Delayed, Denied, and Deficient: How exceptions fail to ensure critical care under Georgia’s abortion law

Co-led in partnership with Amplify Georgia Collaborative

Background

Georgia’s HB 481, originally enacted in 2019, went into effect on July 20, 2022, shortly after the Dobbs v. Jackson Women’s Health Organization US Supreme Court decision overturning Roe v. Wade. The law limits abortions after detectable fetal cardiac activity (around six weeks of pregnancy) but includes several “exceptions” for specific cases, including conditions where abortion is necessary to prevent death or substantial impairment of the pregnant person, pregnancies with fetal anomalies incompatible with life after birth, pregnancies resulting from rape or incest, miscarriage and ectopic pregnancy management, and sexual assault exceptions (which require the pregnant person to file a police report.).

In response to growing evidence and concern from community leaders, Amplify Georgia Collaborative and RISE researchers co-led a study to systematically document and describe experiences of care for pregnancies that might meet the criteria for exceptions under the law. From August 2024 to December 2025, we conducted 25 interviews with patients, clinicians involved in pregnancy care, and community organizations and agencies that support pregnant people and survivors of sexual violence. We sought to understand the extent to which exceptions included in the law may facilitate access, and how and why exceptions may still result in delays and denials of pregnancy-associated care.

Read the full report here.

Study findings

Our study found that exceptions specified in HB 481 did not ensure that individuals potentially meeting those exceptions—people experiencing pregnancy loss, emergency situations in pregnancy, or pregnancy due to sexual assault—were able to receive timely access to essential medical care. Further, we found that the exceptions’ failures to ensure access to critical care have often resulted in direct harms to the well-being of the pregnant person and to providers.

Our findings highlight four major areas:

  1. HB 481 has resulted in delayed, denied, and deficient care in situations that qualify for exceptions or that are not regulated by the law.

  2. Pathways leading to delays, denials, and deficient care are the result of systems and policy, not individuals.

  3. Even with exceptions, the current law results in pregnant people, including those who experience emergencies, life-threatening conditions, and pregnancy losses, having to wait to receive care until they are near enough to death to qualify for treatment.

  4. HB 481 has also compounded stress on an already overburdened maternal health infrastructure and accelerated the widening of longstanding disparities in maternal and reproductive health outcomes.

The right thing to do medically for a patient, based on what we know and have learned our entire careers, is at odds with what the law says.

- Clinical provider

Why does the study matter?

These findings may no longer be surprising, but they are necessary. Our findings complement the findings of additional studies recently published in Georgia and echo similar reports in Louisiana and Florida on the impacts of abortion bans on emergency pregnancy care, as well as growing literature documenting the harms for maternal and child health broadly.

The experiences of individuals in our study indicated that “exceptions” written into abortion bans cannot account for all the nuances of pregnancy care and instead reinforced an atmosphere of fear, confusion, and increasing complexity that frequently yielded dangerous delays and denials of care resulting in lasting harms for patients and providers.

Neither is it evident that laws can be written to avoid ripple effects across a variety of critical situations beyond abortion care. Our findings suggest that legislation ensuring access to timely abortion care that supports patients to seek care and clinicians to address the nuanced medical needs of their patients without fear of punishment or criminalization would likely reduce harm.

Read the report

The full report is available here on Amplify Georgia’s website.