Planned Parenthood of Montana (PPMT) on Thursday told staff members the organization would stop providing medication abortion treatments for patients traveling from states where abortion is currently illegal, citing a rapidly changing legal landscape for providers and patients.

While abortion remains legal in Montana, abortion providers in the state have been preparing for an increase in patients from other states. Three states bordering Montana — Idaho, Wyoming and North Dakota — are expected to make abortion illegal in the coming weeks. South Dakota’s abortion ban went into effect last Friday, the same day Roe v. Wade was overturned. 

News of the policy quickly circulated on Twitter after an internal email from PPMT President Martha Fuller was posted by Missoula-based freelance reporter Hunter Pauli. The state’s Planned Parenthood affiliate confirmed the policy change to Montana Free Press Thursday afternoon.

According to Fuller’s internal email, any patient seeking a medication abortion in Montana will be asked to provide proof of residency to PPMT before their procedure. A list of acceptable documents was not provided.  

Patients from states with abortion bans, including South Dakota, can still obtain an in-clinic, surgical abortion from Planned Parenthood of Montana, Fuller’s email said. Medication abortions are typically the first option for patients who are less than 11 weeks pregnant. Surgical abortions are typically performed for patients who are more than 11 weeks pregnant. 

While Fuller did not explain the distinction between PPMT’s new policies for medical and surgical abortions in her email, the two procedures are different in key ways. Surgical abortion is performed at a distinct point in time and single location, while medical abortion involves two doses of medication and can span multiple days. The latter procedure could allow an out-of-state patient to take one dose of medication in Montana before traveling back to their state of residency where abortion is banned. If the patient completed their abortion in that state, the possibility of legal action against the patient or provider could increase. 

South Dakota’s law, for example, states that anyone who administers, prescribes or procures “any medicine, drug, or substance” for an abortion, unless to save the pregnant person’s life, has committed a felony.

In the internal email, Fuller indicated that the PPMT policy is linked to the possibility of litigation. 

“The risks around cross-state provision of services are currently less than clear, with the potential for both civil and crminal action for providing abortions in states with bans,” she said. “This was a hard decision to make, and I want you to know that is is based on protecting our providers and patients.”

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The change in policy sparked hundreds of critical responses on social media, with some people accusing the Planned Parenthood affiliate of implementing the measure out of fear of litigation. 

“[I] understand the legal finagling and risk assessment here and what have you but somebody’s gonna have to get a backbone at some point and it might as well be planned parenthood,” wrote Twitter user Andrea Grimes. 

PPMT Vice President of External Affairs Laura Terrill provided few additional details about the policy in response to emailed questions from MTFP Friday.

Asked if the policy is being replicated by other Planned Parenthood affiliates in other states where abortion remains legal, Terrill said PPMT “can’t speak to” the decisions of other groups.

“Planned Parenthood affiliates are independent organizations that make their own operational decisions and risk assessments, based on their unique considerations,” she said. “Planned Parenthood of Montana made the decision to suspend medication abortion for some out-of-state patients to minimize potential risk for providers, health center staff, and patients in the face of a rapidly changing landscape. We continue to provide surgical abortion to all patients seeking care, no matter if they live in Montana or come from any other state.”

Terrill said PPMT’s decision was also made in light of Montana’s political climate and Republican elected officials who oppose abortion and are seeking to restrict the procedures statewide.

“Montana is not Washington. Montana is not Oregon. We don’t have a governor or an attorney general or a Department of [Public] Health and Human Services willing to protect abortion providers and the health and privacy of patients. In fact, we have the opposite,” Terrill said. “Right now, we believe that that is the best way of ensuring that out-of-state patients are not … afraid to access … the essential follow-up care they may need because of the intimidation and fear-mongering of extreme anti-abortion politicians.”

Terrill did not provide a comprehensive list of documents PPMT would accept to determine a patient’s residency, but said the organization would accept state- or tribal-issued ID and would otherwise “work closely with each patient to determine what documents they have access to.”

Terrill did not directly answer a question about whether the organization is reconsidering its policy. She reiterated that the organization “did not make this decision lightly.”

“Just like other abortion providers, we are being forced to make difficult operational decisions, due to the rapidly shifting landscape of abortion access in many states,” she said. “We are closely monitoring the legal and service landscapes in Montana and in nearby states and are committed to restarting medication abortion services for all out-of-state patients, if and when we are able to do so.”

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Mara writes about health and human services stories happening in local communities, the Montana statehouse and the court system. She also produces the Shared State podcast in collaboration with MTPR and YPR. Before joining Montana Free Press, Mara worked in podcast and radio production at Slate and WNYC. She was born and raised in Helena, MT and graduated from Seattle University in 2016.