Just because it looks as if your state is still going to have legal access to abortion, that doesn’t mean it will remain that way. All it takes is one election to change the entire makeup of your state legislature and open up an opportunity for more restrictions to pass down the road.
We all know the most powerful thing we can do as citizens is to vote, and to support candidates who will uphold access to reproductive health care. But after that, the best way to protect against future abortion restrictions is to push your current lawmakers to pass a bill that establishes abortion as a constitutional right in your state.
First, be absolutely positive that your state does not have any trigger laws, total abortion bans, or other archaic restrictions that may have been on the books prior to Roe and were never removed once abortion became legal. If you do, press your local state legislator to introduce a bill to strike them down.
Second, encourage your legislators to propose a bill to codify abortion rights in the legislature and even the state constitution. There are many different ways to approach it based on the political layout of your state, such as passing a reproductive parity act that requires insurers who cover prenatal care to cover abortion services as well, legislating a requirement that state-based insurance plans and state Medicaid cover abortion services, or even pushing a full bill to demand equality for women both medically and economically.
In 2016, the Public Leadership Institute released a number of proactive model reproductive rights and health bills for state use, all of which can be found at http://publicleadershipinstitute.org/model-bills/reproductive-rights/29-model-bills-playbook-abortion-rights/.
A sample of a strong bill to champion is the “Women’s Equality Dignity and Fairness Act,” which legislates for abortion coverage in insurance, repeals all state abortion restrictions, rejects any legislative bill that puts medically unnecessary requirements on abortion clinics in an effort to close them down, expands which medical providers are allowed to offer abortions, and more. The sample bill can be found in the Resource Guide at the back of the book.
Also don’t forget to look for new ways to improve access in your state, especially since more people will now be depending on it. Even with abortion legal, access can remain limited for populations who find it difficult to travel for financial or logistical reasons. Opening more clinics—or adding abortion services to existing health centers—creates an easier path to abortion expansion than starting fresh.
California has been leading the way in this respect, allowing more medical professionals like nurses and physicians assistants to offer birth control, medication abortion, and early first-trimester abortions, and requiring that public college and university campuses offer medication-abortion options in their local health clinics (a policy change that was vetoed in September 2018 by Democratic governor Jerry Brown but is expected to be reintroduced and signed into law by governor-elect Gavin Newsom). For students unable to leave campus due to transportation issues and for rural area patients far from large urban clinics, these two tactics mean more nearby options, lowering costs and wait times for abortion care.
Once abortion is illegal or inaccessible in some states, abortion opponents will then turn their attention to closing the clinics that still remain in the states that have access. As we’ve seen in the past, that could come in a variety of ways. They may purchase nearby buildings in order to directly interact with patients entering clinics, or use professional sound systems outside clinic doors to loudly implore, preach at, frighten, or guilt patients waiting for any appointment. They might leaflet neighborhoods with personal information about abortion clinic staff, or harass waste management companies or other businesses that have the clinic as a client. They may even file health department complaints and demand city records to find information about potential complications from abortion or other private patient information.
If you have an abortion clinic in your city, there are a number of ways that you can fight to protect abortion access at the local level, both as a resident and as an activist.
In some ways your city-level government may well be the most important governing body when it comes to keeping abortion accessible. If a state allows abortion to remain legal but the city somehow makes it impossible to operate a clinic it doesn’t matter if the procedure is legal or not.
City councils have already become abortion clinic gatekeepers by changing zoning requirements for existing clinics or conversely by changing zoning laws to allow in those who want the clinic to shut down.
Some examples of how this works are:
You don’t need to be on the city council to help your local clinic. Here’s what you can do to directly impact your city’s clinic(s).
Use Your Tools to Ensure Diversity of Participants. It isn’t necessary to be able-bodied or financially secure to do direct action to support clinics. Thanks to online tools and social media organizing, any person with access to a computer or phone and Internet can take part in efforts like petition creating, e-mail and text campaigns, awareness raising, and more. Newer online apps like ResistBot can help people contact government entities more easily, and allow more participation from those who are unable to organize in a physical, face-to-face setting due to work schedules, childcare, transportation issues, or disability. Be sure that if you are starting a campaign, you are working in a way that includes all supporters, such as by holding virtual, recorded meetings that are captioned and can be played when an activist is most able to tune in, making childcare available during meetings so more parenting attendees can participate, and meeting at locations that are directly accessible to those with mobility issues and those who use mass transit.
Many clinics use volunteers. Some have clinic escorts to help patients navigate their way past protesters and into the clinic itself; others have volunteers who talk to patients during their procedures to help them feel relaxed and supported (abortion doulas). Others call volunteers in on days when they expect larger, specialized, one-off protests, such as on Good Friday.
Always contact your local clinic before arriving to help. Expect to be vetted in some way by the clinic, which will want to ensure its patients and staff stay safe. Then assume that you will go through a training (perhaps more than one) before you actually interact with patients.
ALWAYS follow the clinic’s lead. Do not show up at the clinic until you are invited and especially do NOT take it upon yourself to “counterprotest” or hold any other activity outside a clinic without explicit consent. To patients seeking a termination, there is no difference between anti-abortion protesters and pro-choice protesters: both are there, interfering with their attempt to easily and privately access the clinic.
We will discuss how to get involved with organizations supporting abortion and clinic access in more detail in the “Finding Your Personal Cause” chapter.
Then, of course, there is what to do if your state makes abortion nearly or completely illegal in all cases. The good news is, things aren’t as hopeless as they seem. As long as abortion is legal in the United States as a whole, there is always the possibility that abortion bans can be struck down with subsequent laws if there is enough turnover in the state legislature. Once residents of a state see the actual impact of no longer having legal abortion available, there is a strong possibility that voters and legislators will realize that total bans do far more harm than good.
Until that happens, there are some places where you can make the most impact legislatively even without legal abortion in your state.
While it may not seem like it, a total or near-total state abortion ban still isn’t the worst thing that could happen. The worst thing that could happen would be if there was a total ban and a person who wanted to end a pregnancy couldn’t leave the state to do it.
This sort of Handmaid’s Tale scenario doesn’t seem likely for the general population, but it could easily become a reality for minors wanting to end a pregnancy. For over a decade Congress has introduced in some form a federal Child Interstate Abortion Notification Act (CIANA)—a bill that would make it illegal for anyone other than a minor’s legal guardian to take that child to another state to obtain an abortion, with the adult who crosses state lines subject to criminal prosecution.
While CIANA would impact all minors seeking care, it is those who are poor and especially those who come from immigrant families who would be most affected. Many southern states have parental notification laws that require notarized birth certificates or other costly documentation to prove a familial relationship. Those who are in the country without papers may be unable to officially approve an abortion for their child even though they are legal guardians—especially now that the Trump administration is more aggressively deporting immigrants. Others may be incarcerated, too ill to travel, or unable to get off work, or they may have too many children to care for at home or other obligations. There are a myriad of reasons why another adult could need to take a minor across a state line for an abortion rather than the pregnant teen’s legal guardian, but CIANA rejects all of these factors.
It would not be surprising to see some form of CIANA reintroduced now and for the bill to finally pass—especially if some states had no legal abortion at all. However, we also need to be vigilant about individual states passing their own similar laws that may equate helping a person leave the state with “procuring” an illegal abortion, especially for minors who have little ability to travel on their own.
Also be prepared for any “cleanup” of exceptions that are left in current total bans. Check to see if your state allows an exception to its abortion bans if the pregnant person’s health is at risk, or if they were impregnated as a result of sexual assault. While most people—including many who identify as pro-life—believe that a person should be allowed to terminate if that person was impregnated through sexual assault, many anti-abortion groups reject that exception, primarily because they believe that people may make up rape claims in order to obtain an abortion.
Pressuring your legislators to ensure that at a minimum victims of sexual assault still have access to abortion care—and aren’t forced to carry to term just because of the state they live in—is not just a reasonable action that reflects the majority’s beliefs on abortion. It also offers a clear incremental step toward repealing abortion bans as a whole down the road, and it exposes just how radical the Right’s position has become.
Maternal mortality and poor pregnancy outcomes are rising all across the US already, and that increase is especially concentrated among pregnant people of color. Due to poverty, lack of affordable, consistent preventive health care services including and beyond contraception, and longstanding systemic racial bias in medical care and treatment, black and brown people are far more likely to be less healthy when they get pregnant, receive less prenatal care, and face greater risk of miscarriage, stillbirth, and premature labor.
And if Roe is overturned, every single instance of these poor birth outcomes could be investigated as a potential illegal abortion.
If there is just one bill to be championed in states where abortion is greatly or completely restricted, it would be the Public Leadership Institute’s “Pregnant Women’s Dignity Act.” The model, which would be highly beneficial in both blue and red states alike, demands that law enforcement not be called in to investigate when a person miscarries or delivers a stillbirth. Even with abortion technically legal, numerous people have been arrested and prosecuted, either for allegedly inducing their own abortions, for miscarrying fetuses on the cusp of viability and not seeking medical attention in time, for miscarrying and disposing of fetal remains without alerting medical practitioners or authorities, for unfavorable birth outcomes after illicit drug use, and even for premature labor after a suicide attempt.
Once abortion is illegal ALL miscarriages will potentially be subject to questioning by the authorities, with doctors, police, and district attorneys able to decide at their own discretion what constitutes a “suspicious” circumstance that might lead to a more in-depth investigation. The Pregnant Women’s Dignity Act protects all people from having their unsuccessful pregnancies scrutinized, allowing every pregnant person the same freedom in their birth outcomes.
The model bill can be found at http://publicleadershipinstitute.org/abortion-rights/pregnant-womens-dignity-act/. It is also included in the Resource Guide at the end of the book.
It’s a daunting prospect. With abortion illegal in particular states, there will be three options: getting pregnant people who want to end their pregnancies to states where they can do that, getting them the tools to end their pregnancies in their home states (as well as their literal homes), even if that means defying local laws, and supporting those who are arrested should any illegal actions be discovered and prosecuted.
Each of these options will be explored in detail in the next few chapters.