GOP legislatures in some states seek ways to undermine voters' ability to determine abortion rights

CHRISTINE FERNANDO
Sun, January 28, 2024 

CHICAGO (AP) — Legislative efforts in Missouri and Mississippi are attempting to prevent voters from having a say over abortion rights, building on anti-abortion strategies seen in other states, including last year in Ohio.

Democrats and abortion rights advocates say the efforts are evidence that Republican lawmakers and abortion opponents are trying to undercut democratic processes meant to give voters a direct role in forming state laws.

“They’re scared of the people and their voices, so their response is to prevent their voices from being heard," said Laurie Bertram Roberts, executive director of Mississippi Reproductive Freedom Fund. “There’s nothing democratic about that, and it’s the same blueprint we’ve seen in Ohio and all these other states, again and again.”

Since the U.S. Supreme Court overturned the constitutional right to abortion in 2022, voters in seven states have either protected abortion rights or defeated attempts to curtail them in statewide votes. Democrats have pledged to make the issue a central campaign topic this year for races up and down the ballot.

A proposal passed Wednesday by the Mississippi House would ban residents from placing abortion initiatives on the statewide ballot. Mississippi has among the toughest abortion restrictions in the country, with the procedure banned except to save the life of the woman or in cases of rape or incest.

In response to the bill, Democratic Rep. Cheikh Taylor said direct democracy “shouldn’t include terms and conditions.”

“Don’t let anyone tell you this is just about abortion,” Taylor said. “This is about a Republican Party who thinks they know what’s best for you better than you know what’s best for you. This is about control. So much for liberty and limited government.”

The resolution is an attempt to revive a ballot initiative process in Mississippi, which has been without one since 2021 when the state Supreme Court ruled that the process was invalid because it required people to gather signatures from the state’s five previous U.S. House districts. Mississippi dropped to four districts after the 2000 census, but the initiative language was never updated.

Republican Rep. Fred Shanks said House Republicans would not have approved the resolution, which will soon head to the Senate, without the abortion exemption. Some House Republicans said voters should not be allowed to vote on changing abortion laws because Mississippi originated the legal case that overturned Roe v. Wade.

“It took 50 years … to overturn Roe v. Wade,” said Mississippi House Speaker Jason White, a Republican. “We weren’t going to let it just be thrown out the window by folks coming in from out of state, spending 50 million bucks and running an initiative through.”

But Mississippi Democrats and abortion access organizations panned the exemption as limiting the voice of the people.

“This is an extremely undemocratic way to harm access to reproductive health care," said Sofia Tomov, operations coordinator with Access Reproductive Care Southeast, a member of the Mississippi Abortion Access Coalition. "It’s infringing on people’s ability to participate in the democratic process.”

In Missouri, one of several states where an abortion rights initiative could go before voters in the fall, a plan supported by anti-abortion groups would require initiatives to win a majority vote in five of the state’s eight congressional districts, in addition to a simple statewide majority.

The proposal comes days after a Missouri abortion-rights campaign launched its ballot measure effort aiming to enshrine abortion rights into the state constitution. Missouri abortion rights groups also have criticized Republican Secretary of State Jay Ashcroft, saying he is attempting to impede the initiative by manipulating the measure's ballot summary. A Missouri appeals court recently found the summaries were politically partisan and misleading.

When asked during a recent committee hearing if the GOP proposal was an attempt to get rid of direct democracy, Republican state Rep. Ed Lewis said “I think that our founding fathers were about as fearful of direct democracy as we should be. That’s why they created a republic.”

Sam Lee, lobbyist for Campaign Life Missouri, testified on Tuesday for the need for provisions like this that make sure “the rights of the minority aren’t trampled on.”

“The concern of our founders, and the concern of many people throughout the decades and years, is to avoid having a tyranny of the majority,” he said.

Democratic Senate Minority Leader John Rizzo said controlling who can vote and on what subjects has been “the highest priority of the Republican Party for the last 20 years."

“This is how democracies die,” he said in an interview. “We are watching it in real time. This is the scariest moment that I’ve seen in my lifetime.”

Democratic Rep. Joe Adams criticized the plan in part by alleging that the state's congressional and legislative districts are gerrymandered to favor Republicans. That would make it nearly impossible for an abortion measure to be approved under the proposed legislation.

Attempts to keep abortion measures off the ballot in Missouri and Mississippi follow a similar blueprint in other states to target the ballot initiative process, a form of direct democracy available to voters in only about half the states.

Florida’s Republican attorney general has asked the state Supreme Court to keep a proposed abortion rights amendment off the ballot as an abortion-rights coalition this month reached the necessary number of signatures to qualify it for the 2024 ballot.

In Nevada, a judge on Tuesday approved an abortion-rights ballot measure petition as eligible for signature-gathering, striking down a legal challenge by anti-abortion groups attempting to prevent the question from going before voters.

Ohio abortion rights advocates have said last year’s statewide vote to enshrine abortion rights in the state constitution was as much about abortion as it was a referendum on democracy itself. They said Republicans tried to obstruct the democratic process before the vote and attempted to ignore the will of voters after the amendment passed.

Ohio Republicans called a special election in August attempting to raise the threshold for passing future constitutional amendments from a simple majority to 60%. That effort was defeated at the polls and was widely seen as aiming to undermine the abortion amendment.

After Ohio voters approved the abortion protections last year, Republican lawmakers pledged to block the amendment from reversing the state's restrictions. Some proposed preventing Ohio courts from interpreting any cases related to the amendment.

“It wasn’t just about abortion," Deirdre Schifeling, chief political and advocacy officer of the ACLU, said last fall after the Ohio amendment passed. "It’s about, ‘Will the majority be heard?’"

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Associated Press writers Summer Ballentine in Jefferson City, Missouri, and Emily Wagster Pettus in Jackson, Mississippi, contributed to this report.

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‘Rage’ abortion donations dry up, leaving funds struggling to meet demand

Nathaniel Weixel
Sun, January 28, 2024 



Abortion funds that help people cover the costs of getting the procedure are struggling with money as the waves of donations that followed the end of Roe v. Wade have begun to dry up.

It’s led some of the independent organizations — which help cover expenses for abortions and associated costs, such as transportation, child care, and lodging — to scale back or even pause operations.

After the Dobbs decision in June 2022, many funds received large donations from Americans outraged at seeing the right to an abortion stripped away.


The National Network of Abortion Funds (NNAF), which comprises 100 funds across the country, said its members disbursed close to $37 million to about 103,000 people from July 1, 2022, to June 30. That was an 88 percent increase in spending compared to the year before.

People giving money were so angry at the time that the gifts were described as “rage” donations.

But as the issue has faded from headlines, donations have too, even as demand for help and the costs for helping individual people have skyrocketed.

“We noticed with any sort of moment that happens, whether it is a certain election, an introduction of an abortion ban, or in this case, the overturning of Roe, there is this immediate desire to like, make a contribution to abortion funds or make contributions to the movement,” said Oriaku Njoku, NNAF’s executive director.

“While we appreciate the rage, giving what is actually required to make sure that people can consistently get the care they need is that long-term investment in abortion funds,” Njoku said.

When the Dobbs decision first leaked out, “money was thrown. People went into a panic and dollars were just raining,” said Chasity Wilson, executive director of the Louisiana Abortion Fund.

“Everyone was very mad, because it was in the headlines. It was national, all throughout the U.S. Things were changing pretty rapidly for people. So people were of course mad and they were giving a lot,” said Bree Wallace, director of case management at the Tampa Bay Abortion Fund. “And then a few months after that, it kind of died off.”

The large influx of donations changed how funds operated. Some were pushing money out the door to vastly expand the number of people they could aid. Others tried to save the extra money to boost their budgets long-term.

Wallace estimated the fund spent about $700,000 in 2023, but “we definitely couldn’t do that again this year.”

Donations dropped 63 percent from 2022 to 2023, Wallace said. The fund was previously able to help people across Florida but now is limited to people coming into or out of the Tampa area.

Wilson said individual donors are still keeping the Louisiana fund operational, but she added foundations and philanthropies have noticeably pulled back — a common refrain from funds in the South.

Almost every fund contacted by the Hill said they have seen a decrease in donations at a time when access to abortion care is much more expensive than it used to be. When abortion was still legal, abortion funds were mostly needed to help people drive to local clinics and cover the cost of the procedure.

For funds in the Deep South, the options for sending someone to an in-state clinic were extremely limited, so people had to travel out-of-state frequently.

But now abortion is banned or restricted in more than 21 states across the country, meaning people often must travel much further than before, and navigate an ever-changing landscape of local restrictions.

On top of the travel, abortions also cost more. A medical abortion using pills costs up to $200 more than it used to, according to Kenny Callaway, a health-line coordinator for the abortion fund ARC Southeast, which serves people in Alabama, Florida, Georgia, Mississippi, South Carolina, and Tennessee.

The same amount of money doesn’t go nearly as far as it used to.

“There was a there was a time when we were helping like 20 people a week. Now we’re doing good to help two or three,” said Laurie Bertram Roberts, co-founder of the Mississippi Reproductive Freedom Fund. “We’ve been doing this for 10 years. In a lot of ways it feels like going backwards in our capacity.”

Before Dobbs, Mississippi only had one abortion clinic in the state. Bertram Roberts said the fund spent between $200 to $600 on average per caller. But now, the fund needs to spend between $1000 to $1500 just for people who need an abortion before 12 weeks’ gestation. If they are further along, the costs are significantly higher.

Most people in the state are making a 10-hour drive to Carbondale, Ill., a two-day trip that requires money for food, gas, and lodging.

“No disrespect to the rage givers. They enabled us to get a lot of people seen before Roe fell. Thing is, is that now we have these harder, higher standards to reach to get people to care. And we have less investment,” Bertram Roberts said.

Her organization stopped giving out funds for four months and only reopened at the beginning of January.

“It feels horrible. It feels gross. It feels like you’re letting people down, because you are. It puts you in a position to be like the gatekeeper of people getting access to care. And nobody wants to be that,” Bertram Roberts said.

When abortion was legal, it was not uncommon for funds to pause operations if they ran over their monthly budgets. But fund officials said there’s a ripple effect now, because when one fund closes or pauses, others step in to help.

“That is the reality for organizations like this. We do run out of funds and there are some people we cannot support,” said Callaway.




Abortion expansion or abolition? What 51 years of Roe v. Wade means today

Nicole Fallert, USA TODAY
Updated Sat, January 27, 2024 

The White House marked the 51st anniversary of Roe v. Wade this week by rolling out expanded access to contraception and steps to inform pregnant patients about their abortion options during life-threatening emergencies. The measures were another sign that President Joe Biden will place reproductive rights at the center of his reelection campaign.

The landmark 1973 case has become even more politically potent since it was overturned by the Supreme Court’s conservative majority in its explosive 2022 ruling in Dobbs v. Jackson Women’s Health Organization.

Sins the Dobbs decision, 14 states have completely banned abortion, including Alabama, Mississippi, and South Dakota, while swath of others in the southeast have also enacted early-term bans ranging from six to 18 weeks of pregnancy. Other states have moved to protect abortion access, including Ohio, which voted in a November referendum to include the right to an abortion in the state constitution.
Roe is dead, and still powerful

And 2024 is set to include more decisive moments as abortion hits the polls in states like Maryland and New York, where voters will weigh state constitutional amendments enshrining reproductive rights. Meanwhile, a major decision from the Supreme Court is expected regarding mifepristone, the FDA-approved pill that accounts for more than half of all abortions in the United States.

"Roe is now shorthand for what has been lost," said Joshua Prager, author of "The Family Roe," a history of the legal case. "That is a very powerful thing."

Related: Election lessons: Abortion delivers for Democrats from Ohio to Virginia to Kentucky
Making abortion 'unthinkable'

Amid this complex landscape, voices on both the anti-abortion and abortion rights camps told USA TODAY they share the goal of never returning to Roe − for vastly different reasons.

The anti-abortion side wants complete, total elimination of abortion to the point it is “unthinkable,” said Jeanne Mancini, president of March for Life, an annual gathering in Washington that drew thousands of anti-abortion supporters last week.

“While the Dobbs decision is a huge victory and milestone in building a culture of life there is much more work to be done,” Mancini said.

More: Abortion restrictions repel graduating OB-GYNs from conservative states, report shows

Anti-abortion activists march and rally in front of the United States Supreme Court during the annual March for Life in Washington on January 19, 2024.
Roe was inadequate, activists say

Meanwhile, some abortion rights advocates believe the moment should be for revision, rather than reversion, back to Roe. This means legalizing abortion nationally, and protecting access, especially for members of marginalized groups who struggled to access abortion services even under Roe, said Serra Sippel of The Brigid Alliance, which supports patients traveling to seek abortion care.

It's vital “we don't make the mistake of reinforcing what was there," Sippel said. "That's a 51-year-old decision.”

For abortion rights supporters, Roe should be "the floor, not the ceiling," Sippel said, meaning that the decision was not only too vulnerable to being overturned but also limited in its power to assure equity in abortion access.

Compare this sentiment with the stance of President Joe Biden, who stood in front a banner with the words “Restore Roe” at a campaign event in Virginia on Tuesday, where he castigated his predecessor, Donald Trump, for dismantling the protections previously guaranteed by Roe.

More: Indigenous women, facing tougher abortion restrictions post-Roe, want Congress to step in

President Joe Biden arrives to speak during a Democratic National Committee event at the Howard Theatre, Tuesday, Oct. 18, 2022, in Washington. (AP Photo/Evan Vucci) ORG XMIT: DCEV401
Joe Biden expands access to contraception

Biden’s rally came on the tails of his announcement Monday that the White House was expanding coverage for no-cost contraception through the Affordable Care Act. Federal employees will also receive greater access to contraception under guidelines issued to insurers.

The Health and Human Services Department is rolling out a plan to educate patients about the administration's position that they are entitled to care for pregnancy-related emergences − including abortion care in some cases − under the Emergency Medical Treatment and Labor Act.

Democrats have been increasingly successful in talking about abortion rights, said Jessica Valenti, a feminist writer and founder of "Abortion, Every Day," which tracks national and state-level changes in abortion laws. Valenti spoke to Senate Democrats at a briefing on abortion rights last week and said she felt “hopeful” after leaving the room.

Democrats, Valenti said, "need to get out of a defensive crouch. It can’t be ‘We just want to go back to way things were.’”

Donald Trump appointed three conservative justices to the Supreme Court during his four years in office, including Amy Coney Barrett. They were part of the five-vote majority that overturned Roe v Wade.
Trump dances around abortion

Whether conservatives, in their effort for total abolition of abortion, will gain a key ally in the White House will be decided in less than 10 months.

While former president Donald Trump appointed three of the five Supreme Court justices who overturned Roe, the GOP frontrunner has been largely mute on the issue, giving subtle and nonspecific answers on whether he would push for a national abortin ban if he beats Biden in November.

"He is strategically and deliberately feigning moderation," Valenti said. "He is hoping people who are horrified by the end of Roe ... that they won't attach him to that and think that he will make things worse. That's just not true. Things could get much worse under a Trump presidency."

More: SCOTUS' leaked Roe v. Wade opinion led to near tenfold increase in abortion pill demand, study shows
A 19th century obscenity law could target abortion pills

If Trump returns to the White House, he could order the Department of Justice to use the Comstock Act, an obscenity law from the 1800s, to ban shipments of not only abortion medication, but medical equipment used for abortion or even clinic supplies, Valenti said. The Biden administration has already ruled that sending abortion pills via mail doesn’t violate the act, but a new administration could interpret the law differently.

January 19, 2024: In a snow storm anti-abortion activists march and rally in front of the U.S. Capitol during the annual March for Life in Washington on January 19, 2024. The event ended at the U.S. Supreme Court.

"Politically it's clear we need something more protective," Valenti said.

But she also remarked that many Americans may feel stranded between forceful advocates for unrestricted access and those working toward complete abolition.

For people in the middle, Valenti said, it’s important to consider who they trust to make a major decision about their lives: "At the heart of the matter is, do you think that this is a decision that the government should be involved in or not?”

This article originally appeared on USA TODAY: What 51 years of Roe v. Wade means today

This Year, the Reproductive Justice Movement Showed Us What It Means to Fight

By Garnet Henderson

December 29, 2022Z

Source: TruthOut

Image: Adam Fagen

In a year of worst-case abortion access scenarios, reproductive justice activists showed us what solidarity looks like.

For reproductive justice advocates, the start of 2022 was ominous. In September 2021, the Supreme Court allowed a six-week abortion ban to go into effect in Texas, declining to block the law even temporarily despite the fact that it was an obvious violation of Roe v. Wade.

When oral arguments in Dobbs v. Jackson Women’s Health Organization arrived in December of that year, the Texas ban had been in place for four painful months. That fact, plus some of the justices’ questions during oral arguments, cast an even deeper pall over the coming year. It was clear that the Supreme Court’s new and extremely conservative majority was ready to overturn one of the court’s most significant precedents and eliminate the constitutional right to abortion. But many activists, organizers and people working in abortion care felt like they were screaming and hardly anyone was listening. They didn’t see their sense of urgency mirrored in society at large.

Confirmation came in May, when the (apparently not-so-unprecedented) leak of the court’s majority opinion showed that the justices planned to pave the way for states to ban abortion entirely. This set off a torturous waiting game, where abortion providers and funders prepared for the worst without knowing exactly what day the hammer would fall.

One abortion provider told me at the time that his Texas clinic started packing appointments for the few abortions they were able to offer into the early morning hours in order to do as many procedures as possible each day before any Supreme Court decisions were issued. A telemedicine provider serving Wyoming, a state with a “trigger” ban designed to outlaw abortion automatically in the event of Roe’s demise, said she was checking her phone in between every patient to make sure abortion hadn’t become illegal during her last appointment. In late May, the state of Oklahoma — where nearly half of Texans who traveled out of state for their abortions received care — enacted a total abortion ban. When the official Supreme Court decision finally came down on June 24, providers in many states were forced to send patients home and stop providing services immediately.

2022 was the year that the Christian right succeeded in its decades-long plan to seize control of the Supreme Court and overturn Roe v. Wade. Yes, the Republican Party led that charge. But the Democratic Party failed — or perhaps, chose not to — mount a real defense. For years, pundits and politicians alike dismissed warnings that legal abortion was in jeopardy as hysterical, even as roughly half of U.S. states worked to legislate accessible abortion out of existence and many laid plans to ban abortion the moment they could. So far, 13 states have banned abortion entirely, and one — Georgia — has banned abortion at six weeks. In 10 other states, bans that have been temporarily blocked in the courts remain a threat.

There is no silver lining in suffering. But when the worst-case scenario that reproductive justice advocates had warned of for decades came to pass, they rose to the occasion with a bravery and grit that almost defies comprehension.

Overworked and overwhelmed, clinic workers kept showing up, even when they weren’t sure how much longer their jobs would exist. Though a wave of union organizing efforts began among clinic staff years ago, some of those unionized workers were still without contracts this year. However, just before the end of 2022, workers at Planned Parenthood of Western Pennsylvania — one of whom spoke with Truthout in September — won and ratified their first contract after 20 months of bargaining.

According to Abortion Care Network, an association of independent abortion clinics, 42 independent clinics closed in 2022 — each one a devastating loss. However, in the face of incredible adversity, a handful of independent clinics have managed to stay open to provide non-abortion services in states that now ban abortion. One of them is West Alabama Women’s Center, whose operations director told me in August that the clinic could be forced to close in a few months. It remains open, offering contraceptive access, prenatal care, treatment for pregnancy complications, and other general health care. Other clinics have moved to or opened new locations in nearby states where abortion is still legal, so they can continue providing abortion care.

Abortion providers also found innovative new ways to serve patients traveling long distances. Just the Pill, formerly a telemedicine service, launched Abortion Delivered, the nation’s first fleet of mobile abortion clinics, and several Planned Parenthood affiliates followed suit.

Elevated Access, which flies people from restrictive states to places where they can safely receive abortion and gender-affirming care, told Truthout it has received applications from more than 1,000 volunteer pilots. Partners in Abortion Care, a new all-trimester abortion clinic, opened with help from more than 3,000 individual donors and said it has been seeing patients from all over the U.S. and abroad since October.

Abortion funds have also raised and distributed millions of dollars this year. The New York Abortion Access Fund recently reported that it had disbursed over $1 million as of October this year. The Missouri Abortion Fund distributed more than $647,000. Kentucky Health Justice Network (KHJN) told Truthout it helped roughly 1,650 abortion seekers this year. Prior to August, over 80 percent of its callers were going to one clinic in Kentucky. Now KHJN funds procedures at nearly 20 clinics across the region. Reproductive Freedom Fund of New Hampshire said it met 100 percent of the need for abortion funding for in-state patients and funded $50,000 toward procedures for out-of-state patients. New abortion funds launched, including the REACH Fund of Connecticut and Abortion Freedom Fund, which specifically funds telehealth abortions.

Though most abortion funds have historically ran on volunteer labor, many have begun to hire paid staff in order to make their work more sustainable. For example, DC Abortion Fund, which told Truthout it pledged over $2 million dollars to over 5,000 callers this year, also hired five full-time paid staff members for the first time in its history. Holler Health Justice, a fund in West Virginia, told Truthout its staff unionized with Industrial Workers of the World-West Virginia and finalized a first contract in May.

Online, I Need an A created a new advanced search feature allowing internet users to look for clinics based on the type of procedures offered and local legal restrictions, as well as search for abortion support organizations. Online Abortion Resource Squad told Truthout its volunteers answered 11,000 posts with accurate information on Reddit. A late 2021 Food and Drug Administration rule change made telemedicine simpler and more accessible, although only in the 31 states that allow it.

Advocates have also successfully defended people against criminalization for their pregnancy outcomes. In April, organizing by South Texans for Reproductive Justice, Frontera Fund and the Repro Legal Defense Fund helped secure the release of Lizelle Herrera, who was arrested for allegedly self-managing an abortion and held on $500,000 bail. Repro Legal Defense Fund posted Herrera’s bail and all charges against her were later dropped.

Pregnancy Justice (formerly known as National Advocates for Pregnant Women) told Truthout that it has secured the release of 10 pregnant and postpartum women — and counting — who were being held on unconstitutional bond conditions in an Alabama jail, and secured a policy to change those conditions moving forward. Along with a coalition including the ACLU of Northern California and Drug Policy Alliance, Pregnancy Justice also secured the release of Adora Perez, who spent four years in prison after being charged with murder when she experienced a stillbirth.

In a huge organizing and get-out-the-vote victory, Kansas voters resoundingly rejected an anti-abortion ballot measure in August. Despite concerns that the post-Dobbs momentum had faded, abortion-related ballot measures in the midterm elections in Michigan, Kentucky, Vermont, California and Montana all went in favor of abortion access and rights. Several states also enacted laws to expand and protect access to abortion, and even invested in directly funding abortion. And this is not even a comprehensive accounting of the victories, large and small, that advocates for abortion access have achieved this year against all odds.

And yet, there are many people who aren’t getting the abortions they need.

It’s hard to know exactly how many; based on data from Texas and surrounding states, researchers estimate the abortion rate among Texas residents declined by more than 30 percent after that state’s six-week abortion ban was enacted in 2021. However, that was a six-week ban, not a total ban, and Texas residents were still able to travel to nearby states at that time.

Now, for many people across the South and Midwest, the nearest abortion clinic is hundreds of miles away. Though some will order abortion pills online and self-manage their abortions, it is likely that thousands of people will be forced to carry pregnancies to term and give birth against their will. Every single one of these denied abortions will be a gross violation of human rights and bodily autonomy — not just the ones that endanger the pregnant person’s life.

Across the board, reproductive justice advocates and abortion care providers tell me they are exhausted. No one should have to work as hard as they have this year, with such high stakes. I’m tempted to say that we don’t deserve them, but the truth is that we do. Each and every person deserves someone to fight for their right to self-determination with such ferocity. But these tired, overworked people can’t do it alone. So, for 2023, I ask: How will you help them?

Telehealth makes timely abortions possible for many, research shows





The COVID-19 pandemic brought telehealth into the mainstream.

  Sladic/E+ via Getty Images

Published: January 30, 2024 

Access to telehealth abortion care can determine whether a person can obtain an abortion in the United States. For young people and those living on low incomes, telehealth makes a critical difference in getting timely abortion care.

These are the key findings from our recent studies published in the American Journal of Public Health and the Journal of Medical Internet Research.

We surveyed 1,600 people across the country who accessed telehealth abortion in 2021 and 2022, prior to the Dobbs v. Jackson Supreme Court decision in June 2022 that led to abortion bans in much of the U.S. South and Midwest.

Telehealth abortion, which has been widely available in the U.S. only since 2021, allows patients to be evaluated remotely by a licensed provider and, if medically eligible, receive abortion medications in the mail. Our research has shown that this type of abortion care is extremely safe.

Written by academics, edited by journalists, backed by evidence.Get newsletter

Nearly all the patients we surveyed had positive experiences with telehealth abortion: They were satisfied, trusted their telehealth provider, felt cared for and felt telehealth was the right decision. Our research shows that for many patients, telehealth offers important benefits over abortion care from a clinic.

Why it matters

Since 14 states have banned abortion as of January 2024 following the Dobbs decision, patients have been traveling long distances to access care. This puts increased pressure on clinics in states where abortion remains legal.

Research has shown that the consequences of abortion bans are highly unequal. People of color, young people and those living on lower incomes are disproportionately affected by abortion restrictions. These are the same people who stand to benefit the most from access to telehealth abortion.

Nearly 1 in 10 abortions in the U.S. are now done via telehealth. At the same time, access to telehealth abortion is under threat. The Supreme Court will decide on the Alliance for Hippocratic Medicine v. FDA case in 2024, which could limit access to telehealth abortion across the country.

While there will always be a need for in-person abortion care, and many patients prefer it, our research shows that telehealth can make a critical difference for many. Telehealth can bring an otherwise impossible abortion within reach, especially for people who have been underserved in health care. Restrictions on telehealth abortion threaten equitable abortion access.

Telehealth allows patients to avoid a significant amount of travel to an abortion clinic, which has become prohibitively difficult as abortion clinics have closed in record numbers. Avoiding travel can make abortion care much more accessible without the need to arrange for transport, time off from work and child care. Telehealth abortion appointments are usually available sooner, and in many cases they are more affordable than abortion care from a clinic. Telehealth also allows patients to tell fewer people about their abortion decision.

When we asked people what would have happened if they had not been able to have a telehealth abortion, 43% of those we surveyed said they would not have been able to get a timely abortion without telehealth.

This was more likely to be true for young people, those living on lower incomes, those living in rural areas and those who lived far from an abortion clinic. While only 2% of patients said they would have continued the pregnancy if they had not had access to telehealth abortion, we expect that this proportion would have been substantially higher if we replicated this study after Dobbs.
New York City’s public health system offers telehealth visits to pregnant patients, who then can receive abortion pills by mail.
What’s next

Our future research will look at the structural changes necessary to ensure that the benefits of telehealth abortion are available equitably. We will also test how to tailor telehealth abortion so that it reaches people historically excluded from health care.

The Research Brief is a short take on interesting academic work.

Authors

Leah Koenig
PhD Candidate in Public Health, University of California, San Francisco

Leah Koenig receives funding from the National Institute of Child Health and Human Development and the Society of Family Planning.

Ushma Upadhyay
Professor of Obstetrics, Gynecology & Reproductive Science, University of California, San Francisco

Ushma Upadhyay receives funding from the BaSe Family Fund, Erik E. and Edith H. Bergstrom Foundation, Isabel Allende Foundation, Lisa and Douglas Goldman Fund, Preston-Werner Ventures, and the National Institute of Child Health and Human Development under Award Number 1R01HD110659-01A1. She is a member of the Society of Family Planning, the Population Association of America, and the South Asian Public Health Association.

Abortion rights council calls on California to pay for out-of-state patients if Roe vs. Wade falls

Abortion rights activists wave signs on the Wilshire overpass overlooking the 110 freeway at a Stop Abortion Bans rally organized by NARAL Pro-Choice California in Los Angeles on May 21, 2019. 

File Photo by Chris Chew/UPI | License Photo

Dec. 8 (UPI) -- A council made up of abortion rights and women's health advocates recommended Wednesday that California prepare to provide abortion access -- and funding -- to all Americans if the Supreme Court overturns Roe vs. Wade.

The California Future of Abortion Council was convened in September with support from California Gov. Gavin Newsom and members of the California State Legislature to provide recommendations to government officials on ways to make access to abortion more safe, equitable and affordable. The so-called FAB Council, which comprises more than 40 organizations, issued a report Tuesday making 45 policy recommendations.

The recommendations come as the Supreme Court considers challenges to restrictive abortion laws in states including Mississippi and Texas that could upend the landmark 1973 ruling that protects a woman's right to an abortion. That could result in several states choosing to outright ban abortions, leaving millions of Americans without access to the procedure.

"When I ran clinic services for a women's health center, I saw countless individuals who needed information, services, and support," state Sen. Toni Atkins, president pro tempore, said. "Working with the FAB Council, my colleagues and I will ensure Californians and people from every state can get the reproductive health services they need in a safe and timely way -- and that all our rights remain enshrined in law. This is crunch time, but we will not be dragged into the past. California will keep leading for the future."

Included among the 45 policy recommendations:

-- Provide more funding, support and infrastructure for those seeking an abortion.

-- Reimburse patients for abortion-related expenses.

RELATED  Study: Abortion medically safe, unwanted pregnancy poses greater health risk

-- Invest in a more diverse abortion provider workforce.

-- Reduce institutional barriers to abortion care.

-- Provide legal protection for patients, providers and their supporters.

-- Counteract misinformation and provide accurate education about abortion.

-- Collect data and carry out research on abortion and education needs in the state.

Abortion rights activists wave signs and banners on the Wilshire overpass overlooking the 110 freeway at a Stop Abortion Bans rally organized by NARAL Pro-Choice California in Los Angeles on May 21, 2019. File Photo by Chris Chew/UPI | License Photo

Jessica Pinckney, executive director of Access Reproductive Justice, said the state must strengthen access to abortion as it prepares for an influx of patients from other states. The Guttmacher Institute, a research group that advocates for abortion rights, predicts out-of-state women seeking abortions in California will increase from 46,000 to 1.4 million if Roe vs. Wade falls and 26 states ban abortion.

"Abortion funds and practical support organizations have long supported individuals in transportation to and from their appointments or money for gas, lodging for overnight stays, support with childcare, among other supports, however, the unmet need far exceeds what we are able to support. The policy recommendations made in the FAB Council report are integral to filling the gaps in abortion access that exist for Californians and those in our sibling states," she said.

California plans to be abortion sanctuary if Roe overturned

By ADAM BEAM

 People rally in support of abortion rights at the state Capitol in Sacramento, Calif., May 21, 2019. On Wednesday Dec. 8, 2021, a group of abortion providers and advocacy groups recommended California should use public money to bring people here from other states for abortion services should the U.S. Supreme Court overturn Roe v. Wade. The report has the backing of key legislative leaders, including Senate President Pro Team Toni Atkins, a Democrat. (AP Photo/Rich Pedroncelli, File)

SACRAMENTO, Calif. (AP) — With more than two dozen states poised to ban abortion if the U.S. Supreme Court gives them the OK next year, California clinics and their allies in the state Legislature on Wednesday revealed a plan to make the state a “sanctuary” for those seeking reproductive care, including possibly paying for travel, lodging and procedures for people from other states.

The California Future of Abortion Council, made up of more than 40 abortion providers and advocacy groups, released a list of 45 recommendations for the state to consider if the high court overturns Roe v. Wade — the 48-year-old decision that forbids states from outlawing abortion.

The recommendations are not just a liberal fantasy. Some of the state’s most important policymakers helped write them, including Toni Atkins, the San Diego Democrat who leads the state Senate and 

Democratic Gov. Gavin Newsom started the group himself and in an interview last week with The Associated Press said some of the report’s details will be included in his budget proposal in January.

“We’ll be a sanctuary,” Newsom said, adding he’s aware patients will likely travel to California from other states to seek abortions. “We are looking at ways to support that inevitability and looking at ways to expand our protections.”

Abortion, perhaps more than any other issue, has divided the country for decades along mostly traditional partisan lines. A new decision overturning Roe v. Wade, which could come next summer, would be the culmination of more than 40 years of conservative activism. But Wednesday’s report offers a first glimpse of how Democratic-dominated states could respond and how the debate over abortion access would change.

California already pays for abortions for many low-income residents through the state’s Medicaid program. And California is one of six states that require private insurance companies to cover abortions, although many patients still end up paying deductibles and co-payments.

But money won’t be a problem for state-funded abortion services for patients from other states. California’s coffers have soared throughout the pandemic, fueling a record budget surplus this year. Next year, the state’s independent Legislative Analyst’s Office predicts California will have a surplus of about $31 billion.

California’s affiliates of Planned Parenthood, the nation’s largest abortion provider, got a sneak preview of how people might seek abortions outside their home states this year when a Texas law that outlawed abortion after six weeks of pregnancy was allowed to take effect. California clinics reported a slight increase in patients from Texas.

Demonstrators rally to to demand continued access to abortion during the March for Reproductive Justice, Oct. 2, 2021, in downtown Los Angeles. On Wednesday Dec. 8, 2021, a group of abortion providers and advocacy groups recommended California should use public money to bring people here from other states for abortion services should the U.S. Supreme Court overturn Roe v. Wade. The report has the backing of key legislative leaders, including Senate President Pro Team Toni Atkins, a Democrat. 

(AP Photo/Damian Dovarganes, file)

Now, California abortion providers are asking California to make it easier for those people to get to the state.

The report recommends funding — including public spending — to support patients seeking abortion for travel expenses such as gas, lodging, transportation and child care. It asks lawmakers to reimburse abortion providers for services to those who can’t afford to pay — including those who travel to California from other states whose income is low enough that they would qualify for state-funded abortions under Medicaid if they lived there.

It’s unclear about how many people would come to California for abortions if Roe v. Wade is overturned. California does not collect or report abortion statistics. The Guttmacher Institute, a research group that supports abortion rights, said 132,680 abortions were performed in California in 2017, or about 15% of all abortions nationally. That number includes people from out of state as well as teenagers, who are not required to have their parents’ permission for an abortion in California.

Planned Parenthood, which accounts for about half of California’s abortion clinics, said it served 7,000 people from other states last year.

A huge influx of people from other states “will definitely destabilize the abortion provider network,” said Fabiola Carrion, interim director for reproductive and sexual health at the national Health Law Program. She said out-of-state abortions would also likely be later term procedures, which are more complicated and expensive.

The report asks lawmakers to help clinics increase their workforce to prepare for more patients by giving scholarships to medical students who pledge to offer abortion services in rural areas, help them pay off their student loans and assist with their monthly liability insurance premiums.

“We’re looking at how to build capacity and build workforce,” said Jodi Hicks, CEO of Planned Parenthood Affiliates of California. “It will take a partnership and investment with the state.”

Abortion opponents in California, meanwhile, are also preparing for a potential surge of patients from other states seeking the procedure — only they hope to convince them not to do it.

Jonathan Keller, president and CEO of the California Family Council, said California has about 160 pregnancy resource centers whose aim is to convince women not to get abortions. He said about half of those centers are medical clinics, while the rest are faith-based counseling centers.

Many of the centers are located near abortion clinics in an attempt to entice people to seek their counseling before opting to end pregnancies. Keller said many are already planning on increasing their staffing if California gets an increase of patients.

“Even if we are not facing any immediate legislative opportunities or legislative victories, it’s a reminder that the work of changing hearts and minds and also providing real support and resources to women facing unplanned pregnancies — that work will always continue,” Keller said.

He added: “In many ways, that work is going to be even more important, both in light of the Supreme Court’s decision and in light of whatever Sacramento decides they are going to do in response.”

Roe v Wade: Kansas voters protect abortion rights, block path to ban

2 Aug, 2022
By John Hanna and Margaret Stafford

Kansas voters protected the right to get an abortion in their state, rejecting a measure that would have allowed their Republican-controlled Legislature to tighten abortion restrictions or ban it outright.

The referendum in the conservative state was the first test of US voter sentiment about abortion rights since the Supreme Court overturned Roe v Wade in June. It was a major victory for abortion rights advocates, following weeks in which many states in the South and Midwest largely banned abortion.

Voters rejected a proposed amendment to the Kansas Constitution that would have added language stating that it does not grant the right to abortion. A 2019 state Supreme Court decision declared that access to abortion is a "fundamental" right under the state's Bill of Rights, preventing a ban and potentially thwarting legislative efforts to enact new restrictions.

The referendum was closely watched as a barometer of liberal and moderate voters' anger over the June ruling scrapping the nationwide right to abortion. The measure's failure also was significant because of how conservative Kansas is, and how twice as many Republicans as Democrats have voted in its August primaries in the decade leading up to Tuesday night's tilt.

Kristy Winter, 52, a Kansas City-area teacher and unaffiliated voter, voted against the measure and brought her 16-year-old daughter with her to her polling place.

Jessica Porter, communications chair for the Shawnee County, Kansas, Democratic Party. 

Photo / AP

"I want her to have the same right to do what she feels is necessary, mostly in the case of rape or incest," she said. "I want her to have the same rights my mother has had most of her life."

Opponents of the measure predicted that the anti-abortion groups and lawmakers behind the measure would push quickly for an abortion ban if voters approved it. Before the vote, the measure's supporters refused to say whether they would pursue a ban as they appealed to voters who supported both some restrictions and some access to abortion.

Stephanie Kostreva, a 40-year-old school nurse from the Kansas City area and a Democrat, said she voted in favour of the measure because she is a Christian and believes life begins at conception.

"I'm not full-scale that there should never be an abortion," she said. "I know there are medical emergencies, and when the mother's life is in danger there is no reason for two people to die."

An anonymous group sent a misleading text to Kansas voters telling them to "vote yes" to protect choice, but it was suspended late Monday from the Twilio messaging platform it was using, a spokesperson said. Twilio did not identify the sender.

The 2019 Kansas Supreme Court decision protecting abortion rights blocked a law that banned the most common second-trimester procedure, and another law imposing special health regulations on abortion providers also is on hold. Abortion opponents argued that all of the state's existing restrictions were in danger, though some legal scholars found that argument dubious. Kansas doesn't ban most abortions until the 22nd week of pregnancy.

Backers of the measure began with an advantage because anti-abortion lawmakers set the vote for primary election day, when for the past 10 years Republicans have cast twice as many ballots as Democrats. But the early-voting electorate was more Democratic than usual.

The Kansas vote is the start of what could be a long-running series of legal battles playing out where lawmakers are more conservative on abortion than governors or state courts. Kentucky will vote in November on whether to add language similar to Kansas' to its state constitution.

Meanwhile, Vermont will decide in November whether to add an abortion rights provision to its constitution. A similar question is likely headed to the November ballot in Michigan.

In Kansas, both sides together spent more than USD$14 million on their campaigns. Abortion providers and abortion rights groups were key donors to the "no" side, while Catholic dioceses heavily funded the "yes" campaign.

The state has had strong anti-abortion majorities in its Legislature for 30 years, but voters have regularly elected Democratic governors, including Laura Kelly in 2018. She opposed the proposed amendment, saying changing the state constitution would "throw the state back into the Dark Ages."

State Attorney General Derek Schmidt, a Republican hoping to unseat Kelly, supported the proposed constitutional amendment. He told the Catholic television network EWTN before the election that "there's still room for progress" in decreasing abortions, without spelling out what he would sign as governor.

Although abortion opponents pushed almost annually for new restrictions until the 2019 state Supreme Court ruling, they felt constrained by past court rulings and Democratic governors like Kelly.

Kansas voters resoundingly protect their access to abortion

By JOHN HANNA and MARGARET STAFFORD

1 of 20

Calley Malloy, left, of Shawnee, Kan.; Cassie Woolworth, of Olathe, Kan.; and Dawn Rattan, right, of Shawnee, Kan., applaud during a primary watch party Tuesday, Aug. 2, 2022, in Overland Park, Kan. Kansas voters rejected a ballot measure in a conservative state with deep ties to the anti-abortion movement that would have allowed the Republican-controlled Legislature to tighten restrictions or ban abortion outright.(Tammy Ljungblad AP)/The Kansas City Star via AP)

TOPEKA, Kan. (AP) — Kansas voters on Tuesday sent a resounding message about their desire to protect abortion rights, rejecting a ballot measure in a conservative state with deep ties to the anti-abortion movement that would have allowed the Republican-controlled Legislature to tighten restrictions or ban the procedure outright.

It was the first test of voter sentiment after the U.S. Supreme Court’s decision in June that overturned the constitutional right to abortion, providing an unexpected result with potential implications for the coming midterm elections.

While it was just one state, the heavy turnout for an August primary that typically favors Republicans was a major victory for abortion rights advocates. With most of the vote counted, they were prevailing by roughly 20 percentage points, with the turnout approaching what’s typical for a fall election for governor.

The vote also provided a dash of hope for Democrats nationwide grasping for a game-changer during an election year otherwise filled with dark omens for their prospects in November.

“This vote makes clear what we know: the majority of Americans agree that women should have access to abortion and should have the right to make their own health care decisions,” President Joe Biden said in a statement.

After calling on Congress to “restore the protections of Roe” in federal law, Biden added, “And, the American people must continue to use their voices to protect the right to women’s health care, including abortion.”

The Kansas vote also provided a warning to Republicans who had celebrated the Supreme Court ruling and were moving swiftly with abortion bans or near-bans in nearly half the states.

“Kansans bluntly rejected anti-abortion politicians’ attempts at creating a reproductive police state,” said Kimberly Inez McGuire, executive director of Unite for Reproductive & Gender Equity. ”Today’s vote was a powerful rebuke and a promise of the mounting resistance.”

The proposed amendment to the Kansas Constitution would have added language stating that it does not grant the right to abortion. A 2019 state Supreme Court decision declared that access to abortion is a “fundamental” right under the state’s Bill of Rights, preventing a ban and potentially thwarting legislative efforts to enact new restrictions.

The referendum was closely watched as a barometer of liberal and moderate voters’ anger over the Supreme Court’s ruling scrapping the nationwide right to abortion. In Kansas, abortion opponents wouldn’t say what legislation they’d pursue if the amendment were passed and bristled when opponents predicted it would lead to a ban.

Mallory Carroll, a spokesperson for the national anti-abortion group Susan B. Anthony Pro-Life America, described the vote as “a huge disappointment” for the movement and called on anti-abortion candidates to “go on the offensive.”

She added that after the U.S. Supreme Court ruling, “We must work exponentially harder to achieve and maintain protections for unborn children and their mothers.”

The measure’s failure also was significant because of Kansas’ connections to anti-abortion activists. Anti-abortion “Summer of Mercy” protests in 1991 inspired abortion opponents to take over the Kansas Republican Party and make the Legislature more conservative. They were there because Dr. George Tiller’s clinic was among the few in the U.S. known to do abortions late in pregnancy, and he was murdered in 2009 by an anti-abortion extremist.

Anti-abortion lawmakers wanted to have the vote coincide with the state’s August primary, arguing they wanted to make sure it got the focus, though others saw it as an obvious attempt to boost their chances of winning. Twice as many Republicans as Democrats have voted in the state’s August primaries in the decade leading up to Tuesday’s election.

“This outcome is a temporary setback, and our dedicated fight to value women and babies is far from over,” said Emily Massey, a spokesperson for the pro-amendment campaign.

The electorate in Tuesday’s vote wasn’t typical for a Kansas primary, particularly because tens of thousands of unaffiliated voters cast ballots.

Kristy Winter, 52, a Kansas City-area teacher and unaffiliated voter, voted against the measure and brought her 16-year-old daughter with her to her polling place.

“I want her to have the same right to do what she feels is necessary, mostly in the case of rape or incest,” she said. “I want her to have the same rights my mother has had most of her life.”

Opponents of the measure predicted that the anti-abortion groups and lawmakers behind the measure would push quickly for an abortion ban if voters approved it. Before the vote, the measure’s supporters refused to say whether they would pursue a ban as they appealed to voters who supported both some restrictions and some access to abortion.

Stephanie Kostreva, a 40-year-old school nurse from the Kansas City area and a Democrat, said she voted in favor of the measure because she is a Christian and believes life begins at conception.

“I’m not full scale that there should never be an abortion,” she said. “I know there are medical emergencies, and when the mother’s life is in danger there is no reason for two people to die.”

An anonymous group sent a misleading text Monday to Kansas voters telling them to “vote yes” to protect choice, but it was suspended late Monday from the Twilio messaging platform it was using, a spokesperson said. Twilio did not identify the sender.

The 2019 Kansas Supreme Court decision protecting abortion rights blocked a law that banned the most common second-trimester procedure, and another law imposing special health regulations on abortion providers also is on hold. Abortion opponents argued that all of the state’s existing restrictions were in danger, though some legal scholars found that argument dubious. Kansas doesn’t ban most abortions until the 22nd week of pregnancy.

The Kansas vote is the start of what could be a long-running series of legal battles playing out where lawmakers are more conservative on abortion than governors or state courts. Kentucky will vote in November on whether to add language similar to Kansas’ proposed amendment to its state constitution.

Meanwhile, Vermont will decide in November whether to add an abortion rights provision to its constitution. A similar question is likely headed to the November ballot in Michigan.

In Kansas, both sides together spent more than $14 million on their campaigns. Abortion providers and abortion rights groups were key donors to the “no” side, while Catholic dioceses heavily funded the “yes” campaign.

The state has had strong anti-abortion majorities in its Legislature for 30 years, but voters have regularly elected Democratic governors, including Laura Kelly in 2018. She opposed the proposed amendment, saying changing the state constitution would “throw the state back into the Dark Ages.”

State Attorney General Derek Schmidt, a Republican hoping to unseat Kelly, supported the proposed constitutional amendment. He told the Catholic television network EWTN before the election that “there’s still room for progress” in decreasing abortions, without spelling out what he would sign as governor.

Although abortion opponents pushed almost annually for new restrictions until the 2019 state Supreme Court ruling, they felt constrained by past court rulings and Democratic governors like Kelly.

___

Stafford reported from Overland Park and Olathe.

___

Follow John Hanna on Twitter at https://twitter.com/apjdhanna. For more AP coverage of the abortion issue, go to https://apnews.com/hub/abortion.

It’s not just Texas – anti-abortion activists are targeting women’s rights in Europe

Draconian laws in European countries and the effects of Brexit and Covid-19 are making safe terminations harder to access

‘We will continue this work until our helplines stop ringing.’ Women protest against the six-week abortion ban at the Capitol in Austin, Texas. 

Photograph: Jay Janner/AP

Fri 3 Sep 2021 
Mara Clarke is the founder of Abortion Support Network


The state of Texas now has the most restrictive abortion law to be passed in the US since Roe v Wade legalised abortion in 1973. Texas residents must now add out-of-state travel to the many barriers that already exist to getting an abortion. There has been an outpouring of support for Texas women from people in the UK and European Union, but it’s worth remembering that while the UK and Europe are an abortion utopia compared with some American states, abortion access is still not guaranteed.

Let’s start with the UK. Due to the herculean efforts of activists (and despite the best efforts of a foot-dragging, anti-abortion government), Northern Ireland now has limited access to legal abortion. But Alliance for Choice, the campaign group in Northern Ireland, says that proper access to abortion is still not guaranteed across the country. Women are still waiting for the department of health to commission abortion services, telemedicine and more types of available abortion. Currently, the majority of abortions happen in the first 10 weeks of pregnancy and are performed with pills, which carry a small risk of failure. Because there is virtually no provision for abortions after the first trimester, people seeking these services are still forced to travel to England.

Many people in Scotland who need late abortions also have to travel to England due to a lack of facilities, despite the law allowing terminations at 24 weeks. In England and Wales, abortion is still regulated by criminal code, and waiting times for abortions vary across the country. Whether you are able to access an abortion quickly often depends on where you live.

The charity I founded, Abortion Support Network (ASN), has years of experience helping people who have been forced by a combination of draconian abortion laws and poverty to access abortions abroad. We offer practical information and financial support, and are funded almost entirely by private individuals. We do this work because we believe “I can’t afford an abortion” should never be the only reason someone continues a pregnancy.

Initially we worked in Ireland (where abortion is now legal up to 12 weeks, and in very restricted circumstances after this), the Isle of Man (where abortion was made legal in 2019) and Northern Ireland (where decriminalisation only happened very recently). In 2019, we expanded to Malta , which has some of the most draconian abortion laws in Europe: abortion is illegal even in cases where it will save a woman’s life. We expanded to Gibraltar in the same year. Although it recently voted to allow abortion in some circumstances, Gibraltar’s abortion laws were previously more draconian than those in Texas; abortion was only allowed in cases where it would save a woman’s life.

At the end of 2019 we expanded our work to Poland as part of the Abortion Without Borders initiative. Poland, which already had one of the most prohibitive abortion laws in Europe, recently made its law even more severe, ruling that 98% of the 1,000-2,000 legal abortions performed by the state each year were “unconstitutional”.

Despite how busy our charity is, we are now looking at expanding into additional countries that need support. Andorra has joined Malta in making all abortions illegal, even where they would save a woman’s life. Other European countries have decent abortion laws but still effectively limit access, such as Italy, where 69% of gynaecologists “conscientiously object” to performing abortions, Romania, where activists say abortion is being quietly phased out , and Hungary, where the government has successfully reduced abortion access in recent years .

Our work is particularly focused on ensuring that people can access abortions beyond the first trimester. Most countries in Europe offer access to abortion during the first 12 to 14 weeks of pregnancy. In countries that don’t, many people rely on NGOs such as Women Help Women and Women on Web, which send early medical abortion pills to countries where abortion is restricted. Thankfully, people are increasingly aware of these pills, which are on the World Health Organization’s list of essential medicines and offer a safe means of ending a pregnancy. When we first founded ASN, women in Ireland and Northern Ireland told us they had tried far more dangerous things than pills.

Getting an abortion later in a pregnancy, when pills are no longer suitable, can be difficult depending on where you live. Every country has conditions determining when later abortions are permitted and how they are performed. Navigating access to these services can be difficult, especially for people who are marginalised, young or poor. It can be impossible for those with insecure immigration or refugee status. In Europe, the best places to travel to are the Netherlands, where abortion is available on request in clinics up to 22 weeks, England and Wales, where you can get an abortion up to 24 weeks, and in some cases Spain.

And here we return to Texas. Many will say that if a person in Texas now requires an abortion after six weeks, they can travel to a different state. We have been hearing this argument for years. Irish women can “just travel”. Polish women can “just travel”. But this fails to take into consideration the obstacles to travelling for an abortion, such as childcare, insecure immigration status, the fear of stigma or ostracisation, money and Brexit, which is making it hard for non-EU or UK residents to come to England.

These obstacles predate Covid-19, but the pandemic has made the problem worse. Many of our service users have been affected by airport closures in Poland and Malta, and expensive PCR tests required for people entering and returning to a country. Some of the obstacles have been farcical: one non-English-speaking service user arrived at her booked hotel in England to find all the rooms had been given to key workers and rough sleepers, while another woman had her flights cancelled and rebooked seven times for one journey. And travelling during a global pandemic carries extra health risks. The irony of risking your health to access healthcare is not lost on us.

Helping people get abortions requires a strong constitution. We will never be able to reach everyone who needs our help. But we know that as abortion funders we are part of a growing global network of activists who are finding ever more creative ways to help people access abortion care, and that we will continue this work until our helplines stop ringing.


Mara Clarke is founder of Abortion Support Network