to induce an abortion at home. The protocol now accounts for more than half of all abortions in the U.S., according to Guttmacher.
Planned Parenthood reports that medication abortions are 98% effective in the first eight weeks of pregnancy and 93% effective at 10 weeks. At the Gaithersburg clinic of Planned Parenthood of Metropolitan Washington, D.C. (PPMW), only medication abortions are offered, according to Anne Cavett, PPMW’s co-director of clinical services. Patients who require a surgical procedure are usually referred to PPMW’s clinic in downtown D.C.
“We’re seeing a lot of confusion amongst patients themselves,” and even local patients seeking an abortion aren’t always sure if it’s still legal here, Cavett says. Since Dobbs, people have come from as far as Florida and Louisiana for an abortion and some are scared to return to their own states afterward for fear of being arrested, or they are afraid to tell their primary care doctors, she says.
Kelly and others anticipate that within the next few years, the county will see a significant increase in the number of people who come here for an abortion, especially as more states restrict the procedure. And that, Kelly says, will put a strain on the county’s abortion providers unless more are added. Though Montgomery County data shows the county has at least eight abortion providers, 16 of Maryland’s 24 counties have none, Kelly says.
“When Texas passed [its] abortion ban, which was really draconian, we started seeing patients in Maryland coming all the way from Texas because there [are] cheap flights on Southwest,” Kelly says. Plus, “We don’t know where places like Pennsylvania will end up…we’re looking at the long game here.”
For those traveling from outside the D.C. region, the situation has become so complex that PPMW recently hired a patient navigator to assist with securing transportation, lodging and other needs. “When you are traveling for health care, there are still a ton of other things that go into that,” Cavett says. “It’s become more complicated for patients who are just seeking routine medical care.”
Montgomery County has gone further than most Maryland jurisdictions with its abortion-rights policies. In May, after the Dobbs decision was leaked, County Executive Marc Elrich and Councilmember Nancy Navarro, both Democrats, announced their support of a supplemental appropriation of $1 million in county funding to increase abortion access. By late summer, the application process for grants was opened to providers. A memo from the county executive’s office states that “preference will be given to programs that prioritize serving to low-income, uninsured, and/or other historically underserved beneficiaries.”
In June, the county also banned its employees from traveling on business to 25 states that “restrict access to reproductive health care services.” In announcing the ban, which excludes public-safety-related travel and other essential business, Elrich said, “We can make certain Montgomery County does not provide additional revenue to states which are unwelcome to women’s freedom.”
Officials here hope the county’s liberal policies on reproductive rights might even lead to a boom in business development. In August, a letter signed by Elrich, Kelly and Democratic Del. Eric Luedtke was sent to 10 corporations headquartered in states that restrict abortion, urging those businesses to relocate here. “Perhaps the single most significant statement you could make in support of those who work for you would be to refuse to continue to locate your company’s headquarters in a state that bans abortions,” the letter reads.
None of the corporations has responded, according to the county executive’s office.
There are some who aren’t happy with the county’s abortion-rights stance. “Everything has changed, and in other ways, for us, nothing has changed,” says Bethesda’s Lisa Tennant, director of Right to Life of Montgomery County.
“[County leaders] are willing to support the abortion industry, but they are not willing to support the pregnancy aid centers” that don’t offer abortion, Tennant says. The abortion clinics in the county, she says, “don’t offer free diapers, free baby clothing. It’s so lopsided.”
Tennant points out that the three pregnancy aid centers in the county—in Shady Grove, Rockville and Silver Spring—receive no county funding; they are supported solely by volunteers and donations. “Even if you think women should be able to have a legal abortion,” she says, “why wouldn’t you support these places that help the women who don’t want to have an abortion?”
On a steamy Saturday afternoon this past August, the 64-year-old Tennant and her family, and about 10 activists, are picketing on Old Georgetown Road in Bethesda. Tennant’s 22-year-old son, Edward, is holding up a sign that reads: “Honk 4 Life.” Every few minutes, drivers honk their horns, eliciting applause and thumbs-up from the group. The posters that Tennant and her 26-year-old daughter, Emily, are presenting are designed to elicit an even stronger response: sonogram photos of fetuses at various stages of development.
Behind the picketers is a nondescript medical office building that is home to the CARE Clinic, short for Clinics for Abortion & Reproductive Excellence. The clinic’s co-founder and medical director, Dr. LeRoy Carhart, has long performed late-second-trimester and third-trimester abortions, though Kansas-based Operation Rescue, an anti-abortion organization that has tracked his activity for years, says he has recently retired.
Carhart, who lives in Nebraska, is currently named as a co-defendant in two lawsuits filed by women who allege that they were seriously injured while having late-stage abortions performed by other doctors at his North Bethesda clinic. One case, filed in U.S. District Court for the Southern District of Maryland, involves a Georgia woman who came to the clinic in May 2020 to abort her 23-week-old fetus after learning that the baby likely had Down syndrome. Complications from the procedure resulted in the emergency “removal of her uterus rendering her infertile,” the filing alleges. Neither Carhart nor his attorney responded to requests for comment from Bethesda Magazine.
The county, Tennant says, is “basically supporting an industry that does not need to be supported. If they do not give a million dollars to the abortion industry in Montgomery County, they do not have to worry. The abortion industry will still thrive.”
Just before sunset on a muggy evening late this past summer, 13 abortion-rights advocates march down a leafy residential street in Chevy Chase. Some wave signs with slogans including, “Reproductive Rights are Human Rights,” and two carry a rainbow banner bearing a fist. The group’s soft chants of, “My body, my choice,” mingle with the sounds of children playing in a backyard nearby.
The protesters stop at the home of Supreme Court Justice Brett Kavanaugh, where a handful of police stand guard on the lawn. The activists repeat their chant for several minutes and then continue toward the home of Chief Justice John Roberts, a few blocks away. When the protesters march past Kavanaugh’s house on their return trip, they change their mantra to: “We won’t go ’til you bring back Roe!”
Several neighbors watch from their porches, though most ignore the protesters and the dozen or so police officers who stand sentry at street corners nearby. Many of the neighbors say they agree with the message, but they are ready for the activists’ parades to end. About half of the yards in the neighborhood sport tasteful white signs that read “Chevy Chasers for Choice” in an elegant black font.
The police are there in case picketing gets raucous—which happened during earlier protests, when activists showed up with drums and bullhorns, and shouted obscenities at neighbors who told them to quiet down as they put their children to bed.
In June, an armed California man—who was not considered to be among the protesters—was arrested outside Kavanaugh’s house and charged with attempted murder. In a letter to county leaders later that month, Supreme Court Marshal Gail Curley wrote that “threatening activity” had increased at justices’ homes, and requested that the county enforce its own ordinances against picketing at private residences.
But on this night, there are no drums or bullhorns or angry confrontations. “There are certain neighbors who come out every week and they wave at us from their front porch and cheer us on, and there are also a couple of neighbors who’ve complained about us when it comes to noise, and the police have come out and policed us about it,” says Sadie Kuhns, 28, a Virginia resident who has led more than 100 protests across the D.C. region in front of the homes of many of the justices. “We’re not here to harass anybody,” Kuhns says, following tonight’s Kavanaugh-focused protest. “We’re there for one person, so we do our thing and we leave.”
Kuhns and other abortion-rights activists began organizing these weekly protests shortly after the draft opinion was leaked. Initally, the goal was to send a message about the unfairness of “six people making decisions about millions of women’s bodies,” Kuhns says in reference to the six conservative justices who voted to overturn Roe, with the high court’s three liberal justices dissenting.
After the ruling became official, the U.S. House of Representatives voted to pass a bill protecting abortion rights, but it failed in the Senate. And in September, Republican Sen. Lindsay Graham of South Carolina introduced a bill to ban most abortions after 15 weeks. It, too, has failed to gain traction so far.
Now, Kuhns says, the activists’ message is this: “We want to see change, see abortion rights codified. If we start to see that…we’ll stop [the protests]. It’s kind of like an ultimatum targeted at Congress.”
On what has become a typical weekday morning at the Potomac Family Planning Center in Rockville, patients are queued up at the check-in desk, waiting for forms they’ll have to fill out. It’s August. A nearby sign reads: “Currently, our wait times are longer than normal.”
Among its services, the clinic offers medication abortions up to 10 weeks from a patient’s last menstrual cycle and surgical abortions up to approximately 17 weeks. Allie Harper, the center’s executive administrator, says more out-of-staters are coming in for abortions since the Dobbs ruling, but the extra volume hasn’t been overwhelming—yet.
Harper says one recent patient drove from her home in Georgia to have an abortion after learning that the fetus she was carrying likely had abnormalities. “It had been a wanted pregnancy,” Harper says.
Following the Dobbs decision, Georgia has banned most abortions after a fetal heartbeat is detected, usually about six weeks. That’s often before many people even know they are pregnant.
The patient, Harper says, had an appointment at an abortion clinic in Virginia, but after she arrived there and was given a sonogram, the woman was told her pregnancy was too far advanced for that clinic to perform the surgery. In desperation, the woman found the Rockville clinic online. The patient and her sister, who’d driven with her from Georgia, rushed over.
A sonogram showed that the woman was 15 weeks pregnant, which met the clinic’s requirements, but she had to wait two more days until the doctor was available. The clinic gave the sisters contact information for groups that could help them find a place to stay. The woman’s sister almost lost her job over the delay; the clinic had to call the sister’s employer to explain the situation.
For many low-income people, just saving up for an abortion can delay having the procedure by weeks, or even a month, Del. Kelly adds. That’s a particular problem for residents of restrictive states that offer no financial assistance. For example, she says, if someone lives in a state that bans abortions at 10 weeks and only allows medication abortions, “and if you need to work for an extra month or two to save up money to pay for it, you are looking at a 12-week procedure.”
For Cara and her family, it was a $250 donation from Planned Parenthood of Tennessee and North Mississippi that finally provided them with enough money to return home. Still, a procedure that took less than 10 minutes to perform had cost Cara a week of school and hundreds of dollars her family couldn’t spare, including the blown radiator in their car by the Virginia-
Tennessee border and the express-lane tolls they didn’t realize they’d incurred until days later. “We got home on banana skins,” says her grandmother, who has since received a letter from Cara’s school threatening legal action regarding Cara’s truancy.
But her grandmother was grateful for all the help they received, mostly from organizations she’d barely heard of. “I really appreciated it,” she says. “I didn’t think we’d get any help at all.”
By the numbers
25.9: Number of abortions performed in Maryland per 1,000 women aged 15-44 in 2020; the national average was 14.4. Source: Guttmacher Institute
4: Number of surgical abortion centers licensed in Montgomery County; there are 11 total in the state. Source: Maryland Department of Health
8: Number of providers verified to offer abortion services in Montgomery County. Source: Montgomery County Council data.
93%: Percentage of U.S. abortions performed during the first 13 weeks of gestation in 2019. Source: Centers for Disease Control and Prevention.
59%: Percentage of U.S. abortions obtained by women who already have children. Source: Guttmacher Institute.
Maryland Law: An abortion is legal until fetal viability (around 24-26 weeks); at or after viability, abortion can be performed only if the patient’s life or health is endangered or there is a fetal anomaly.
Maryland does not require a counseling session or a waiting period before getting an abortion.
The parent of a minor must be notified before an abortion in Maryland; health professionals are allowed to waive parental involvement in limited circumstances.
Journalist Amy Halpern has worked in print and television news, and as the associate producer of an Emmy Award-winning documentary. She lives in Potomac.
This story appears in the November/December 2022 issue of Bethesda Magazine.