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Florence, a 24-year-old Houston woman, suffers from a life-threatening genetic disease. She has been in and out of hospitals her entire life and has a pile of medical bills she can’t pay. Her partner left after she recently became pregnant, saying he couldn’t handle her constant illness.
Then Florence, who did not want to be identified by her real name, learned at her second-trimester ultrasound that her fetus, which had inherited her disease, would never be healthy either. She decided her only option was to terminate the pregnancy before her child could suffer as she does.
“It broke me into pieces,” she told Al Jazeera.
But then Florence had another problem.
By the time she made her decision to have an abortion, there were no clinics in Texas that could help her. On Oct. 29, a new law went into effect outlawing abortions after 22 weeks of pregnancy. In the wake of the ruling, many abortion clinics in Texas started canceling appointments — even turning away one woman at the door. Suddenly Florence had no choice but to travel out of state for the procedure she desperately wanted.
So she caught an overnight bus to Albuquerque, N.M.
She didn’t tell her friends or family where she was going or why because she was afraid they would judge her. She had never been to Albuquerque and didn’t know anybody there.
“I was told there would be a shuttle to the clinic,” she said. “It’s a dicey situation, so I want to believe it’s true.”
A volunteer from a reproductive-rights organization in New Mexico picked her up from the bus station and drove her to the clinic. The clinic offered her a steep discount on the $3,500 cost of the abortion, and staff arranged for a local family to host Florence for the duration of her procedure.
Such generosity is not unusual. Across the U.S. there are grass-roots organizations set up to help low-income women like Florence have access to abortions. In most states, Medicaid won’t pay for an abortion unless the woman’s life is at risk. More than 86 aid groups known as abortion funds exist across the U.S. to provide small grants to women struggling to pay for abortions. Many clinics offer discounts too.
But as a recent wave of anti-abortion legislation has swept the nation and forced abortion clinics to close, paying for an abortion isn’t the only problem. Physical access is a real and growing barrier. The Huffington Post reported this summer that more than 50 abortion clinics have closed in the last three years. In Texas last week, another 15 clinics shut their doors overnight after a law went into effect requiring doctors to have local hospital admitting privileges — a requirement that is bureaucratically difficult for many abortion physicians to meet.
It is too soon to measure how many women will travel out of Texas to get a safe, legal abortion as a result, but abortion-rights advocates expect the number to rise.
Vicki Cowart, CEO and president of Planned Parenthood of the Rocky Mountains, which runs a Planned Parenthood surgical clinic in Albuquerque, said usually about 5 percent of patients at the the clinic come from Texas. In October that number leaped to 14 percent.
“When there’s a lot of news about abortion being unavailable,” she said, “women often go ahead and make other plans.”
Yet getting to these far-flung destinations is no trivial task for women dealing with financial hardship. As clinics close in anti-abortion states such as Texas, Mississippi, North Dakota and Wyoming, displaced women are forced to travel farther and farther in search of safe, legal abortions. Transportation, accommodation and child-care costs — more than half of women seeking abortions are already mothers — are big logistical barriers. Some experts fear these barriers are becoming so high that only the affluent can overcome them on their own, leaving women like Florence reliant on activists and volunteers.
Since the beginning of the year, an informal latticework of volunteers has sprung up in states where abortion rights or access to clinics is in decline. In Mississippi, which now only has one abortion clinic, in Jackson, Laurie Bertram Roberts launched the Mississippi NOW Reproductive Freedom Fund to provide practical support for women who need help getting to an abortion clinic. Roberts coordinates volunteer drivers from across the state to transport women to their nearest abortion provider, often crossing state lines.
Similarly, in Kentucky abortion access is increasingly only for the mobile. There are just two abortion clinics, in Lexington and Louisville. Accordingly, the Kentucky Support Network started in February to help low-income women get the services they need. Farah Ardeshir, the network’s organizer, said volunteers have driven Kentucky women to Indiana, Illinois, Missouri, Tennessee and Ohio. They have helped more than 50 women since the group launched.
Since the omnibus anti-abortion bill passed the Texas legislature this summer, volunteers in the Lone Star State are increasingly aware of the need for practical as well as financial support to ease abortion access. An anonymous contributor recently made a large donation to Planned Parenthood’s abortion clinics in Albuquerque with the specific purpose of funding transportation and accommodation for women arriving from Texas. Angie Hayes launched the Clinic Access Support Network in Houston after a woman posted on Facebook that she needed help getting to a clinic. Hayes’ network now has about 30 volunteers willing to drive women to abortion clinics in the Houston area, with requests rising since the new law took effect.
Fund Texas Women, based in Austin, also just launched and gets women where they need to go, even across state lines. Megan Peterson, deputy director of the National Network of Abortion Funds — the nationwide membership group for abortion funds — notes that at least five more practical support groups like these plan to launch in Texas.
But their work may get even harder.
Now that abortions past 20 weeks of gestation are illegal in Texas, the closest late-term abortion provider is in New Mexico. But a citywide ballot measure in Albuquerque on Nov. 19 seeks to ban abortions in that city after 20 weeks as well. If the initiative passes, there will be no provider in New Mexico able to provide abortions past 20 weeks of pregnancy.
“This is a national disgrace,” said Dr. Sandra Penn, spokeswoman for Respect Albuquerque Women, a coalition working to oppose the ballot measure.
Yet whatever happens in New Mexico, Florence’s ordeal continues.
When she arrived in Albuquerque this week, her physical condition was so poor that the abortion was too risky to perform in an abortion clinic. She now has an appointment with a hospital in San Francisco next week — the closest hospital that would accept National Abortion Fund money. Donors coordinated by the Lilith Fund, a Texas abortion fund, and Fund Texas Women are raising funds to cover her travel costs to California. A separate fund will cover her hospital fees.
Florence’s supporters say her story points to a new trend in the U.S. abortion wars. As abortion restrictions continue to pass and as abortion clinics close, more and more women will crisscross the country in a bid to exercise their constitutional right. If they are low-income, they must increasingly rely on the kindness of strangers to do so.
Sen. John McCain, R-Ariz., said that the Crimea region of Ukraine might already be lost to Russian control