“I’ll walk you through a common experience when accessing abortion in PA,” says Dr. Lin-Fan Wang, a Philly-based family physician and an activist for reproductive health access.
She describes the average person who seeks an abortion in America as “a Christian woman in her 20s with a child, [who] was using birth control when she finds out that she’s about six weeks pregnant,” citing data from the Guttmacher Institute. Pennsylvania’s Department of Health statistics confirm that nearly 60 percent of abortions in PA are sought by women in their 20s, and over 60 percent are eight weeks pregnant or less.
When this pregnant person calls to schedule an appointment, “that’s when she encounters the restrictive state laws in PA,” says Wang. “She is told that even though she made her decision, that at least 24 hours before her abortion, she must have counseling from a physician about her pregnancy options and the risks of abortion, and she is offered a booklet written by the state to persuade them against having an abortion. She goes through the mandated counseling, but then her appointment is scheduled two weeks out instead of 24 hours out.”
After that, Wang says this person will likely have to “take time off work and make child care arrangements. She also has to save up money, because PA law prevents her insurance from covering her abortion.”
If she doesn’t live in Philadelphia, Allegheny, Northhampton or Delaware counties, the counties where 80 percent of PA abortions are performed, she will likely have to travel nearly two hours to reach a clinic, and one that may only provide abortion care once a week.
As of April 2017, Pennsylvania passed a number of restrictions that made abortion harder to access, including requiring the “state-mandated counseling” Wang mentioned, installing a waiting period, and requiring medically unnecessary tests be performed on the patient.
These new rules also make the procedure more costly. For people whose health-care plans were purchased in the ACA exchange or who are public employees, insurance can’t cover abortion, except in the case of danger to the pregnant person’s life, or unless they happen to have an optional rider for such coverage, which comes at additional cost.
Additionally, minors seeking abortions are required to have parental consent, clinics must conform to a number of arbitrary hallway and room-sizing regulations, and patients seeking hormonal birth control implants must wait for a subsequent visit now, all due to these new laws.
The future looks even more difficult, as anti-abortion legislation increases across the nation, clinic funding is attacked, and the Supreme Court is filling with judges antagonistic to reproductive freedom. As recently as January, eight U.S. senators, and eight GOP House of Representative members from Pennsylvania sent a brief to the Supreme Court asking for Roe v Wade to be overturned, which would reverse abortion rights nationwide.
Locally, Targeted Regulation of Abortion Providers (TARP) laws attempt to make it impossible for clinics to operate, while so-called fetal heartbeat bills set deadlines for abortions before most women can realize they’re pregnant, effectively banning the procedure. The Pennsylvania House of Representatives introduced such a bill in 2018, which failed in committee. But in 2019, the state passed a ban on abortions after 24 weeks, despite the procedure being almost entirely performed for the health of the pregnant person at that point.
“The current state is horrific – both in PA and nationally. PA is really the birthplace of the anti-choice movement nationwide,” says Elicia Gonzales, executive director of Women’s Medical Fund, an organization that provides financial assistance to women seeking abortion.
On top of the increasing legal obstacles, “cost is a primary barrier to someone being able to access abortion care,” Gonzales says. She says last year Women’s Medical Fund was “able to provide financial support to just over 3,200 people. All of the folks we help are living in poverty, earning around $8K a year. (Some) 72 percent of folks calling our Help Line are already parenting one or two children at home.”
There doesn’t seem to be a dearth of funds for trying to talk people out of abortion, though. Gonzales says Real Alternatives, a Harrisburg-based anti-abortion group, has received $90 million in state funds, including Temporary Assistance for Needy Families (TANF) money, to run anti-abortion centers, which she says, “lie to and manipulate pregnant people out of having an abortion.”
“We heard one story of a pregnant person seeking abortion care who was told she had miscarried – only to find out weeks later she was still pregnant,” Gonzales says.
It wasn’t always this difficult.
“I had planned to spend a weekend out of town visiting my sister, so I didn’t have to ask for time off work,” says Katie, a barista who was living in Center City when she had an abortion in 2011. “I went to the Planned Parenthood clinic that’s right in Center City – I felt very lucky that there were no protesters outside the clinic and I experienced no harassment. I chose a medication abortion – so they did an exam and an ultrasound and then sent me home with the medication. My boyfriend went with me to the clinic and paid for half of the expense, which I think was $300 with my insurance.
“The medication basically induces a very heavy period which happens over the course of a single day – so I spent the day feeling nauseous and bleeding pretty heavily. It was a fairly uncomfortable experience for the one day, but afterwards all I felt was relief. I’ve never regretted my decision,” she says.
Since then, Katie says, “I’ve felt compelled to speak about my experience to normalize abortion and be an advocate. I’ve been working the last few years with PP and NARAL as much as I can, doing everything from lobby days to organizing marches to volunteering at events.”
Jessa Jordan, a South Philly-based writer, activist and model, has felt similarly motivated to share her experiences.
“I had an abortion when I was 20. The easiest part was the immediate decision to have one,” she says. “I’m extremely lucky that very little about my experience was challenging. I could afford the procedure and didn’t have to travel out of my city or state for it.
“Planned Parenthood made everything as comfortable and calming as they could,” she says, and supplied her with information about the medications involved in the abortion as well as those that can would help with subsequent pain and nausea. The hard part, she says, was the stigma.
“Even though my family and friends supported me through my abortion experience, I felt a lot of societally imposed shame and guilt for choosing to abort my pregnancy. Up to that moment, I never thought I’d be in that position,” Jessa says. She internalized blame even though the pregnancy was a result of a partner removing a condom during sex without telling her.
“When I happened upon Shout Your Abortion,” the movement to normalize abortion, she says, “I felt compelled to share my story to set myself free from that shame. I’ve been trying to be authentic and unapologetically myself and aim to empower others to do the same.” She is now in the process of working with Shout Your Abortion to organize Abortionpalooza, a one-day film and arts festival.
“We heard one story of a pregnant person seeking abortion care who was told she had miscarried – only to find out weeks later she was still pregnant.”– Elicia Gonzales, executive director of Women’s Medical Fund.
What accounts for this stigma and these increasing legislative attacks on abortion rights? Nationwide, support for abortion rights has remained steady and over 60 percent of Americans believe abortion should be legal in all or most cases.
“Anti-choice folks have seeped into the hearts and minds of folks seeking abortion care,” says Gonzales. “Stigma has resulted in folks wondering if they are going to hell or questioning if the fetus will feel pain. It’s important to note that these are sentiments that were not expressed a decade ago.”
“There is still so much stigma regarding abortion, even though it is one of the most common outpatient procedures,” adds Wang. “We need to break the silence and see the people having abortions as the thoughtful, complex, and loving people that they are.”
“Abortions are safe medical procedures and everyone who desires an abortion should be able to have one and not have to go through extremes to have one,” says Jessa. “The stories of people who have abortions should be told by those who have that experience, not a narrative of control, fear and propaganda.”