Post-Roe: How We Mobilize for New Realities

Although many around the world were shocked by Friday’s Supreme Court decision overturning Roe v. Wade, reproductive justice, rights, and health advocates and organizations as well as providers “have been preparing for this moment for a long time, and, sadly, we knew this was coming,” said Sylvia Ghazarian, executive director of the Women’s Reproductive Rights Assistance Project, a national abortion fund.

Readying for this outcome, in which abortion will become illegal in over half the states, has been years in the making. “One silver lining of COVID-19 was that we started working with virtual clinics as well as increasing access to medical abortion. Since SB8 in Texas was first proposed,” said Ghazarian, referring to the six-week abortion ban passed in May 2021, “we prepared for months to help patients travel out of state, and for people who couldn’t, we worked to get them the abortion pill funding.”

Many reproductive justice advocates and organizations have “been operating as if Roe and Casey are nonexistent already,” said Rachael Lorenzo, co-founder and executive director of Indigenous Women Rising, an abortion fund open to all Indigenous people in the United States and Canada. “Organizations led by Black and Indigenous people, and people of color, are likely not changing too much. We anticipate a higher call volume this year and an increase in costs for travel, but otherwise, it's business as usual. Our people have already faced significant barriers to abortion access.”

While 26 states are poised to ban abortion quickly in the aftermath of Dobbs v. Jackson Women’s Health Organization, “a number of states are working to protect and expand abortion access, and some abortion providers have been preparing for an influx of patients to these states,” said Melissa Fowler, chief program officer at the National Abortion Federation (NAF), the professional association of abortion providers. They operate a national hotline to help people find access to abortion care. NAF “is working closely with our members to navigate how this ruling will impact abortion care in each state and how we can together ensure access to essential abortion care for all who need it,” Fowler said. “That includes providing security services to clinics that are likely to see a rise in harassment and violence from extremists emboldened by this ruling.”

NAF’s 2021 Violence and Disruption Statistics report found significant increases in stalking, bomb threats, invasions, and assault and battery. On May 25, the Wellspring Health Access clinic in Casper, Wyoming, burned down in a suspected arson attack two weeks before it was due to open. Founded by veteran reproductive rights advocate Julie Burkhart, who is still moving forward to open the clinic, it would have been the only one in the state performing both medication and procedural abortions.

Despite the increasingly hostile environment across the country, organizations and advocates are focused on ensuring that people can still access abortion, even in states where it will soon be illegal. “Our biggest concern is protecting the access we have now, and expanding that access to everyone who needs it,” said Tarina Keene, executive director of Repro Rising Virginia, a state-level advocacy organization. “We are working with abortion funds and providers to make sure patients in state and those crossing our borders have the transportation and support they need to get to their appointments no matter who or where they are. We are still doing the same policy and political work we’ve always done, but we’ve added a focus on providing practical care and support for those seeking abortions — especially for people with lower incomes and already struggling to receive health care. We are building out programs that focus on increasing access to care and responding in real time. Our Practi-Cab program is volunteer-based and provides patients seeking abortion care with transportation to and from appointments and emotional support before and after receiving care. And we now have at least half a dozen telehealth providers offering medication abortion services across Virginia. This will dramatically help alleviate some of the bottleneck in appointment availability at clinics for procedural abortions.”

Abortion funds have always had to contend with navigating the myriad of state abortion laws, which further complicated their already difficult work. “Even before the fall of Roe, we have had to work to make sure to get people to the right state, either where the procedure is cheaper or has more flexible gestational limits,” said Madeline, a volunteer case worker with the Chicago Abortion Fund.

Surrounded by six states with abortion restrictions, Illinois is being called an “island of abortion access.” In direct response to the draft of the ruling that was leaked in May, CHOICES: Memphis Center for Reproductive Health, an abortion clinic, announced plans on May 9 to open a clinic in Carbondale, Illinois, because of the impending abortion ban in Tennessee.

“There will be even more of this kind of work to redirect people to the appropriate place,” said Madeline. “Here in Illinois, one of the main concerns is that we will be inundated and that we don’t have enough providers to fill the need. So the funds are looking to state governments to help with funding. We are also looking to increase involvement and to build up an interstate network. The overturning of Roe was not a surprise, and yet many states still don’t have clear laws about codifying abortion, which leaves providers in a potentially vulnerable position.”

Advocates and organizations are also having to counter misinformation promulgated by extremists. “We are fighting misinformation and helping patients to identify crisis pregnancy centers, which are not legitimate health care clinics, getting factual, safe abortion and funding resources to the communities, including information about self-managed abortions,” said Allie Wampler, who is on the board of the Iowa Abortion Access Fund and an abortion nurse and women’s health care nurse practitioner. “Abortion funds are a community, and if we have a person with need for travel funding, we are working to connect with other funds to provide that support. With the leak, we saw a huge jump in donations, and there has been an outpouring of support since Roe was overturned.”

While there has been an influx of donations to abortion funds, “we need more corporations to be on board, and to put actual dollars into this effort to keep abortion safe and accessible, not just issue statements,” said Ghazarian. “And only 3% of foundation grants [for reproductive rights issues] go to abortion funds. Because of the leak, people started to pay more attention, including male allies, but some people wait until there is a crisis to do anything.” Instead of waiting to see the outcome in the Dobbs case, advocates have been in crisis mode since the court decided to take the case. Ghazarian and other advocates in California “have been working since last August to make California a sanctuary state and now have 13 recommendations to keep abortion accessible on deck to be signed into law by Governor Newsom."

One big question is “what happens around self-managed abortions and being able to access pills,” said Charity L. Woods Barnes, a longtime reproductive justice advocate and founder of the Reproductive Justice Resilience Project, a Black-founded, women-led national organization based in Atlanta. There is a lot of confusion around the legality of medication abortion in states where abortion will become illegal, and potential for the criminalization is especially “terrifying for communities of color,” she said.

Ultimately, though, there won’t be any real progress until there is an even more vocal majority demanding and voting to make abortion legal and accessible everywhere. “Roe was the floor, not the ceiling, and [abortion access] wasn't a reality for many people even before the Supreme Court overturned it,” said Ann Marie Benitez, senior director of government relations at the National Latina Institute for Reproductive Justice. “More people now are paying attention to this and seeing what is happening, and what is happening in their own states. They want to do something.”

Some advocates have noted that the Biden administration’s response to the Dobbs ruling lacks concrete plans, despite months of notice, including the leaked draft. “Reproductive justice advocates knew this was coming, and we felt like we were often not heard,” said Woods Barnes. “I think overall our folks are feeling like it is on us to do what we need to do for ourselves and communities. Black and brown folks are keenly aware of what this means but also hold the reality that we have never been able to fully access our rights anyway.”

For advocates, the outrage over the Supreme Court decision and the rallies and increases in donations that followed “solidifies and confirms that people do support abortion,” said Wampler. “We are not going away, we are not giving up."