Ann Soares remembers protesting for women’s rights about 50 years ago when she was a teenager. During a sit-in at Westport High School, she said she wore a tie-dye shirt with something like “Women Power” written on it.
Standing in front of Wareham Town Hall during a protest last weekend, Soares, now 66, wore a newer t-shirt that was light pink with “Freedom of Choice” written in marker.
“We’re going to go back if we don’t do something about this,” Soares said.
The Wareham abortion rights protest and others across the nation this past weekend came in response to the recent leak of the Supreme Court draft opinion, which suggests the court could overturn Roe v. Wade within the next two months. While abortion would still be legal in Massachusetts, advocates and providers say bans in other states could drive up the need for more resources locally, with some already preparing by expanding services now.
“Having a legal right to abortion doesn’t necessarily mean it’s accessible,” said Margaret Batten, a board member of the Eastern Massachusetts Abortion Fund (EMA), an organization that provides assistance to people who live in or are traveling to eastern Massachusetts for an abortion.
About 13% of Massachusetts women lived in counties without abortion clinics as of 2017, according to the Guttmacher Institute, a pro-abortion rights research organization.
“In southeastern Massachusetts, there are often transportation issues on top of just the cost of the procedure,” Batten said. “For a lot of folks, getting an abortion means coming to the Boston area or some people in southeastern Massachusetts may want to go to Rhode Island or to Worcester.”
The closest abortion clinics for people in New Bedford are Planned Parenthood in Providence, Four Women in Attleboro and then several hospitals and clinics in Boston.
Planned Parenthood of Southern New England, which has clinics in Connecticut and Rhode Island, from 2020 to 2021 saw about 320 patients from Fall River and New Bedford, according to a spokesperson.
At the Planned Parenthood Providence health center, the procedure can range from $600 to $900, according to a spokesperson. Janeen Ortiz, vice president of clinical operations for Planned Parenthood of Southern New England, explained cost depends on the type of procedure, how far along the patient is in the pregnancy, and whether they want any pain medication or sedation.
Depending on the patient’s insurance plan, none, some or all of that cost can be covered. Certain levels of MassHealth and other public health plans in Massachusetts cover abortion, but under Rhode Island law, patients on Medicaid and state employee insurance cannot use their insurance for abortion, which affects nearly one in three residents, according to a Planned Parenthood spokesperson.
If a person is not insured or underinsured, the EMA Fund works to get them enrolled in MassHealth, find doctors who will take their insurance or negotiate with providers for discounts. Currently, the fund does not have any arrangement with online providers of medication abortion (abortion by pill), but is looking into it, Batten said.
Until recently, people were required to obtain abortion pills in person from a certified health provider, but the Food and Drug Administration in late 2021 lifted that restriction permanently after it had been temporarily lifted during the COVID-19 pandemic.
Kristina Shepherd, a certified nurse midwife, in July of 2021 started Lilith Care, a private practice that provides medication abortion and mails it to patients’ homes. She said she has been doing abortion work since 2014 and was motivated to start Lilith Care in order to increase access.
The cost for the medication abortion through Lilith Care is $200 dollars, which is cheaper than other medication or surgical abortions by hundreds; Shepherd does not accept insurance.
Like Batten, she noted travel is a significant factor for people in southeastern Massachusetts and New Bedford, given there are no physical clinics in the immediate area.
It can take a matter of just a few days from when a person reaches out to Shepherd to when they receive the medication by mail. Sometimes she will consult with a patient through a video call, but otherwise the patient can sign forms online and receive the pills at home if they meet the eligibility criteria.
She has served people from New Bedford, Fall River and across the state.
Preparing for a ripple effect
Batten said the work can be daunting and that there’s been increased concern since September, when Texas banned abortions once fetal cardiac activity is detected, which is around six weeks. Massachusetts law protects up to 24 weeks, with exceptions after that.
After the Texas law took effect, the fund started receiving calls from people in Texas and other states seeking assistance.
“We’re sort of preparing ourselves for the reality,” she said. “The sheer volume, the number of people who will no longer be able to get care locally is going to increase such that I think it’s going to affect all states in which abortion remains legal.”
Following news of the draft opinion, the fund has had a “generous increase,” in donations, as have abortion funds nationwide, Batten said.
The state House last month passed a budget that included $500,000 toward “improving reproductive health care access, infrastructure and security,” including grants to abortion funds.
Shepherd said following the Supreme Court news, she has seen a “big increase” in demand. Some people who are not pregnant are also requesting provisional prescriptions as they want the medication in case they get pregnant and abortion is not as accessible.
“Everyone applying or reaching out is equally very anxious, even if they have safe access easily because they live in Massachusetts or Rhode Island,” Shepherd said.
She is licensed to prescribe the medication only in Rhode Island and Massachusetts, and works with about 25 patients per month.
A producer of abortion medication, Danco Laboratories, told ABC News last week that it has ample supply to meet any increases in demand.
Ortiz said Planned Parenthood has been preparing for the potential overturning of Roe v. Wade for some time. They’ve seen some patients coming from out of state, including Texas, but haven’t yet seen an influx related to the draft opinion.
“While we haven’t seen an increase in patients yet, we definitely have seen an increase in folks wanting to get more involved and patients expressing their gratitude and their appreciation for us being there,” Ortiz said.
Sarah Gordon-Brilla, senior director of communications for Planned Parenthood of Southern New England, said there will likely be a ripple effect given the trigger laws. At least 13 states have so-called trigger laws that would immediately ban the procedure.
Planned Parenthood of Southern New England has expanded hours (abortion is also offered on weekends and in the evenings), and improved online scheduling. The organization is also working to add a telehealth option for medication abortion for its Connecticut and Rhode Island health centers (telehealth is an existing option for its other services, such as family planning and gynecology).
The Planned Parenthood League of Massachusetts currently offers medication abortion care via telehealth. The website notes, however, that the patient must be in Massachusetts during the visit.
Shepherd said she hopes more laws will be passed to protect telehealth providers against extradition and prosecution from other states.
“The more protective the telehealth legislation can be, and the more expansive it can be about enabling providers to practice and provide care for patients who might not live or be in their state, that’s going to be really important,” she said.
Gordon-Brilla said Planned Parenthood of Southern New England was discussing the telehealth option for abortion before the draft opinion was leaked.
“I think like other proactive measures across the nation, for certain states, it is increasingly more important to get to that point where we can provide telemedication abortion because of what may happen,” she said. “So we’ve been working towards it, but the urgency has definitely escalated it.”
Medication abortion common in Massachusetts
The Massachusetts Legislature in late 2020 passed the ROE Act, which codified abortion and expanded access by allowing minors as young as 16 to get an abortion without consent from a parent or judge.
The Massachusetts law also allows abortion past 24 weeks when it is in the interest of the patient’s physical or mental health, or there is a fatal fetal anomaly. Physicians, physician assistants, nurse practitioners and nurse midwives can perform the procedure.
For 2020, the state’s most recently available data, 16,452 abortions were reported. About 47% were “medical (non-surgical),” meaning the person took medication to induce the abortion.
According to the Guttmacher Institute, more than half of the nation’s abortions in 2020 were by medication.
In Massachusetts, at least 93% of the abortions were for residents, with 593 being non-residents and 396 being of unknown status in 2020.
The Massachusetts Department of Public Health divides the state into six regions. For the Southeast, which encapsulates New Bedford and extends to Holbrook, Seekonk and the Cape and Islands, 1,726 abortions were performed at one facility, Four Women, in Attleboro.
It’s possible people from the Southeast also traveled to Boston or Rhode Island. Boston, for example, reported 8,527 abortions across seven clinics and hospitals, accounting for more than half of the state’s abortions in 2020.
Dr. Marcus Gordon, the medical director of Four Women, said abortions have declined steadily in Massachusetts over the last decade, in large part due to family planning programs, education and contraceptives, all of which can prevent unplanned or unwanted pregnancies.
He estimates his facility performs about 160 abortions per month; he regularly serves patients from New Bedford, Fall River, the Cape and Islands, and some from Rhode Island.
In line with the statewide figure, Dr. Gordon said a majority of the abortions he provides are now through medication.
Ortiz said over the years, Planned Parenthood has also seen an increase in patients choosing medication abortion, which the FDA authorizes for up to 10 weeks into pregnancy.
Based on the state’s 2020 data, at least 73% of abortions in Massachusetts were potentially eligible for the medication option (the nine and 10-week pregnancies were counted in a subset of data with the 11- and 12-week pregnancies, so the number is likely higher).
About 18% of patients were nine to 12 weeks pregnant, and 6.4% were 13 to 18 weeks pregnant, which is part of the second trimester.
Some of the women at the Wareham protest knew women who had abortions, some before it was legal, while others had first hand experience. A common sentiment among them was that it felt like they are now going backwards.
One hot pink sign read, “We won’t go back,” while others referenced the risk of banning abortions with drawings of coat hangers.
Sandy Cormier, 60, the organizer of the Wareham protest, had an abortion decades ago. Neither she nor her husband wanted children, and she said she doesn’t regret her decision.
“I can’t speak for anybody else but me,” she said. “I just want women to have that choice.”
The protesters waved to cars as they passed, at some points receiving long honks and hand waves of support from drivers.
Locally, abortion rights protests are set to continue with the Women’s Alliance, a coalition of local organizations, planning to stand in front of the federal Social Security Administration building in New Bedford every Wednesday from noon to 1 p.m. for at least the next four weeks.
If the court overturns Roe v. Wade, supporters in Massachusetts are working to ensure not only residents, but also people across the country have continued access to abortion.
“There are a lot of organizations out there to help … It’s a very connected world,” said Batten. “And if you reach one person, the chances are that they’re going to help and if they can’t help you, they know who to send you to … so I would just encourage people to reach out, to call that first number and let us know what you need and we’ll do our best to make sure that you get it.”
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