The Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization came on June 24, eliminating the federal guarantee of abortion rights established in 1973 by Roe v. Wade. Since we believe reporting on the realities of access to health care in our community is important, we set out to learn the facts about abortion services on Cape Cod. It has not been easy.
Those of us who live on the Outer Cape have few options when it comes to medical care. Two organizations manage virtually every medical facility on the Cape: Outer Cape Health Services (OCHS), with clinics in Provincetown, Wellfleet, and Harwich, and Cape Cod Healthcare (CCHC), which runs the Cape’s two hospitals and almost all of its other clinics and medical offices.
Abortion is legal in Massachusetts up to the 24th week of pregnancy, and the state allows all doctors, physician assistants, nurse practitioners, and nurse midwives to perform abortions and to prescribe abortion medication. But OCHS has told us it does not provide these services because it is a federally qualified health center and is prohibited from offering abortions by the Hyde Amendment.
Cape Cod Healthcare is under no such restriction. But it issued a statement on June 28: “Cape Cod Healthcare does not offer abortion services.”
We asked CCHC to explain why it won’t allow abortions. At first, there was silence, then a suggestion that our questioning was a threat and a request that it stop.
Then, on June 29, a new statement came: “CCHC does provide abortion services in situations where, due to underlying medical issues and out of concern for the wellbeing of the mother, a higher level of care is required than could be achieved in a freestanding outpatient center.”
Since then, we have tried repeatedly — without success — to get answers to questions about what this means for women seeking abortions. What situations would qualify, who makes those decisions, and how long would approval take, for example. Does CCHC allow its doctors to write prescriptions for abortion pills?
Unable to get answers, we contacted the offices of 17 obstetrician-gynecologists practicing on Cape Cod to ask those questions. None of them responded.
A well-placed source, speaking off the record, told me that one reason for the silence on abortion was fear of violence — “vandalism, assaults, and bombings” — from extremists “on both sides of the controversy.”
Many people believe Massachusetts is a stronghold of reproductive rights. But Cape Cod is not. It is disturbing that in spite of the state’s official protection of abortion rights, doctors here — and presumably their patients — are living in fear.
What we know from looking at the past is that fear and silence do not aid and abet the progress of human rights. History tells us that what we are witnessing is the progress of oppression. I can’t predict what stories about the pursuit of health care and of women’s rights are ahead. But I know that if we are to create a future for democracy, it will be necessary for good men and women in every community to break their silence.