Despite whatever lies Sen. Susan Collins had to tell herself to justify voting yes on Brett Kavanaugh to the Supreme Court, most legal experts and reproductive health care advocates expect that Roe v. Wade will either be overturned or functionally gutted within the next two years. More than a dozen cases are winding through the federal court system right now that pose overt challenges to legal abortion, and with a five-justice majority that opposes reproductive rights, it's just a matter of how soon and how badly the right to abortion is nullified, not whether it will happen.
When that happens, the Center for Reproductive Rights predicts that 22 states will end legal access to abortion within their borders -- soon, if not immediately. More than one-third of American women of reproductive age will not have an abortion provider in their state. And while the religious right would have you believe that the one in four women who will get an abortion at some point in their lives will simply stop needing the service — either because they give up sex or will suddenly welcome every unplanned pregnancy — evidence shows that banning abortion doesn't actually reduce demand. On the contrary, areas that have abortion bans typically have higher abortion rates, because places with anti-abortion policies also tend to be hostile to contraception and sex education, leading to more unintended pregnancies.
In a Wednesday morning press call, Rachel Sussman, the national director of state policy for Planned Parenthood Action Fund, explained that making sure abortion is available to women who need it "is not optional," and that Planned Parenthood has "a moral obligation to plan for a day when Roe may be gone."
“We started preparing for this moment since Donald Trump and Mike Pence were elected into office," she noted, referencing the seating of the fifth justice who is expected to end abortion rights.
Before abortion was legal in the United States, there were underground services, most notably the Jane Collective of Chicago, that helped women seeking illegal abortion services find them safely. Reproductive rights advocates are hoping it won't get that bad, because the internet will help educate women on how they can still get legal abortions. But Planned Parenthood is reviving the idea of a network that gets help to women who are being denied their rights.
Most of Planned Parenthood's work is in offering contraception services, STI testing and treatment, and cancer screenings, but the organization is also a major provider of abortion care in the United States. Roughly one in three abortions in the country are provided through Planned Parenthood, which often keeps clinics open in areas hostile to reproductive rights to make sure more women are covered.
But with possibility likely off the table in many states, the organization announced a new plan Wednesday called Care for All, aimed at making sure women who live in rapidly expanding abortion deserts still have options.
The main plank of the plan is to build up abortion services in states where it is expected to remain legal and relatively accessible — such as California, Illinois and New York — with the expectation that women will travel in great numbers to those states to get abortion care. More doctors, more clinics, more hours: These are the kind of things that the group plans to offer in these states, anticipating that there will a massive influx of women from elsewhere. Those on the call also suggested that there will be a push to raise funds to help low-income women who need help with travel expenses.
There is little question this flood of interstate travel will happen -- because it's already happening in states like Missouri and Ohio, where bureaucratic harassment to forcibly shut down clinics, creating a deluge of abortion demand and not enough clinics to meet it.
“Every day in our health centers, we see firsthand the kind of impact severe abortion restrictions have on the women in states that border Illinois," Dr. Amy Whitaker of Planned Parenthood of Illinois said in a statement. "Already, women are forced to face the financial burden of traveling to us from out of state to access care."
There's also a plan to expand the use of abortion through telemedicine to reach women who can't travel. With telemedicine, women can use the phone and internet — and old-fashioned mail — to communicate with a doctor who can prescribe abortion pills to be taken at home. Telemedicine abortion is quite safe, but 19 Republican-controlled state legislatures have tried to hobble this option by passing laws meant to keep women from legally accessing it. Still, the hope is that the internet will allow Planned Parenthood to communicate legal options to women living in such states, so that they can piece together a plan to get access if they need it.
Planned Parenthood representatives also indicated that they would advocate for states that are already abortion-friendly to pass laws protecting legal abortion. California passed such a law in 2002, enshrining the right to choose abortion into their legal system. Similar bills are being considered in other states, most notably New York, and those could help shield clinics in the event of a full Roe overturn.
The seriousness of this moment was driven home during the press conference, when efforts by journalists to get more specifics on this plan — how many more clinics there will be, how would telemedicine work — were not answered by the Planned Parenthood representatives.
Sussman told reporters that the organization wants "to avoid creating an environment where we’re laying out our plans for everyone," and that's no surprise. Just as Planned Parenthood is shifting strategies in the face of the changing judicial environment, anti-choice activists are no doubt shifting strategies in hopes of preventing Planned Parenthood from helping women who have lost abortion access in their own states.
Too many details about these plans could drive anti-abortion forces to harass and threaten anyone involved with building up abortion services in an effort to stop them, as well as to encourage anti-choice legislators to pass laws that prevent women in their states from seeking help elsewhere.
How well this new plan will work to prevent women in red states from taking matters into their own hands — either by buying abortion pills from shady online sources online or, worse yet, hurting themselves with coat hangers and other gruesome methods, as in the bad old days before Roe — remains to be seen. But one thing is absolutely certain: No matter how much Republicans slice away at legal abortion, women who are pregnant but don't want to be will continue to do whatever it takes to terminate those pregnancies. The only question is whether they can do so safely or must expose themselves to unnecessary harm.