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As barriers to care expand, women seeking abortions turn to volunteer network for help

Nonprofit groups help with the cost and logistics of travel, lodging, food and child care

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June 14, 2019 at 5:03 p.m. EDT

Adapted from a story by The Washington Post’s Lenny Bernstein.

As new state restrictions on abortion threaten to force women to travel farther, pay more and wait longer, the work of a nationwide network of volunteers and nonprofit groups that assist women trying to end unwanted pregnancies has reemerged.

The groups, which help with the cost and logistics of travel, lodging, food, child care and the abortion procedure itself, say they’re working harder and spending more. They’ve also seen an increase in donations for aid to the low-income women who have three-quarters of U.S. abortions and who are most of their clients.

Leah Greenblum, founder of one of the groups, the Midwest Access Coalition, said her group will aid 240 to 360 women this year, up from 185 in 2018 and compared with just 35 for all of 2015.

Since May 14, when Alabama passed perhaps the nation’s most restrictive abortion law, the networks have also received about $1.07 million in donations, said Lindsay Rodriguez, a spokeswoman for the National Network of Abortion Funds, an umbrella organization of 76 groups in 41 states.

For some, the need for stepped-up help is an unwelcome reminder of the efforts of groups such as the Jane Collective, which covertly assisted women seeking abortions before the 1973 Supreme Court decision that legalized them.

“It’s the present,” said Yamani Hernandez, executive director of the National Network of Abortion Funds.

The work of such groups, many of which rely solely on volunteers, was highlighted in recent weeks when a handful of states in the South and Midwest approved severe restrictions on abortion, and Planned Parenthood fought in a Missouri court to keep the state’s last abortion clinic open. A judge’s order is allowing the clinic to continue operating for now.

Nevertheless, some women are finding it difficult to end unwanted pregnancies as new restrictions increase the cost of abortions as well as the travel time and distance. The support groups’ costs are also increasing as more states impose obstacles to abortion. Some organizations cannot meet the demand.

Costs and complexity of accessing an abortion

There is no reliable data on the number of women seeking abortions who cannot obtain them, according to the Guttmacher Institute, a research and advocacy group that supports abortion and reproductive rights. But providers and activists are certain there are many.

“There are still individuals, pregnant people out there, who are not getting their care,” said Odile Schalit, director of the Brigid Alliance, a New York City-based assistance group she founded last August. “Especially when we think about minorities, especially when we think about undocumented folks and folks who live in rural areas.”

To describe the costs and logistical complexity of a single abortion, the groups cited the case of a woman from St. Louis who flew to the District last week to secure a later-term abortion. She had little money of her own and relied on assistance from the Brigid Alliance, the all-volunteer Midwest Access Coalition and an unnamed fund that paid for the abortion, activists said.

Her pregnancy was too far along to be terminated in her hometown clinic, which does not perform abortions after 21 weeks and six days of gestation. Missourians in her situation generally look to the District, Maryland, Colorado and New Mexico, where providers still perform later-term abortions. But that means thousands of dollars in expenses and days or weeks of potential delays.

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The organizations that helped the woman declined to make her available to The Washington Post. They described her as a woman in her late 20s with four children who was seeking a surgical abortion. (Abortions induced by medication are available during the first 10 weeks of a pregnancy.) The groups do not inquire why a woman seeks an abortion.

The Midwest Access Coalition, based in Chicago, paid about $1,300 for round-trip flights for the woman and a friend, according to Marie Khan, its director of operations. The coalition also paid for transportation to and from the airport and from the hotel to the clinic and back, which totaled $140.

The Brigid Alliance, the tiny group staffed by Schalit, paid $683 for the hotel room the two women shared, Schalit said.

The abortion itself probably cost $1,500 or more, based on data collected by the Guttmacher Institute. An abortion at 10 weeks averages $500, according to state policy analyst Elizabeth Nash. An abortion at 20 weeks averages $1,350 but can range from $750 to $5,000, depending on medical complications and other needs, Nash said.

Two large groups raise and donate money to pay for the procedures: The National Network, whose member groups have $5 million for abortions, and the National Abortion Fund, which did not return telephone calls and emails. Smaller regional funds and some providers also chip in financial support for procedures, officials said.

Data collected by the National Network on 2,000 requests to its Tiller Fund, most of them for second-trimester abortions, shows that women had on average $500 to contribute toward their care. That was less than a quarter of what they needed for abortions from 2010 to 2015, the period studied. The fund is named for George Tiller, a late-term abortion provider who was shot in the head and killed in his Wichita church by an antiabortion extremist in 2009.

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The current situation places the responsibility for money and arrangements mainly on the woman, “who basically has to do fundraising to get [her] abortion, which we think is ridiculous,” Hernandez said. To reduce costs, some groups arrange for women to sleep in the homes of volunteers rather than in hotels.

Last month, a hotel owner in Michigan offered free lodging to women who might seek abortions there. Another woman launched an effort, called the “Auntie Network,” on Facebook and Reddit to house women in volunteers’ homes.

Of the 76 groups in the National Network, 47 rely solely on volunteers, Hernandez said, while the rest have at least one paid staff member. Some are tiny; the average group has $75,000 to spend annually, she said.

Schalit said her organization has helped 370 women since August. Most of the money comes from small donations, but some foundations also support the work.

Other barriers to care

The number of providers — clinics, hospitals, private doctors and others — had also dropped sharply to 1,671 in 2014, the latest year for which the Guttmacher Institute had data, after peaking at 2,908 in 1982.

About 11 million women — 18 percent of the women age 15 to 44 — live more than an hour from an abortion clinic, according to a Post analysis of a list of clinics provided by the Bixby Center for Global Reproductive Health at the University of California at San Francisco. The analysis measured the time to the nearest facility even if the facility was in another state.

In Missouri, 55 percent of poor women are more than an hour from a clinic. The state had the greatest disparity in proximity to a clinic between poor and nonpoor women.

Fifty-nine percent of the women who had abortions in 2014 had given birth at least once before and the vast majority were low-income: Forty-nine percent lived below the federal poverty line of $23,850 annual income for a family of four and another 26 percent lived in families earning less than $47,700, according to the Guttmacher Instititute.

The effort to help poor women access abortions will continue, and broaden, as more states enact restrictions on abortion, Hernandez said.

“Abortion is always going to be a necessary piece of health care and reproductive health care,” Schalit said. “What we have to do is reduce and remove the systemic barriers that exist, so people can access it when and where and how they need it.”

Dan Keating contributed to this story.