Lisa Jarvis
When Miami recently experienced catastrophic rainfall that grounded flights for days, staff at the Women’s Emergency Network, an abortion fund that serves Florida, scrambled to help clients get in and out of the state.
One woman, who had flown to Virginia for an abortion, was panicked because she didn’t have child-care coverage for an extra day, says WEF’s executive director Kamila Przytula. She had to get home.
The nonprofit eventually got her on a plane to Orlando, then arranged for a ride. But the story illustrates the lunacy of requiring women to travel for health care.
Such stories have become too common in the two years since the U.S. Supreme Court overturned Roe v. Wade and replaced it with the Dobbs decision, a change that erected impossibly high barriers to abortion access for millions of women.
In that time, a network of doctors, abortion funds, volunteers, researchers, lawyers, and donors have, against all odds, connected women with abortion providers. Their colossal efforts prevented a collapse in the number of abortions in the U.S. in the first post-Dobbs year.
But a state-by-state patchwork of abortion access is not a sustainable model for public health.
For women affected by new state bans, the challenges to getting an abortion are mind boggling. Abortion funds provide support, like transportation and child-care costs, but also step in when the unexpected happens. Sometimes that’s a natural disaster. It can also mean a patient arriving at a clinic with a medical complication that requires getting her to a hospital for help.
All of this costs money. A lot of money. The Chicago Abortion Fund, the largest such fund in the Midwest, has spent nearly $7 million in direct service costs over the last two years. Before Dobbs, it was supporting about 200 pregnant women each year; today, it’s now helping some 200 to 300 each week, says CAF Executive Director Megan Jeyifo, an effort that has required significantly expanding its staff and cadre of volunteers.
Each new ban makes it more expensive to clear those unnecessary hurdles. Before Florida’s ban, which hurt access across the South, WEF was providing about $300 in practical support to abortion seekers. In May, that average was closer to $800, a figure echoed by another fund in the region, ARC-Southeast.
Nevertheless, most abortion funds will tell you that when a pregnant person calls asking for financial help, whether that’s to pay for the procedure or to travel to an appointment, their answer in the last two years has been an unequivocal yes. Yes, we can provide a plane ticket or gas money for your 11-hour drive to a clinic. Yes, we have a voucher for your food and hotel or a ride from the airport or bus station. Yes, we can help you find and pay for child care during your visit.
As the costs rise, callers may start to hear a different answer.
And while certain moments, like a new ban passing or a viral news story of a woman nearly losing her life after being denied care, inspire a flood of donations, that’s not enough. “That is not going to sustain the movement,” says Oriaku Njoku, executive director of the National Network of Abortion Funds. “We need deep, long-term investment.”
What could fix this problem? Of course, the best solution would be to codify reproductive freedom in the U.S. That would mean passing laws that go beyond the protections offered by Roe, which never went far enough to ensure access to care. (There’s a reason abortion funds existed well before Dobbs — the biggest have been helping women for decades.)
Nationwide reproductive health-care access is crucial to countering the country’s shameful rates of infant and maternal mortality, which early data suggests are already worsening due to abortion bans.
But even if a federal right to abortion was restored tomorrow, it would take time to rebuild the health-care infrastructure in states with restrictions. Many clinics have already shuttered, and some providers have moved away.
So for now, it’s critical to provide transformational funding to the interconnected teams getting women to care. The states that have proclaimed themselves havens for reproductive justice can play a role by putting up public funds. And more philanthropists should be asking what they can do to provide stability to this network — and how to do it in a way that puts trust in the folks working in the trenches. Given the constantly evolving legal landscape and complexity of individual cases, that might mean writing a big check without strings attached. Maybe it means helping funds to, as the Chicago Abortion Fund just did, hire staff that focus on fundraising.
This grassroots network is at once impressively resilient and, given what’s at stake, far too fragile. The people who keep it going share an intense dedication to ensuring women can get the care they need, and with as much dignity and as little trauma as possible. But the magnitude of the challenge in front of them keeps growing.
When I asked leaders of abortion funds whether, two years in, they’ve been able to maintain their optimism, several were brought to tears. That emotion comes not from hopelessness, but from the deep pride in what they’ve accomplished. But it’s also tinged with fury over how much easier it ought to be.
Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care, and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.