The day after Politico reported on a leaked Supreme Court draft opinion quashing Roe v. Wade, Sean Mehl was trying to figure out how to answer the phone.
Mehl is associate director of clinical services for Whole Women’s Health, an abortion provider and nonprofit advocacy organization that operates nine clinics across the United States, including four in Texas, a state that has already severely restricted access. to abortions.
He knew from experience that whenever information about potential abortion restrictions comes out, the organization sees an increase in calls and many callers are confused. Could they keep their appointments? Would his clinic accept new patients?
His first priority this week, he said, was to make sure there was a recorded message to reassure people that the clinics were still open and still providing services, at least for now. .
“It really sparks a lot of urgency when things like this break,” Mehl said.
“They may not even have taken a pregnancy test at home, but the fear, in particular – a potential decision as monumental as this that has a lot of devastating impacts, people really jump on it as soon as ‘they can.’
With this cold, hard look at the potential future, providers are now planning how to connect their customers to the services they need, even if that means sending them out of state. Clinics in states that have protected abortion access are adding staff and space to meet demand. In fact, they’ve been doing it for quite some time.
Texas has one of the most restrictive abortion laws in the country, which prohibits abortion after about six weeks of gestation. The law is enforced through an unusual mechanism that encourages private citizens to sue anyone who “aids and abets” an abortion. Successful chases can be rewarded with $10,000. It was written to withstand legal challenges, and the courts refused to overturn it. Other states, including Idaho and Oklahoma, have recently passed similar laws.
In addition to these restrictions, Texas and 12 other states have passed so-called trigger laws that go into effect if Roe v. Wade is canceled. Texas law is set to ban all abortions — except those necessary to prevent serious injury or death to a pregnant person — 30 days after Roe’s cancellation. Still other states have pre-Roe abortion bans on their books that haven’t been enforced for the past 50 years, but could be if the judgment is quashed.
The reproductive health research organization Guttmacher Institute estimates that 26 states are certain or likely to ban abortions if Roe falls.
“I think we kind of see where it’s headed, and as devastating as it is, it’s not entirely a surprise because it’s been reduced over the years,” Mehl said.
Anticipating further restrictions, Whole Women’s Health launched the Abortion Wayfinder program, which helps people who cannot access services in their states. This turns clinics into de facto travel agencies, as social workers help each client figure out where they can go and how to pay for them.
“We are able to get them an appointment where they need to go. And we can work closely with state and national organizations that can help coordinate and, in many cases, fund the actual travel and procedural costs involved,” Mehl said.
Since the program launched in March, Whole Women’s Health has helped about 70 women through the Wayfinder program, the organization said.
Sometimes, if a pregnant person has transportation and can miss work, it may mean that they need to make an appointment at the new Whole Women’s Health clinic in Minnesota. It serves local customers but is also close to Minneapolis/St. Paul and Interstate 35, which connects Texas to Minnesota. It takes 14 hours to drive to Minneapolis from Dallas by car and about 21 hours by bus.
The clinic opened in February and about 30% of clients come from out of state, according to the organization.
Most people who have an abortion – 59% – have other children, according to statistics from the Guttmacher Institute, and this type of trip may not be possible with young children. Three-quarters of abortion patients in the United States are poor or low-income and may not be able to afford gas, hotel rooms or vacation time.
In those cases, Mehl says, they look for other options, like telemedicine appointments to get abortion pills — which seems to be more convenient, but sometimes isn’t.
In 2021, the United States Food and Drug Administration made medical abortions easier to access by removing requirements that abortion pills must be dispensed during in-person appointments, paving the way for people to obtain them through mail. That same year, however, Texas made the practice a felony punishable by jail time and a $10,000 fine.
So if a Texan wants a prescription for abortion pills, Mehl says, his group will sometimes help arrange a trip just for a telemedicine appointment.
“If, for example, we are only able to offer telemedicine services in New Mexico, the patient would have to be in the state of New Mexico to receive those services. So there is an element of travel there in many cases,” he said.
“We had patients from Texas who drove, sometimes overnight, so as not to miss any work. They will have a telemedicine visit, and they could come right back to go back to work. They might have kids with them,” Mehl said.
They also have to pick up the pills in New Mexico, so Mehl says people can choose to extend their stay in New Mexico by two or three days, the time it usually takes to get the medicine. “Or some come and go, depending on what really makes sense to them.”
Other times, Mehl says, people who are closer to the border with Mexico will go there.
“People are actually looking to Mexico, even to be currently more supportive or more accessible even than their own country, which I think really shows how devastating that access to care really is,” he said. declared.
Abortion providers in so-called sanctuary states like Oregon say more programs like Wayfinder will be needed if the leaked opinion becomes final.
“That’s one of the things that I think we need to help make easier for people is a kind of traffic control,” said Dr. Maria Rodriguez, obstetrician-gynecologist at Oregon Health Science. University and director of the state’s Title X program. Title X is a federal program that provides family planning services to low-income people through grants to nonprofit clinics.
“It’s a health issue, people are stressed, and then they have to add all this logistics of financial worries as well as logistical worries of travel. It’s a lot. It’s a lot to go through and people need to lots of support,” she said.
Oregon borders Idaho, which has passed a Texas-style abortion law that bans the procedure after about six weeks of pregnancy.
This ban has already increased traffic to clinics in Oregon. It is one of 16 states, along with the District of Columbia, that have protected the right to abortion.
These sanctuary states are preparing for an influx of people traveling for abortions. Oregon, for example, created a $15 million fund to help cover travel and medical expenses. The Guttmacher Institute estimates that the state will see a 234% increase in the number of pregnant people going there for abortion care.
Rodriguez thinks that number seems realistic. “We have people coming from Texas. We have people coming from all over the country,” she said.
To prepare, she says, her clinic added two or three days of operating room time each week.
“We’ve almost probably increased our response capacity by 40%, and it’s being filled,” she said.
Her clinic has also coordinated with independent abortion providers like Planned Parenthood and the Lilith Clinic. Their healthcare providers have obtained additional medical licenses in other states so they can offer more telehealth care.
Rodriguez knows that even if organizations try to facilitate access, they won’t be able to help everyone who needs it. This makes the gut.
“When I was a trainee, I would listen to the attending physicians who are older, talk about what it was like during their training, before Roe v. Wade, and they literally took care of women’s wings with septic abortions. or complications arising therefrom at county hospitals. And I always found it kind of like the 1700s, to me, something medieval,” she said. “I can’t believe that now we are going to experience this again. And I feel bad that this is the legacy we pass on to the next generation.
Diana Greene Foster, Research Director for the The Advancing New Standards in Reproductive Health program at the University of California, San Francisco studied the effects of having or being denied an abortion in nearly 1,000 women over 10 years.
Her research, called the Turnaway Study, was designed to explore the claim that abortions harm women. She said she found the opposite: not having an abortion when they wanted one increase in household poverty and economic insecurity, tied women to violent partners or increased the likelihood of them raising their children alone. Women who gave birth were also more likely to suffer mental and physical harm from the experience than those who had abortions.
Based on her research, she says, some women will not be able to remove the barriers that may soon be put in place to access an abortion.
“It’s pretty guaranteed,” Foster said. “It’s just not the case that people always find a way. When it’s illegal, some people won’t be able to get it. And some people will fail to order pills online or do something terrible. They will carry this pregnancy to term.