Abortion in Hawaii

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Abortion in Hawaii is legal. 66% of adults in Hawaii said in a 2014 poll by the Pew Research Center that abortion should be legal in all or most cases. [1] The 2023 American Values Atlas reported that, in their most recent survey, 79% of people from Hawaii said that abortion should be legal in all or most cases. [2] Hawaii began allowing abortion care de jure in 1970, the first state to do so. State law enacted at that time stated said, "the State shall not deny or interfere with a female's right to choose or obtain an abortion of a nonviable fetus or an abortion that is necessary to protect the life or health of the female."

Contents

The number of abortion clinics in the state has been declining for years. There were 15 hospitals that performed abortions in 1970, 51 clinics in 1982, 52 clinics in 1992, six in 2011, four in 2014, and three in 2017. In 2017, women in rural parts of the state had trouble accessing abortion services because of lack of clinics and costs to travel. There were 3,643 abortions in 1970, 2,147 in 2014 and 3,200 in 2017. [3] Public funding existed for abortions for poor women using state Medicaid funding. People in Hawaii participated in the #StoptheBans movement in May 2019.

Many of the state's poor, rural women rely on Title X services that provide family planning assistance, including prenatal carry. Under Donald Trump, these dollars have been cut in Hawaii, leaving poor and rural women particularly vulnerable when it comes to the ability to access prenatal care. [4]

History

Legislative history

In March 1970, not long before the Supreme Court made their decision in Roe v. Wade , Hawaii became the first state in the US to decriminalize abortion by removing all requirements to justify having the procedure done. It was required that the abortion be performed by a licensed physician at an accredited hospital, [5] [6] [7] [8] and there was a 90-day residency requirement in place at the time, but women were not required to provide a reason they were seeking an abortion [8] [9] Alaska and Washington also joined Hawaii in repealing abortion that year. [5] [10] In 1971, the state repealed its statute that said inducing an abortion was a criminal offense. [11] State law in 1971 required that any woman getting a legal abortion in the state needed to be a resident for some specific period between 30 and 90 days. [12]

As of May 14, 2019, the state prohibited abortions after the fetus was viable, generally some point between week 24 and 28. This period uses a standard defined by the US Supreme Court in 1973 with the Roe v. Wade ruling. [13] As of May 2019, state law on abortion said, "the State shall not deny or interfere with a female's right to choose or obtain an abortion of a nonviable fetus or an abortion that is necessary to protect the life or health of the female." [14] [15]

Judicial history

The US Supreme Court's decision in 1973's Roe v. Wade ruling meant the state could no longer regulate abortion in the first trimester. [6] However, the Supreme Court overturned Roe v. Wade in Dobbs v. Jackson Women's Health Organization , No. 19-1392 , 597 U.S. ___(2022) later in 2022. [16] [17]

Clinic history

Number of abortion clinics in Hawaii by year Number of abortion clinics in Hawaii by year.png
Number of abortion clinics in Hawaii by year
Location of Hawaiian abortion clinics by island in 2017 Location of Hawaiian abortion clinics.png
Location of Hawaiian abortion clinics by island in 2017

Abortions in 1970 were required to take place in a hospital.  They cost around US$350, and 57.5% of women used personal funds or loans to cover the cost of their abortion. In 1970, the first year that abortion was legal in the state, abortions were performed at fifteen hospitals. [8] Between 1982 and 1992, the number of abortion clinics in the state increased by one, going from 51 in 1982 to 52 in 1992. [18] In 2011, there were only six clinics in the state, partly a result of the lack of doctors more generally in the state. [4] In 2014, there were four abortion clinics in the state. [19] In 2014, 40% of the counties in the state did not have an abortion clinic. That year, 5% of women in the state aged 15–44 lived in a county without an abortion clinic. [20] By 2017, there were only three clinics left. [4]

In 2017, 28 facilities in Hawaii provided abortion care, with 4 of those facilities being clinics, [21] including 2 Planned Parenthood clinics. [22] Despite a demand on Kauai, an island of 67,000 people, there were no abortion clinics there in 2017. Of Hawaii's eight major islands, only two islands have abortion clinics. [4]

Telehealth abortion services are currently available in Hawaii. Patients seeking a medical abortion are evaluated by a clinician using video conferencing. This service allows many women seeking abortion to avoid inter-island travel to an abortion clinic. [23]

Statistics

From March 1970 to December 1970, 3,643 abortions took place at 15 hospitals in the state, with an abortion to live birth rate of 1:45. [8] Demographics of women seeking abortions in Hawaii that year said that 47% were white, 21% were Japanese, 10% were Hawaiian, 8.4% were Filipino, 5.0% were Chinese, 54% had never been married, 51% had never been pregnant before, 71% were in a relationship, 20% were teenagers.  Outside racial demographics, the profile of women getting abortions in Hawaii in 1970 was similar to that of other women in the United States.  Women getting abortions that year were more educated than the rest of women in childbearing range in the state. There were a variety of reasons these women had abortions including limiting family size or not using contraception.  Some had complications, with 22.5% of the complications being cervical laceration, 19.5% being hemorrhage and 16% infection. [8]

In 1990, 136,000 women in the state faced the risk of an unintended pregnancy. [18] In 2013, among white women aged 15–19, there were abortions 60, 10 abortions for black women aged 15–19, 50 abortions for Hispanic women aged 15–19, and 380 abortions for women of all other races. [24] In 2014, 66% of adults said in a poll by the Pew Research Center that abortion should be legal in all or most cases. [25] In 2017, the state had an infant mortality rate of 5.3 deaths per 1,000 live births. [26]

Number of reported abortions, abortion rate and percentage change in rate by geographic region and state in 2014, 2016, and 2017. [27]
Census division and stateNumberRate % change 2014–2017
201420162017201420162017
US Total926,190874,080862,32025.922.922.9-8
Alaska1,4701,2601,26010.08.68.6-14
California157,350140,700132,68019.517.416.4-16
Hawaii3,7603,1003,20014.011.612.0-14
Oregon9,3309,8509,64012.012.311.9-1
Washington19,23017,35017,74013.712.112.1-12
Number, rate, and ratio of reported abortions, by reporting area of residence and occurrence and by percentage of abortions obtained by out-of-state residents, US CDC estimates
LocationResidenceOccurrence % obtained by

out-of-state residents

YearRef
No.Rate^Ratio^^No.Rate^Ratio^^
Hawaii12,190461992 [28]
Hawaii7,51029.31995 [28]
Hawaii6,93027.31996 [28]
Hawaii2,0117.51082,1478.01160.92014 [29]
Hawaii2,0427.61112,0267.61100.32015 [30]
Hawaii2,4799.31372,5549.61411.02016 [31]
^number of abortions per 1,000 women aged 15–44; ^^number of abortions per 1,000 live births

After Hawaii legalized abortion in 1970, the number of live births of children with Down syndrome decreased. [12]

Abortion financing

State Medicaid coverage of medically necessary abortion services. .mw-parser-output .legend{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .legend-color{display:inline-block;min-width:1.25em;height:1.25em;line-height:1.25;margin:1px 0;text-align:center;border:1px solid black;background-color:transparent;color:black}.mw-parser-output .legend-text{} Medicaid covers medically necessary abortion for low-income women through legislation Medicaid covers medically necessary abortions for low-income women under court order Medicaid denies abortion coverage for low-income women except for cases of rape, incest, or life endangerment. State abortion funding.svg
State Medicaid coverage of medically necessary abortion services.
  Medicaid covers medically necessary abortion for low-income women through legislation
  Medicaid covers medically necessary abortions for low-income women under court order
  Medicaid denies abortion coverage for low-income women except for cases of rape, incest, or life endangerment.

Seventeen states including Hawaii use their own funds to cover all or most "medically necessary" abortions sought by low-income women under Medicaid, thirteen of which are required by State court orders to do so. [32] In 2010, the state had 1,279 publicly funded abortions, of which zero were federally and 1,279 were state funded. [33]

Women in rural Hawaii faced huge problems getting access to abortion services in 2017. [4] Women seeking abortions in 2017 often had to travel great distances, often paying more than $300 and take one or more days off and book accommodation, to get an abortion. This could make the total cost of an abortion over US$1,000. [4]

Abortion rights views and activities

Women from the state participated in marches supporting abortion rights as part of a #StoptheBans movement in May 2019. [34]

Following the Roe v. Wade overturn leak on May 2, 2022, abortion rights protesters held a protest outside the District of Hawaii courthouse in Honolulu [35] and in Waimea. [36]

Footnotes

    Related Research Articles

    Abortion in Louisiana is illegal as of August 1, 2022.

    Abortion in Alaska is legal at all stages of pregnancy. In September 2024, an Alaska superior court judge struck down the requirement that only licensed physicians provide abortions, meaning that the procedure can now also be legally performed by nurse practitioners and physician assistants. As of 2016, Alaska does not require a minor to notify a parent or guardian in order to obtain an abortion. 63% of adults said in a poll by the Pew Research Center that abortion should be legal in all or most cases. The 2023 American Values Atlas reported that, in their most recent survey, 69% of Alaskans said that abortion should be legal in all or most cases. Alaska was one of only four states to make abortion legal between 1967 and 1970, a few years before the US Supreme Court's decision in 1973's Roe v. Wade ruling. Alaska had consent requirements for women seeking abortions by 2007 that required abortion providers to warn patients of a link between abortion and breast cancer, despite it being scientifically unsupported.

    Abortion in Arkansas is illegal except when it is necessary to save the life of the pregnant individual. Doctors determined to have performed an abortion face up to 10 years in prison and fines up to $100,000.

    Abortion in Colorado is legal at all stages of pregnancy. It is one of seven states without any term restrictions as to when a pregnancy can be terminated.

    Abortion in Delaware is legal up to the point of fetal viability. As of June 2024, Civiqs polling found that 72% of Delawareans believed that abortion should be legal in all or most cases, while 23% believed it should be illegal in all or most cases. There was a therapeutic exceptions in the state's legislative ban on abortions by 1900. Informed consent laws were on the books by 2007. In 2017, Senator Bryan Townsend, D-Newark introduced legislation to try to make clear that abortion would remain legal in the state in case 1973's Roe v. Wade ruling was overturned. The legislation was subsequently updated. Attempts have been made to introduce mandatory ultrasound laws, but they failed to get out of committee. State legislators tried to move ahead the week at which a woman could get a legal abortion in 2019.

    Abortion in Maine is legal, although terminations after fetal viability can only be performed if a physician determines it to be medically necessary. According to a poll by the Pew Research Center, 64% of adults said that abortion should be legal, with 33% stating that it should be illegal in all or most cases.

    Abortion in Minnesota is legal at all stages of pregnancy and is restricted only to standards of good medical practice. The Minnesota Supreme Court ruled the Minnesota Constitution conferred a right to an abortion in 1995 and the DFL-led Minnesota Legislature passed and Minnesota Governor Tim Walz signed into law a bill in 2023 to recognize a right to reproductive freedom and preventing local units of government from limiting that right. The Center for Reproductive Rights labels Minnesota as one of the most abortion-protective states in the country.

    Abortion in Montana is legal. The number of abortion clinics in Montana has fluctuated over the years, with twenty in 1982, twelve in 1992, eight providers of which seven were clinics in 2011, and five clinics in 2014. There were four clinics from 2015 to February 2018 when All Families Healthcare clinic in Whitefish reopened. There were 1,690 legal abortions in 2014, and 1,611 in 2015.

    Abortion in Nevada is legal up to the 24th week of pregnancy, under the Nevada Revised Statutes chapter 442, section 250; and after 24 weeks if the pregnancy could be fatal for the pregnant individual. 62% of adults said in a 2014 poll by the Pew Research Center that abortion should be legal while 34% said it should by illegal in all or most cases. The 2023 American Values Atlas reported that, in their most recent survey, 76% of Nevadans said that abortion should be legal in all or most cases. Legislation by 2007 required informed consent. Attempts were successfully made to pass abortion legislation in May 2019, being pushed through a largely Democratic controlled state legislature. The number of abortion clinics in Nevada has declined over the years, with 25 in 1982, seventeen in 1992 and thirteen in 2014. There were 8,132 legal abortions in 2014, and 7,116 in 2015. Due to the high level of support for abortion rights in the state, continued access to abortion is supported by all parties, including the Republicans.

    Abortion in Oregon is legal at all stages of pregnancy. The Center for Reproductive Rights classifies Oregon as highly protective of abortion rights.

    Abortion in Rhode Island is legal up to the point of fetal viability. On June 19, 2019, the legal right to abortion was codified into Rhode Island law by passage of the Reproductive Privacy Act.

    Abortion in Tennessee is illegal from fertilization and provides no exceptions for rape, incest or the health of the pregnant individual. Tennessee's abortion legislation provides no explicit exceptions for the pregnant patient’s health. It makes an exception for an “affirmative defense” for emergencies, but the vagueness of what constitutes an emergency means that physicians hesitate to provide abortions even when the pregnant individual's life is in jeopardy. Attempts to codify the exceptions into law have been rejected by Republican politicians in Tennesse. Tennessee is among the four states which forbid abortion access through their state constitution; alongside Alabama, Louisiana, and West Virginia.

    Abortion in Utah is legally performed under a temporary restraining order blocking enforcement of the state's trigger law, which bans abortion. According to HB136, which is effective state law from June 28, 2022, abortions are banned following 18 weeks of gestation. Abortion was banned following the Supreme Court case, Dobbs v. Jackson Women's Health Organization on June 24, 2022. Utah State Legislation enacted SB 174 in May 2020, which, upon the overturn of Roe v. Wade, made inducing an abortion a second-degree felony. The law includes exceptions for pregnancies "caused by rape or incest," pregnancies that put the mother's life at risk, or "if two doctors say the fetus has a lethal defect." Rape and incest exceptions will only be viable if the crimes were previously reported to law enforcement officials.

    Abortion in Vermont is legal at all stages of pregnancy. A 2014 Pew Research Center poll showed 70% of adults in the state believed abortion should be legal in most or all cases, the second highest percentage in the country. The 2023 American Values Atlas reported that, in their most recent survey, 76% of Vermonters said that abortion should be legal in all or most cases. The state funds abortions deemed medically necessary for low-income women via Medicaid.

    Abortion in the U.S. state of Virginia is legal up to the end of the second trimester of a pregnancy. Before the year 1900, abortion remained largely illegal in Virginia, reflecting a widespread trend in many U.S. states during the 19th and early 20th centuries. Abortion was viewed as a criminal act and subject to state laws that prohibited it. However, by 1950, Virginia introduced a legal therapeutic exception, allowing for abortion under specific circumstances, primarily when a woman's physical or mental health was at risk. Notably, the University of Virginia Hospital established a review board in 1950 responsible for evaluating and approving abortion requests, particularly those grounded in psychiatric reasons. This thorough approval process resulted in a significant decrease in the number of abortions performed at the hospital.

    Abortion in Washington is legal and available up to the point of fetal viability, or in case the pregnancy poses a risk to life or health. In a 2014 poll by the Pew Research Center, 60% of adults said that abortion should be legal in all or most cases. The 2023 American Values Atlas reported that, in their most recent survey, 73% of Washingtonians said that abortion should be legal in all or most cases.

    Abortion in West Virginia is illegal except in cases of rape or incest, fatal fetal abnormalities, and when the mother’s life is at risk from a pregnancy.

    Abortion in Wisconsin has been legal since September 18, 2023, and is performed in Madison, Milwaukee and Sheboygan through 22 weeks gestation. However, elective abortions in Wisconsin are under dispute after the overturning of Roe v. Wade by the Supreme Court of the United States on June 24, 2022. Abortion opponents cite an 1849 law that they claim bans the procedure in all cases except when the life of the mother is in danger. However, lower level courts have argued that the law only applies to infanticide and not consensual abortions. The enforceability of the law is disputed and being considered by the state courts. Planned Parenthood of Wisconsin announced that they would resume abortion services in Madison and Milwaukee on September 18, 2023. Planned Parenthood of Wisconsin later announced that they would resume abortion services in Sheboygan on December 28, 2023.

    Abortion in New Mexico is legal at all stages of pregnancy. The number of abortion clinics in New Mexico has declined over the years, with 26 in 1982, 20 in 1992 and 11 in 2014. There were 4,500 legal abortions in 2014. There were 7 facilities providing abortion in New Mexico in 2017, and 6 of those were clinics. In 2017, 91% of New Mexico counties had no clinics that provided abortions, and 48% of New Mexico women lived in those counties.

    Abortion in Wyoming is currently legal due to a temporary court injunction.

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    19. ↑ Gould, Rebecca Harrington, Skye. "The number of abortion clinics in the US has plunged in the last decade — here's how many are in each state". Business Insider. Retrieved 2019-05-23.{{cite web}}: CS1 maint: multiple names: authors list (link)
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    22. ↑ "Here's Where Women Have Less Access to Planned Parenthood" . Retrieved 2019-05-23.
    23. ↑ "Hawaii Doctors Turn To Telemedicine As Number of Abortion Providers Dwindles". Honolulu Civil Beat. 2019-06-06. Retrieved 2020-04-20.
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    28. 1 2 3 Henshaw, Stanley K. (2005-06-15). "Abortion Incidence and Services in the United States, 1995-1996". Perspectives on Sexual and Reproductive Health. 30: 263–270. Retrieved 2019-06-02.
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    30. ↑ Jatlaoui, Tara C. (2018). "Abortion Surveillance — United States, 2015". MMWR. Surveillance Summaries. 67 (13): 1–45. doi:10.15585/mmwr.ss6713a1. ISSN   1546-0738. PMC   6289084 . PMID   30462632.
    31. ↑ Jatlaoui, Tara C. (2019). "Abortion Surveillance — United States, 2016". MMWR. Surveillance Summaries. 68 (11): 1–41. doi: 10.15585/mmwr.ss6811a1 . ISSN   1546-0738. PMC   6289084 . PMID   31774741.
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    36. ↑ "Abortion rights activists rally in North Hawaii". West Hawaii Today. Retrieved 2024-02-19.
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