“What used to be a one-day procedure in your own state can now mean flying out of state, staying overnight and taking off work. Most Americans can’t afford any surprise costs.”
— Marisa Falcon
For “B,” news last year that the Supreme Court had overturned Roe v. Wade felt devastating.
“It’s hard to express how I felt,” said “B,” now age 19, who asked that only her initial be used.“I don’t think they understand what they did.”
Two years ago, “B” needed an abortion, but because she lives in Texas, the law required she get her parents’ consent. She had already seen her sister struggle as a teen mom, but was afraid to go to her parents for permission.
She went online and was eventually referred to Jane’s Due Process, a pro bono legal aid group that helps Texas youth navigate parental consent laws on birth control and abortion. They helped 17-year-old “B” obtain a judicial bypass — a process in which a judge allows a patient to forgo parental consent — and pay for an abortion.
“Me and my sister made the opposite choices, but I believe we both made the right ones,” she told The Nation’s Health. “I am happy I had my abortion.”
Long before the Supreme Court overturned Roe last summer in Dobbs v. Jackson Women’s Health Organization, people depended on local abortion advocates and navigators such as Jane’s Due Process for help overcoming legal restrictions and practical barriers to abortion access, such as travel and cost. Post Dobbs, which eliminated the constitutional right to abortion, such barriers are even greater and the support networks even more important.
As of 2020, most U.S. counties did not have an abortion clinic, and early estimates show Dobbs made the problem much worse: Average travel time to an abortion clinic nearly quadrupled to 100 minutes just a few months after the court overthrew Roe. As of mid-February, according to the Center for Reproductive Rights, abortion was illegal in 12 states and legislators in at least a dozen other states were trying to follow suit.
Lori, a volunteer driver for the Midwest Access Coalition, crosses state lines in June. The coalition offers transportation to and from appointments for abortion services. As abortion is banned or becomes harder to access in more states, volunteers are helping those in need, sometimes in new ways.
Photo by Angela Weiss, courtesy AFP/Getty Images
About half of U.S. abortion patients are living below the poverty line, according to the Guttmacher Institute.
“These problems have been increasing for years, because as more clinics have closed, the farther people have had to travel,” said Marisa Falcon, co-founder and executive director of Apiary, a national hub for groups that provide logistical assistance, such as lodging, child care and transportation, for people seeking abortions. “Practical support is an economic justice issue.”
Apiary, which started in 2019, maintains a nationwide directory of practical support organizations and hosts digital spaces where the groups can regularly collaborate and share information. The overall goal is to help facilitate abortion access, but Falcon said the hub is also a “space of solidarity” where such activists can connect about the challenges they face.
Locally, providing logistical support for abortion is not only more legally murky since Roe fell, but more expensive, she said. Before Dobbs, some people might have only needed a $50 gas card to help them get an abortion. After Dobbs, help with gas is rarely enough.
“What used to be a one-day procedure in your own state can now mean flying out of state, staying overnight and taking off work,” Falcon told The Nation’s Health. “Most Americans can’t afford any surprise costs, and average cost just for travel for an abortion can be over $1,000.”
To help lessen the pressure on local support workers, Falcon said Apiary is developing a training program to help build volunteer ranks on the ground.
Lila, with D.C. Doulas for Choice, gives a blanket to a patient in the recovery room at a Virginia abortion and family planning clinic. In some parts of the U.S., doulas are serving as navigators for people who are seeking and having abortions, providing emotional, informational and logistical support.
Photo by Evelyn Hockstein, courtesy The Washington Post/Getty Images
“A lot of direct service folks just don’t have the time to train new people,” she said.
Planned Parenthood is expanding its network of patient navigators, with 90 navigators across 41 affiliates as of mid-February. Leah Mallinos joined Planned Parenthood of Greater Ohio as its first patient navigator in 2021, helping patients deal with burdensome restrictions, such as mandatory waiting periods, and providing practical support with gas cards, bus tickets and hotel vouchers.
Before Dobbs, abortion in Ohio was legal up to 21 weeks and six days. Within hours of Roe’s reversal, Ohio criminalized abortion after six weeks — before many know they are pregnant — effectively shutting down abortion access in the state.
The drastic legal shift made patient navigation vital, Mallinos said, since most abortion seekers would now have to travel out of state. From June to September 2022, when Ohio had a six-week ban, the Ohio Planned Parenthood clinic helped more than 500 people access abortion in nearby states.
Now the law has swung back — Ohio’s six-week ban was blocked in September — and the majority of residents can stay in state for an abortion, Mallinos said. The legal shift had another effect: a new surge of abortion patients traveling into Ohio from now-more restrictive states such as Texas, West Virginia and Kentucky.
“It’s incredibly hard to keep up (with the changing laws), which is a strategy the opposition uses to create confusion around abortion access,” Mallinos told The Nation’s Health. “It’s an issue that comes up with nearly every patient I work with.”
A small handful of states have set up hotlines to help people sift through the confusion. Oregon — where abortion is still protected — launched a Reproductive Rights Hotline in January to dispense free, confidential legal advice. Anna Sortun, JD, a lawyer in Portland, volunteered to help set up the hotline and find lawyers to staff it. So far, about 70 have volunteered.
“It was super easy to recruit,” Sortun said. “Oregon shares a border with Idaho (where abortion is banned) and that’s made a lot of people interested in doing something to help.”
The hotline’s legal scope is limited to Oregon law, but Sortun said the information can be just as helpful to out-of-state callers looking for abortion options. Lawyers can also refer callers to other abortion support sources.
“I’m grateful I live in Oregon,” she told The Nation’s Health. “But I want to do whatever I can to help on a broader level.”
In Texas, Jane’s Due Process has completely stopped its abortion-related judicial bypass work, said Nan Kirkpatrick, its director of external affairs. As abortion is now banned in the state, judicial bypass is no longer a legal option for the procedure. Before the ban, the group was helping about 350 young people a year bypass parental consent laws to access abortion.
Immediately after Dobbs, the organization experienced an increase in teens calling with questions about birth control and emergency contraception, Kirkpatrick reported.
Young people can still call the hotline at Jane’s Due Process and get information about legal abortion. But because of the threat of state prosecution, the nonprofit is unable to help anyone travel out of state. Jane’s Due Process and a number of Texas-based abortion funds are suing over the issue.
“It’s a long game,” Kirkpatrick told The Nation’s Health in February. “We know the people are with us. We just need to flex that power.”
For more on local support, visit www.apiaryps.org and https://abortionfunds.org.
- Copyright The Nation’s Health, American Public Health Association
