By ship, drone, or bulletproof van: Persecuted patients in abortion-banning states won’t be deserted

For two decades, Dr. Gomperts has been providing medical abortion access to those who live in nations that criminalized reproductive choice by taking them out to international waters. Even though ports were often hostile, international treaties and regulations forbid nations from denying access to commercial vessels. Women on Waves has traveled to nations across the globe, from the Middle East to Latin America to Asia and Eastern Europe.  A movie was made about the group in 2015:  

By 2015, Women on Waves created Women on Web, a telemedicine abortion service that has utilized aerial drones, robots, and the internet to ensure those in restrictive lands would have access to abortion medication. A robot named rAborta was sent into Mexican states where abortion was illegal. (Recently, the Mexican Supreme Court said any restriction on abortion was unconstitutional. This was also the case in Ireland. It’s only in the U.S. where women’s rights are going in the opposite direction.)

The women are careful to follow the letter of the law. Since the robot was being controlled by medical professionals in Mexico City, where abortion has always been legal, it didn’t run afoul of Mexican law. “Abortion drones” were used in Poland and Northern Ireland without the need for any sort of government authorization because of a legal loophole that the group exploited to bring citizens the needed medication. Anti-choice activists vowed to shoot the drones down but were unsuccessful

Here in the states, Dr. Meg Autry’s organization is trying to secure its own vessel. Her organization is called PRROWESS, which stands for Protecting Reproductive Rights of Women Endangered by State Statutes. It will provide surgical abortions. Dr. Autry told NBC that she and a team of licensed medical professionals will offer surgical abortions up to 14 weeks of pregnancy, which is entirely legal in federal waters.

Dr. Meg Autry

Still, she is preparing for legal challenges from the states whose citizens she will be serving. It will be difficult, but Dr. Autry told Daily Kos that this is her mission. “If you are wealthy in this country, you will be able to get the health care you need and want anywhere, anytime you want. For people that this vessel will serve, there may be no other option because of how far clinics are even if people are providing funding,” Autry said. “It is a reproductive health clinic—providing contraception, surgical abortions, STI testing and treatment and maybe vaccinations. We plan to be on a sliding scale or free.”

Because I considered the United States a first-world, free nation, I never thought we’d need to resort to these kinds of tactics for American women to receive the care they need, but here we are. By 2018, red states were already making national headlines for testing the waters on complete bans (or near-complete bans) of abortion services. Certain state legislatures felt confident passing restrictive laws that violated the precedent of Roe v. Wade, since Donald Trump and Mitch McConnell were in the process of completely perverting our justice system with unqualified judges who ruled only on the basis of their personal right-wing ideology.

One such law that passed was Texas’ Senate Bill 8, which banned abortion access if any “cardiac activity” could be detected. This happens normally within the second week of pregnancy, before most women even know they are pregnant. Many groups saw the writing on the wall and started preparing for what they correctly predicted would be the end of our constitutional protections.

Dr. Gomperts’ foray in the United States was the establishment of Aid Access. This new initiative worked with 10 U.S.-based providers to help low-income American women receive abortion medication by mail. The Trump administration immediately retaliated by using stooges in the Federal Drug Administration (FDA) to go after Gompert’s organization. Although FDA enforcement for drug and food safety plummeted under Trump, the agency went all in on trying to intimidate Aid Access into ceasing operations. Aid Access not only refused to stop but wound-up suing Trump-appointed Health and Human Services Secretary Alex Azar for illegally “seizing its packages from the mail.”  

Thankfully, the FDA has done a 180-degree turn under the Biden administration. The agency relaxed medication abortion restrictions during the pandemic, which allowed the pills to be sent by mail rather than require them to be dispensed in person. Organizations have taken full advantage of this new direction. Aid Access currently consists of four doctors with about a dozen staff members who prescribe medication and ship the pills from a pharmacy in India. The organization went from receiving 600 requests a day in the U.S. to over 4,000 requests a day since Roe v. Wade was overturned.

“We will continue to serve women who need it. We’re not going to stop.”

— Dr. Rebbecca Gomperts

However, that hasn’t prevented red states from trying to stop her. Nineteen states have banned telemedicine for abortion medication, although enforcement of that law remains difficult at best. The National Right to Life Committee even published a model state law that would make it a felony to maintain a website giving instructions for self-managed abortions, which not only violates the First Amendment, but would be nearly impossible to enforce if the website is based outside of an anti-choice state.

This has enraged Republicans enough to go for an even more extreme tactic: attacking a woman’s right to travel. Senate Republicans recently blocked a Democratic bill which would have codified into law the long-standing legal precedent that Americans can travel between states, without obstruction, to receive medical care. Sen. James Lankford of Oklahoma put a stop to the measure, saying Democrats were being alarmist and declaring it unnecessary. “No state has banned interstate travel for adult women seeking to obtain an abortion,” he said. What he failed to mention is that in places like Texas, Republicans are hard at work trying to do just that.

Eleven Texas GOP lawmakers recently sent a letter to the state’s largest law firm promising “criminal prosecution and the disbarment of its partners, among other penalties” if they reimburse their employees for abortion-related travel and legal expenses. The lawmakers also said they plan on introducing legislation (after the midterm elections, of course) that would impose “additional civil and criminal sanctions” for abortion-related travel.

A 33-year-old mother of three from central Texas is escorted down the hall by clinic administrator Kathaleen Pittman prior to getting an abortion, Saturday, Oct. 9, 2021, at Hope Medical Group for Women in Shreveport, La. The woman was one of more than a dozen patients who arrived at the abortion clinic, mostly from Texas, where the nation's most restrictive abortion law remains in effect. (AP Photo/Rebecca Blackwell)
Abortion clinic

Ironically, these attacks have galvanized organizations into helping low-income women travel to states where they can receive care. A nonprofit group called the Haven Coalition offers to shelter women who travel from places where getting an abortion is either extremely difficult or illegal. They not only provide a safe place to sleep on the night between appointments but offer meals and even escorts to and from the clinic to protect them from violent protesters.

The Brigid Alliance is a more recently established nonprofit that provides transportation, and even child care, to low-income women seeking abortion care. It was launched in 2018 and serves clients who must travel an average of 1,000 miles to get an abortion. The group has been busy since its founding, but with Roe overturned, the group is dealing with an even larger surge of requests. Beyond financial demands there is also currently a capacity problem, since blue-state abortion clinics are becoming overwhelmed.

We desperately need more abortion clinics, especially ones accessible to people traveling across state lines. Thankfully, there are providers determined to fill these gaps. CHOICES, a longtime abortion provider in Memphis, Tennessee, announced in May it would open a “border clinic” in Carbondale, Illinois. This will be the southernmost abortion clinic in the state, which will allow for access from the Southeastern states that have banned abortion. (Please note that several shady anti-choice “pregnancy centers” copied the name “Choices” in order to confuse patients.) With medical ships off the Gulf in the South and border clinics available in the North, red-state residents will hopefully have more choices for access.

There is still another organization that is taking the idea of the “border clinic” to an extreme.  Just the Pill offers bulletproof vans that can provide medication abortion services near the borders of states where abortion is illegal. The mobile clinic will move as close to the border as it possibly can while physically remaining in the state where abortion is still legal.

Dr. Julie Amaon, Just the Pill’s medical director, says her organization drives over 1,200 miles a week. Currently there are two mobile clinics: one for in-person pill pickup, and the other for first-trimester abortion procedures. The mobile clinics have traveled through the Western states of Wyoming, Montana, Minnesota, and Colorado. According to the organization, Colorado has the best regulatory environment for abortion providers, and it borders several states that have banned the procedure. This includes Oklahoma, which passed the most restrictive abortion law in the entire nation even before Roe was overturned.

The National Network of Abortion Funds connects potential patients with organizations that can provide both financial and logistical support, such as the ones I’ve listed here. Unfortunately, in states that have a complete Republican government trifecta, creativity is absolutely required during these desperate times.

I talked it over with my wife: If Roe falls in Florida, which is likely under DeSantis’ new state Supreme Court, I will offer transportation to those I can help. It will require the real support of all of us to get through these dark times. I know these measures are temporary stopgaps until our constitutional rights are restored, but that will require a sustained effort over the next few election cycles.

Hopefully, this will end up being just another quick, ugly chapter in our history, but I frankly don’t know if this will last for years or decades. Until that time comes when everyone has equal rights and equal access to health care, I plan on supporting these groups as best I can. I encourage you to volunteer or donate, as well.

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