It’s been an open secret in New Bedford and beyond for years now.
There is far less local access to abortion in Southeastern Massachusetts than any other part of the state. Nowhere on South Coast, Cape Cod or the Islands is there a single clinic or hospital that performs abortions.
There’s a term for this: “an abortion desert.” But many are surprised that the phenomenon exists in Massachusetts, where reproductive choice laws are strong.
But Dr. Nate Horowitz-Willis, an executive with Planned Parenthood of Massachusetts, acknowledged that there is indeed a problem accessing pregnancy termination in Southeastern Mass.
“We know there is an abortion desert within Massachusetts, within that region,” he said.
According to reproductive rights advocates, the impact of the problem is greatest for low-income women who may lack insurance and accessible transportation and who work in frontline jobs where they are subject to being docked pay if they don’t show up.
“It’s just another example about what’s broken with our health care system in America,” said former city councilor and women’s advocate Jane Gonsalves of the challenges facing low-income women trying to obtain an abortion on South Coast.
According to the state’s Executive Office of Health and Human Services, the Southeast region has just two providers, both in Attleboro, far from the center of the region and the local cities of New Bedford and Fall River, both of which have roughly 100,000 residents.
All five of the other regions of the state have at least six abortion providers, with MetroWest having six; the Central and Northeast regions having seven; Western Massachusetts having eight; and Greater Boston having 12.
The nearest in-state place where a Greater New Bedford woman who is more than 11 weeks pregnant (the Massachusetts cutoff date for medication abortions) can receive a surgical abortion is Four Women, an Attleboro clinic, or Sturdy Memorial Hospital, also located in Attleboro. Both are 44 miles from New Bedford and 33 miles from Fall River.
While there are three abortion clinics in Providence, 32 miles from New Bedford, none of the area’s four hospitals — St. Luke’s, St. Anne’s, Charlton Memorial or Tobey — perform abortions.
Asked about its practices by The New Bedford Light, Southcoast Health — the parent organization for St. Luke’s in New Bedford, Charlton in Fall River and Tobey in Wareham — issued a statement that said it was not licensed to perform non-medication abortions.
“Like the majority of hospitals across the Commonwealth and around the country, ours refer patients seeking surgical abortion to ambulatory clinics that specialize in providing this service, in accordance with state law, which has codified a woman’s right to determine the course of her own reproductive health,” read the statement issued on behalf of Renee Clark, the executive vice president and chief operating officer of Southcoast.
As far as whether Southcoast policy allows its physicans to issue prescriptions for medication abortions, the health group’s statement did not answer the question, citing privacy: “Throughout a patient-provider relationship, whether in Southcoast hospitals or at our ambulatory facilities, any medications discussed, prescribed, and/or dispensed comprise protected health information and would be administered entirely on a case by case basis,” read the statement.
Spokespersons for St. Anne’s Hospital in Fall River did not respond to The Light’s request for comment.
Officials with both Hawthorn Medical Associates of Dartmouth and Greater New Bedford Community Health Center both said they do not provide abortion services, either surgical or medication.
“It’s unfortunate that we don’t have services here,” said Gail Fortes, the longtime executive director of the YWCA Southeastern Massachusetts. “And as far as I know, I don’t think we’ve ever had anything local, those kinds of services, for a long, long time.”
The local YWCA describes its mission as eliminating racism and empowering women. Fortes was among a group of women who the last two weeks have been protesting the recent leak of a Supreme Court draft decision that would overturn Roe v. Wade, the landmark 1973 decision that legalized abortion rights. The group has been demonstrating outside the Hastings Keith Federal Building in downtown New Bedford on Wednesdays at noon.
Another protester, Donna Criscuolo, the executive director of Leadership SouthCoast, acknowledged the lack of clinics in the region is a problem.
“I believe there are conversations going on around starting an abortion fund, and bringing a clinic to this area,” she said. “So, people are very aware of that issue and we’re looking at it very seriously. Accessibility is key.”
The last time New Bedford had an abortion clinic was when Alternatives, an independently operated provider, was located on Brigham Street in the West End, near St. Luke’s Hospital. Throughout the 1980s, the clinic was regularly the site of protests, especially on the anniversaries of the Roe v Wade decision, and in at least one case the clinic hired a security guard, fearful of the strong feelings of demonstrators across the country at the time.
The Light was unable to determine exactly when Alternatives closed its doors, but city residents have told this reporter it was decades ago.
Across the board, local women’s advocates say they are aware of the vulnerability of low-income women to the local lack of abortion access and that there are programs trying to address it.
Horowitz-Willis said that Planned Parenthood is working in the area on a number of fronts. The growth of telehealth medicine, he said, is one way to combat “misinformation” that is prevalent on the internet. Informing women of the improved availability of medication abortion (the state last year relaxed rules that an in-person doctor’s visit was necessary for a prescription) and more effective contraception methods is also helpful. And telehealth conferencing by way of smart phones can be used to address some women’s fears of traveling outside their region for an abortion procedure, he said.
In addition, there are programs available to pay for transportation outside the region and for abortions themselves, although nonprofit providers acknowledged that more money is needed, particularly for programs that will pay for abortions and transportation for undocumented immigrants who have not been eligible for MassHealth’s insurance program.
“We are working to make sure this comes at no cost to the people contributing a lot to our state,” Horowitz-Willis said of the immigrants, adding that Planned Parenthood is working with Senate leadership on the funding.
As for the future, Horowitz-Willis said the use of community health centers would be one way to establish a clinic in Southeastern Mass. That may face some political challenges, however, as Cheryl Bartlett, the CEO of the Greater New Bedford Community Health Center, said that as recently as the previous presidential administration, the partially federally funded center was discouraged from providing abortion information.
“People who want to stop abortion want to stop conversations about reproductive health,” Bartlett said. “They hounded us about abortion under the Trump administration.”
Bartlett, however, said that in her five years at GNBCHC, abortion access had never been a big issue.
“Nobody has brought that to my attention,” she said. “There is more conversation about access to birth control.”
With the improvements to contraception and medication abortion, the number of abortions has declined over the last decade although there are certainly many South Coast women still going to Providence and other parts of Massachusetts for abortions.
According to Anastasia Lennon’s recent New Bedford Light story on the state of abortion rights in Massachusetts, some 320 women from Southeastern Mass. obtained abortions in Providence last year, and the medical director of the Attleboro clinic said he regularly sees patients from New Bedford and Fall River.
Health Imperatives, a nonprofit in the area that facilitates a variety of difficult-to-access health care for low-income people across the region, acknowledged the access problem in Southeastern Massachusetts for abortion care and for reproductive system cancers. They work on both the transportation issues and on identifying a provider for abortion services.
“We will work with people about what insurance they have and where they can go,” said Julia Kehoe, the Health Imperatives CEO.
Kehoe noted that even the low-end $600 cost of an abortion can be a lot of money for some people. “It’s case by case,” she said. “It really depends on individual cases.”
Anyone with questions about sexual and reproductive health care can call Health Imperatives’ confidential phone line at 508-984-5333.
“It’s the women who can least afford not to have an abortion who are not going to be able to get one,” said Leslie Knowles, an artist and founding board member of the Women’s Center back in the 1970s when it focused on abortion services.
Knowles said she remembers efforts to open a clinic, but it never got off the ground.
“For a while, it got very dangerous to be a provider,” she said. “We started to get a group on it and then it became political.”
Helena DaSilva Hughes, the longtime CEO of the Immigrants Assistance Center, said that she believes the traditional religious culture of New Bedford’s ethnic groups has worked against easy availability of abortion in the city. Even women who choose to exercise their right to an abortion keep their decisions to themselves and say little, she said.
“The religious component of this is huge,” she said.
As for the future, one activist said that South Coast health professionals have it in their power to make medication abortions easier for many local women, a practice that would reduce the need for surgical abortions in clinics outside the region.
“Abortion is safe, legal and increasingly common,” said Margaret Batten of the nonprofit group EMA Fund (Eastern Massachusetts Abortion Fund), which provides women with assistance obtaining abortions. “There is no reason why primary care doctors, gynecologists, nurse practitioners and community health centers cannot make abortion more available to residents of Southeastern Mass. There’s nothing complicated about it.”
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