The legal landscape for abortion rights has been profoundly altered in the wake of the U.S. Supreme Court’s decision on June 24 in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade and ended the federal right to abortion. In the ensuing days, ten states outlawed abortion completely. By fall, that number is expected to increase to twenty-six states.
The ramifications of this decision are already devastating, and the ripple effects will be far worse. The resulting chaos has overwhelmed abortion funds, clinics, advocacy groups, and even abortion seekers who are waiting for the dust to settle.
Two weeks after the court’s decision, on July 8, President Joe Biden signed an Executive Order designed to protect access to reproductive health care services. The order directed the Department of Health and Human Services to protect and expand access to medication abortion and to take additional steps to protect emergency medical care for those who are pregnant or experiencing pregnancy loss. It also ordered that additional steps be taken to protect patient privacy, among other actions. But it stopped far short of more decisive action that abortion-rights advocates had been demanding, such as declaring a public health emergency to preserve broad access to all abortion services.
Shutterstock
A typical abortion patient will now have to travel an average of 276 miles—each way—to the nearest legal provider. Local practical support organizations are networked to help.
As a result, an unprecedented 300,000 people might now need to travel out of state for abortion care each year. At least one-third of them will likely require help to cover travel expenses and other costs, Marisa Falcon, executive director of Apiary for Practical Support, tells The Progressive.
This is not a new reality for many abortion seekers or those providing reproductive services. In Southern states especially, abortions have never been easily accessible for people struggling to make ends meet or for people of color. Much of the country has been in a post-Roe reality for years.
This is where practical support organizations (PSOs) like Apiary come in—their volunteers and trained staff help clients navigate the complicated process of obtaining an abortion and provide any logistical support that is needed to get a patient into a clinic. While PSOs have existed informally for a long time, they were previously not as organized as they are today. Some PSOs provide holistic support, which might include booking travel arrangements, paying for child care, or providing meals, while others simply offer rides to the clinic.
PSOs can help patients access clinics across the country, especially in areas where it traditionally has been difficult. To do so, these organizations have established partnerships with existing abortion-assistance networks. Some are the result of the expansion of local abortion funds, services offered by doula collectives, or independent nonprofits with robust, Uber-like technology. All of them are the result of a need for reliable and safe logistical support for abortion seekers.
Carly Manes’s abortion doula collective used to periodically send out emails seeking volunteers to drive patients to and from their appointments. Sometimes those requests included a few nights of housing in an extra bedroom. Six years ago, Manes began to see a steady rise in the number of these requests.
“These asks would continue to increase,” she says. “So another doula and I decided to form a collective. We started out with a Google form and emailed it to clinics in the area and other abortion people in our network. That’s how we started recruiting volunteers.”
Providing this kind of logistical support goes beyond transportation, Manes says. “It creates a sense of community. It says, ‘I will create this temporary community for you, while you get the care that you need, because you can’t be in your own community.’ ”
The Guttmacher Institute, a research organization that supports abortion rights, predicted that after the Dobbs ruling, a typical abortion patient will have to travel an average of 276 miles—each way—to the nearest clinic where abortion is legal. That’s six times farther than the average distance before the decision, which puts pressure on an already strained reproductive health care system.
Traveling for abortion care has historically been undertaken as a last resort, due to the significant resources it requires. Providing a person and their companion with the means for interstate travel, lodging, food, and often child care can cost thousands of dollars during the best of times. As patients travel farther into states that may enact waiting periods, requiring an even longer visit, these costs will inevitably rise.
Practical support organizations have shown that they will not go down without a fight. Apiary for Practical Support is the first organization of its kind to serve as a national hub for groups providing travel assistance to abortion seekers. The organization also provides training and resources to support people on the ground and to help new groups get started.
Since the Dobbs decision, many groups have had to pause their services—some indefinitely. But this has created opportunities for practical support in unlikely areas of the country.
“In the Northeast, where there has been no real need for practical support to this point, due to the number of nearby clinics and the ease of traveling between states, groups are reaching out to us wanting to start offering services of their own to help manage the influx of people who will be traveling to them,” Falcon says. “There is a lot of grief, but practical support is community care. Its roots are tied into the kind of support we all offer each other: a ride to the doctor, a dropped-off casserole, watching your niece for a few hours.”
“Auntie” networks, “underground railroads,” and other schemes to aid abortion access have harmed a movement composed of professionals, trained volunteers, and systems tested time and again.
Other PSOs are filling the need for practical support in big ways, too. Just days before a draft opinion of the Dobbs decision was leaked to the press in early May, Mike Bonanza launched Elevated Access with the goal of using volunteer pilots to transport pregnant people—at no cost—from states where abortion is banned to clinics in protected ones.
When Elevated Access first began promoting its services on social media, Bonanza said he hoped to attract six pilots. Today, more than 800 pilots have signed up across all fifty states.
“Getting an abortion should be as simple as going to the grocery store,” Bonanza tells The Progressive. “You go to the store, maybe someone says hello, maybe someone asks if you need any help, and you just do your thing.”
Elevated Access flew its first patient on June 12.
In the aftermath of the Supreme Court ruling, many social media users offered “camping trips” or made thinly veiled references to “breweries,” “poutine,” and “maple syrup”—implying that someone needing an abortion in a red state could reach out to the person sharing the post for help.
While perhaps well-intentioned, the camping euphemisms quickly turned into online memes. Suddenly, countless people were offering their homes to vulnerable abortion patients whom they had “met” on the internet—without considering the potential legal risks for both parties. Aside from being a dangerous practice, the posts interfered with the work of PSOs. These “auntie” networks, “underground railroads,” and other schemes to aid abortion access have harmed a movement composed of professionals, trained volunteers, and systems that have been tested time and again and that provide the best possible services to those who need them.
“This is why we ask folks to connect with their local practical support group,” Falcon says. “It not only ensures . . . safety, but also because housing is only one small part of what it means to travel for abortion care. Without being part of this larger ecosystem of care, including partnerships with clinics and ensuring all medical costs will be covered, there is a real risk for harm or lack of care despite the best of intentions.”
The good news is that everyone can get involved in practical support because many PSOs are currently seeking volunteers. The best ways to help are by joining a collective effort, driving patients to clinics, or offering a spare room. Those without a car or space at home can help in other creative ways, such as using credit card rewards to obtain gasoline cards to donate to a PSO; transferring frequent-flyer miles to an organization that can redistribute them; offering to babysit; or taking a home-cooked meal to someone’s hotel room. No matter how you get involved in practical support, the time, energy, and money you spend will help to reduce the financial burden on existing networks and those traveling for care.
“Get connected to an existing group in your area, but be patient,” Falcon says. “In these unprecedented times, groups are being flooded with requests while also assisting clients in crisis and working to understand their legal constraints.”
We all have the opportunity to provide mutual aid to our neighbors from out of state. For every person you help, your net of community care will widen—and community care is what keeps us going, by allowing patients to control their own lives and futures.
“I want to live in a world where we support each other,” Manes says.