Right to choose
Every person should have the right to choose irregardless of grave disability. Being under LPS conservatorship confers a conservator the right to treat the grave disability not the right to decide whether an abortion is appropriate. That right to choose is highly personal and only you can make that decision. Not your conservator, not the treating psychiatrist, not your legal counsel, or judge hearing your LPS case. Those decisions remain between a patient and their reproductive health provider.
Abortion in California remains legal. It's your right.
In light of Roe v. Wade, 410 U.S. 113 (1973) and Planned Parenthood of S.E. Pennsylvania v. Casey, 505 U.S. 833 (1992) being overturned in full by Jackson Women's Health Org. v. Dobbs, 945 F.3d 265 (5th Cir. 2019), abortion remains legal in all California counties for up to 24 weeks.
Even though abortion is legal in California that does not guarantee accessibility to all. Many marginalized groups cannot access the care they need or cannot afford said care. LPS conservatees and the seriously mentally ill fall into such a group. Acute psychosis/ untreated mental illness places patients at higher risk of an unwanted pregnancy.
LPS conservatees although under conservatorship do not have their right to choose stripped from them and the Public Guardian must honor their right to choose. Few appellate cases discuss the intersection of LPS conservatorship and abortion access. (Foy v. Greenblott, 141 Cal. App 3d 1, Cal. App. 3d 981, 190 Cal. Rptr, 678 (2nd Dist. 1983)).
Abortion in California remains legal. It's your right.
In light of Roe v. Wade, 410 U.S. 113 (1973) and Planned Parenthood of S.E. Pennsylvania v. Casey, 505 U.S. 833 (1992) being overturned in full by Jackson Women's Health Org. v. Dobbs, 945 F.3d 265 (5th Cir. 2019), abortion remains legal in all California counties for up to 24 weeks.
Even though abortion is legal in California that does not guarantee accessibility to all. Many marginalized groups cannot access the care they need or cannot afford said care. LPS conservatees and the seriously mentally ill fall into such a group. Acute psychosis/ untreated mental illness places patients at higher risk of an unwanted pregnancy.
LPS conservatees although under conservatorship do not have their right to choose stripped from them and the Public Guardian must honor their right to choose. Few appellate cases discuss the intersection of LPS conservatorship and abortion access. (Foy v. Greenblott, 141 Cal. App 3d 1, Cal. App. 3d 981, 190 Cal. Rptr, 678 (2nd Dist. 1983)).
In California, people have the option to choose from the pill or have a surgical procedure.
Abortion pill (Mifepristone and Misoprostol)
The pill option available for patients up to 10 weeks of pregnancy. In California most clinics offer the pill. After an intake to take medical history and ensure you know all of your options, you will be given the first pill MIfepristone. This stops the body from producing progesterone which supports the pregnancy in progressing. Then at the direction of your health care provider you will take the second pill, Misoprostol, around the same time or the next day. Patients should expect moderate to severe cramps after taking the second pill and some nausea with the first pill.
Surgical Abortion (Dilation and suction or Dilation and curettage)
For a surgical procedure, California allows surgical abortions up to 24-26 weeks (viability). However, this does not mean that option in available equally to all. According to ineedana.com and abortionfinder.org many facilities that offer the pill do not offer surgical abortions.
For the surgical abortion, patients have the option of having a local anesthetic administered or having partial/full anesthesia depending on the clinic/facility they go to. California does not have any waiting period so patients may schedule their procedure the same day as the intake interview and paperwork. The surgical procedure takes a far shorter time to complete than the pill. Outside of intake and waiting time, the actual procedure takes around 10-15 minutes. After the appropriate pain medication has been administered the physician will dilate the cervix with dilators (hegar dilators) so that they can insert the cannula to suction out the products of conception. Many patients report discomfort when they are being dilated and some when the physician is suctioning out the products of conception. Others do not report pain at all. It is an highly individual experience and a conservator cannot dictate what kind of care your medical provider is offering so long as it is medically appropriate. Once the procedure is done, the patient will have to wait a period of time to make sure there is not excessive bleeding. If the patient chooses to have anesthesia they will need to have an approve transportation person. The public guardian should be able to arrange for such.
For all patients the medical facility or clinic will request a follow up visit to ensure there are no complications.
Abortion pill (Mifepristone and Misoprostol)
The pill option available for patients up to 10 weeks of pregnancy. In California most clinics offer the pill. After an intake to take medical history and ensure you know all of your options, you will be given the first pill MIfepristone. This stops the body from producing progesterone which supports the pregnancy in progressing. Then at the direction of your health care provider you will take the second pill, Misoprostol, around the same time or the next day. Patients should expect moderate to severe cramps after taking the second pill and some nausea with the first pill.
Surgical Abortion (Dilation and suction or Dilation and curettage)
For a surgical procedure, California allows surgical abortions up to 24-26 weeks (viability). However, this does not mean that option in available equally to all. According to ineedana.com and abortionfinder.org many facilities that offer the pill do not offer surgical abortions.
For the surgical abortion, patients have the option of having a local anesthetic administered or having partial/full anesthesia depending on the clinic/facility they go to. California does not have any waiting period so patients may schedule their procedure the same day as the intake interview and paperwork. The surgical procedure takes a far shorter time to complete than the pill. Outside of intake and waiting time, the actual procedure takes around 10-15 minutes. After the appropriate pain medication has been administered the physician will dilate the cervix with dilators (hegar dilators) so that they can insert the cannula to suction out the products of conception. Many patients report discomfort when they are being dilated and some when the physician is suctioning out the products of conception. Others do not report pain at all. It is an highly individual experience and a conservator cannot dictate what kind of care your medical provider is offering so long as it is medically appropriate. Once the procedure is done, the patient will have to wait a period of time to make sure there is not excessive bleeding. If the patient chooses to have anesthesia they will need to have an approve transportation person. The public guardian should be able to arrange for such.
For all patients the medical facility or clinic will request a follow up visit to ensure there are no complications.
Note for lps conserved clients
Because LPS conservatees are in a special class of persons, scheduling care through Planned Parenthood may limited as they do not routinely deal with patients who have been deemed unfit by the state. However, this does not mean that care is impossible. The best option is to call the Public Guardian and ask them initiate an investigation and assistance with getting this kind of care.
In the case where a conservatee needs an abortion, there is a high chance that the public guardian or the conservator will have to arrange for a hospital to perform the procedure as they may believe that a hospital is better equipped to consider the legal aspects of LPS conservatorship.
The Public Guardian does not interfere with a patient's right to choose except in the case where a patient is completely unresponsive or they are in a medical emergency and are unable to give verbal or written consent and without said treatment they will suffer grave injury or death. The public guardian may authorize an emergency D&C for example but this is rarely a scenario.
Welfare and Institutions Code specifically states that after a finding of grave disability, the conservator may have the right to require the conservatee to receive routine medical treatment unrelated to their condition of being gravely disabled. Welf & I C §5358(b). Absent an emergency situation, invasive surgery may be performed on the conservatee without the conservatee's consent only if a court order is obtained pursuant to Welf & I C §5358.2.
A court can also authorize the conservator to consent to nonroutine treatment, including surgery, for a specific medical condition. Welf & I C §§5358(b), 5358.2.
Additionally, in emergency cases, in which the conservatee faces loss of life or serious bodily injury, the procedure, including surgery, may be performed on the conservatee without the conservatee's prior consent or a court order specifically authorizing the procedure. Welf & I C §5358(b).
In these trying times, everybody needs to be aware that finding the appropriate and verified services is of upmost importance as resources are limited (even in California) and only certified medical providers can provide safe abortions. Below are links to safe and legal providers and funds for those who may be unable to finance their care.
If you have a conservator then the Public Guardian will most likely be in charge of finding out to pay for services.
If you have a conservator then the Public Guardian will most likely be in charge of finding out to pay for services.
[mother] said she had used methamphetamine almost every day during her pregnancy with [minor] and did not stop using drugs because she did not want to have another baby, but was afraid to have an abortion since she had already had about 11 to 12 abortions.
In re Mariah T., No. D063920, 2013 WL 5451673, at *1 (Cal. Ct. App. Oct. 1, 2013)
In re Mariah T., No. D063920, 2013 WL 5451673, at *1 (Cal. Ct. App. Oct. 1, 2013)