Funding Abortion Care and Practical Support in a Hostile Landscape

Following the overturning of Roe v. Wade, abortion funds have been working overtime to support skyrocketing amounts of patients in need. And while there was a large influx in donations to abortion funds after the Dobbs v. Jackson Women’s Health Organization Supreme Court case, those donations have waned in recent years. Lindsey Mullen, Co-Executive Director of the Alabama Cohosh Collaborative and Natalie Price, board member of the Fountain Street Choice Fund, sits down to talk with us about abortion funds, practical support funds, and their work and needs in the years after Dobbs.

Targeted regulation of abortion provider (TRAP) laws are increasing after Dobbs. These laws often impact a clinic’s ability to keep staff or stay open, and many staff have lost their employment or seen their clinics close. Closures force patients to have to look and travel even farther for care-- sometimes outside state lines. Telehealth needs have been amplified, with many depending on telehealth care for self-managing their abortion, while some states continue to see their maternal health care desert grow due to a loss of practicing OB/GYNs. With waning financial support, it’s increasingly difficult for abortion funds and practical support funds to continue to provide people access and assistance.

Links from this episode

Fund-A-Thon
Alabama Cohosh Collaborative
Alabama Cohosh Collaborative on Facebook
Fountain Street Choice Fund
Fountain Street Choice Fund on Facebook
Court Allows Alabama Abortion Support Lawsuit to Move Forward

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Transcript

Jennie: Welcome to rePROs Fight Back, a podcast on all things related to sexual and reproductive health, rights, and justice. [music intro]

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Hey rePROs! I'm your host Jennie Wetter, and my pronouns are she/her. So, how's everybody doing this week? I am, well, I'm recording this on the Friday before you're listening, so I'm looking forward to the weekend. I am having lunch with a friend today. Super excited. I haven't seen her in a long time. We're gonna go down near the Wharf and like I'll be able to walk around 'cause I'm off today, so I'll be able to just like walk around and enjoy the afternoon and have a really chill day. Very much looking forward to that. And then I think I'm gonna go home and spend my weekend watching the most recent season of Bridgerton, all that. But I have not watched the second season and I'm kind of really ambivalent on the second season, but I feel like I need to watch at least some of it so that I am ready for season three. And then I'm just really excited to watch Penelope's story or Penelope and Colin's story. Very excited. So, that is what I'm looking forward to this weekend. Let's see, what else is exciting? Well, right now I'm watching one of my kitties Luna pout because I had to close the window that she was sitting in so that way I could record without you hearing all of the outdoor noise. There's so much noise outside and we have to keep it so you don't hear all of that. And so, she is very much pouting because she can't sit in the open window. It's such a rough life for them. I think I might just leave it there. I'm excited for this week's episode and we do have a tiny bit of housekeeping first.

Jennie: So, I just wanna do a quick, it sounded like there was maybe some confusion on our episode we did on the anti-abortion movement in the US' global impact. We talked about abortion in Kenya a couple times, and I think there was some confusion and first I think it's 'cause we were talking about abortion during two different time periods. Jodi starts off with telling the story of Editar who had an abortion in 2006, which was before the Kenyan constitution was amended legalizing abortion. So, that I think created a little bit of confusion. And then just to clarify then, abortion in Kenya now is restricted but not illegal. So, according to that constitutional amendment I talked about that happened in 2010, abortion is generally not permitted except under specific conditions. And those exceptions include cases where in the opinion of a trained health professional, there is a need for emergency treatment, or the life or health of the mother is at risk. And it sounds like from some of the things I heard from some people on the ground, that there can be some pretty broad interpretation of that on the ground. The conversation we had might have made it seem like it was more restricted than it is. So, I just wanted to offer that clarification so that people had a better understanding of what abortion looks like now in Kenya.

Jennie: Okay, so with that, let's go to this week's episode. I am excited to talk to two abortion funds about, you know, we're getting to be about two years post-Dobbs and it's important to talk about, like, what is everything looking like right now. And also, really important, right now is Fund-A-Thon time. So, while it is always important to donate to abortion funds, right now historically is when abortion funds raise most of their money for the year. So, make sure to donate to your favorite abortion fund or find a new abortion fund now. But very excited to have with me Lindsey Mullen from the Alabama Cohosh Collaborative and Natalie Price with the Fountain Street Church here to talk about abortion funds today. With that, let's go to my conversation with Lindsey and Natalie. Hi Lindsey. Hi Natalie. Thank you so much for being here today.

Natalie: Hi.

Lindsey: Hi.

Jennie: So, before we get started, I'm gonna have each of you introduce yourself and include your pronouns. So, let's go with Lindsey.

Lindsey: My name is Lindsey Mullen. My pronouns are she/her, and I'm the co-director of the Alabama Cohosh Collaborative.

Jennie: Great. Natalie?

Natalie: Hi, I'm Natalie. My pronouns are she/they, and I am on the board of the Found Street Choice Fund.

Jennie: Wonderful. I am so happy to talk to both of you today. You know, we're getting on close to the two-year anniversary of the Dobbs decision and a lot has happened and changed since then. So, what are you seeing two years post Dobbs? And since I went with Lindsey first, let's go with Natalie this time.

Natalie: Yeah, just based off of things I've been seeing in the news and things that have impacted Michigan so far. My hometown is Grand Rapids, Michigan, and that is where the Fountain Street Choice Fund was first founded. And I'm so proud for their work that they have accomplished since pre-Roe. So, before 1973. And just things that I've seen lately are all these new TRAP laws and unnecessary regulations that have impacted thousands of patients' access to care and those clinic closures, just that huge loss of medical expense and community-based jobs, comprehensive reproductive and sexual health services and neighbors who have cared so much. So, last year, 2023, Grand Rapids had its only procedural abortion clinic that was serving West Michigan patients for over 50 years close due to the passing of the medical director and gynecologist there. So, the clinic was forced to close, and it forced all of those patients that were accessing abortion care there to travel distances that was so hard on them. So, that procedural abortion after 11 weeks of pregnancy, they're forced to travel across the state or even the next state over. So, that's something that impacted my community the most. And we're still seeing independent clinics like that close and just the access to telehealth is greater than ever. We're seeing over 63% of self-managed and telehealth abortions. That was increased after Dobbs was passed. So, just expanding that, that is the most critical resource that we're after right now.

Jennie: Definitely have to give a special shout out to Michigan since I'm from Wisconsin and, you know, gotta support the Midwest. Especially, you know, being from Wisconsin, like I know how important it is that Michigan has had access right now since, for a long time post the Dobbs decision, Wisconsin didn't have access until they had a Supreme Court election. So, it's nice to see some of the friendlier states in the Midwest having access. Lindsey, what have you been seeing?

Lindsey: So, I am in Huntsville, Alabama and Alabama, as most folks would know, is a state that is hostile towards reproductive freedom and reproductive justice. We have a, not only do we have a total ban and so do our two neighboring states of Tennessee and Mississippi right now. And since 2022, we also have an attorney general who has threatened legal action against organizations that help people get out of state to access abortion. That is being challenged in court. And just this week there was some movement on that case with it being allowed to continue. So, our fund, which was a practical support fund, we were- our group of abortion doulas has not been able to provide that support since Dobbs. We are still giving people resources. We know there are still funds in other states that are helping people access those out of state abortions and getting people access to telehealth abortion. But it really is a difficult place here, especially if you don't have a lot of means to do things like, you know, travel across to another state. At the same time, we're seeing rising maternal health rates in maternal health deserts. We're seeing that abortion bans like we have in Alabama make it harder to work in that field as an OB. And so, we are seeing less care, less care availability in our communities for sure. And we are seeing folks working on the ground all the time to get that care out to our communities. Our fund, Alabama Cohosh Collaborative and the Yellow Hammerfund, the other big fund in our state as well as other states like ARC South, other funds like ARC Southeast that work across the south are doing everything they can to get people the support they need to get the healthcare that they need.

Jennie: Yeah, I think you drew some really important connections. I think a lot of people don't necessarily think about, you know, when abortion care is lost in one state, they don't necessarily think of like, oh, how is this gonna impact other states or how far people may have to travel to access that care? Like decisions that are happening in isolation, right? I think people hear of a ban and they think of this one thing and then they don't also make the connections to maternal healthcare. Like, I think those are just really important connections to always be drawing because I think it just is not something that is first and foremost in a lot of people's minds when they hear about a particular ban. And right now, it's also important to talk about how we're still seeing new states adding their bans. So, most recently being Florida, and I'm sure that is just making the access in the South even more tenuous right now.

Lindsey: Yeah. It just means, again, like you're saying, people have to travel farther. Even Florida still having six weeks or fetal cardiac activity like Georgia does, does give some possibility for people in Alabama to travel to those states. But it definitely restricts access and yeah, just pushes people farther away to get the care, which also can impact if they need care after an abortion, whether they're able to access that care, how long they would have to stay in the place that delivers that care--all of those things are impacted.

Jennie: Yeah, I feel like, and correct me if I'm wrong, but I feel like I had someone prompt me early on when Dobbs happened that, you know, if you have a clinic where you are and need post-abortion care, are the clinics able to provide that safely?

Lindsey: So, in Alabama, that's also part of the lawsuit that's currently in place is that several doctors who have sued the attorney general together to say they don't feel safe providing that care. And that's the ACLU is doing that as well. So, we are hopeful but that has been since last July that that lawsuit has been active. So, in the meantime, funds like ours are doing our best to just maintain our infrastructure knowing that as these laws change or we get more UpToDate information, we can continue then to offer whatever is within our risk profile to offer to folks.

Jennie: Yeah. Natalie, has Michigan seen impact from like all of these, you know, kind of as new bans get introduced?

Natalie: Yeah, I was just gonna mention that Michigan actually had a major win for reproductive freedom recently with the Reproductive Health Act that was passed earlier. However, there still is that financial piece that needs to be figured out for low-income patients and especially in communities of color where Medicaid is one of the only options. And that's actually where our fund and abortion funds come into play is that backup for people that really do need those funds the most. So, that is the one piece that we're seeing as a struggle for, for those in Michigan, is those bans on Medicaid coverage as it's almost like a de facto abortion ban for people with low income. And I keep hearing this word flux that's used like we may have bans in other states, but we're never truly solving the problem of those who are protected in other states. We just see this constant back and forth of people traveling who really need care to other states, but then where are we getting the funds for those patients if we already have people being taken care of in that state. So, it's a constant flux, it's a constant challenge to solve.

Jennie: You know and talking about all of the bans that we're seeing popping up in other states. We talked about what was happening in Florida, but we forgot to mention what is going on in Arizona. And I think that's partially because it's a little confusing to some people, right? They heard this ban went into effect, they heard it's been repealed, but it's still a little more complicated than that. Natalie, do you wanna talk a little bit about Arizona and what that's gonna mean?

Natalie: Yeah, I'll just start by saying that this repeal, even though it is a better outlook in terms of the effect that will happen after that goes into effect in the fall, but then we have this problem of, okay, what are people going to do when it goes into effect this summer, which I think it starts in June, but what are we going to do? What are those people going to do when they have to travel for that short amount of time? And this is looking at total ban on abortion, so no exceptions to survivors of sexual assault or incest after 15 weeks. And even though that is such a short amount of time where this ban is in effect, it's still, again, to your point Jennie, it's confusing like, what are these people going to do and how are they going to be able to afford this travel? So, this is just another example of a ban where we have so many different pieces going on and it's not being communicated very well to everybody. So, I think that's a great example. And then another thing I wanted to bring up too is I just saw an article actually on NPR about medical residents avoiding states where abortion is restricted, Arizona being one of them, and how this will have a huge impact over time for people accessing abortions. So, just the limitations of healthcare providers in these states that we have total bans and just the impact of that, including independent clinics and the decline of that. So, it's a huge impact.

Jennie: I think this really goes back to something that Lindsey said was just the confusion, right? Like, the not knowing what the status of things are. It all just makes it really hard for people trying to access care because they may not know all the details. They may have heard a headline and knew there was a ban in place, and then they may have heard it was repealed, but now they're not able to get an abortion during that summer, but maybe they never heard it was repealed, like, and think they can't get one forever. Like, there's just the confusion that people are facing on the ground is, it's a lot.

Lindsey: I'm just over here nodding at what y'all are saying. And adding that context of, like, the confusion is hard enough when you're working for an organization. And it's another thing when you're also like, have literally realized you could be on a clock for what your options are. So, not only if you realize that you need to access an abortion, not only are you having to sort through those things, you're having to sort through those things on a timescale and under really a lot of duress. So, just putting out there that there's this essential work of, like, us just funding and supporting abortion and there's also something about meeting people in this human moment of this confusion and threat that we're living under to just be these little, I don't know, pinpoints of light or something like that, that are, like, you're not here to criminalize or stigmatize or anything like that, but are showing up to people as humans making a very personal decision, navigating their own lives. And just where that confusion hits. I can feel it in my heart as well as in my organization.

Jennie: Okay. I'm going to direct this one to Natalie because I know Lindsey's group doesn't do this right now, but we talk about abortion funds a lot on the podcast. But before I ask a question related to how abortion funds are keeping up with everything, do you wanna do the two second, like, what is an abortion fund for any new audience?

Natalie: Yeah, absolutely. An abortion fund is a public fund, local or national for those who know the National Network of Abortion Funds for those who do not have the financial means to cover an abortion or their pre- or post-abortion care. And this looks like donations from those who are able to give regularly. There are monthly memberships that you can have or an acre fund which the Choice fund actually recently just joined, but those donations go directly to callers, those who need abortion care. And that is no ask. So those who call, you're given those funds as needed and those are fielded to your abortion provider of choice. As long as you have one and you set up an appointment, those funds are there for you to cover your care.

Jennie: I wanna just reiterate, like the monthly donation part is so important for abortion funds because they can know them that they can count on that money every month as they're trying to budget how much they have to give to people seeking abortion. So, you know, even if you can't give a large amount, like I am a monthly donor to a couple different abortion funds, because I want them to always know that that money is there as they're doing their budgeting and their planning. So just a special shoutout to always give to abortion funds, but also if you could be a monthly donor, that really goes a long way. I do that, but I also am very notorious for rage donating. So, like, when something new happens, right? Like the, oh, okay, now I have to go donate to this or I have to go donate to that, and I can only imagine that that means abortion funds have like a huge influx in donations post-Dobbs, but I've been hearing, like, that's not keeping up. So, like, would you like to talk a little bit about what you are seeing right now and, like, how are funds keeping up with this? And we'll start with Lindsey and Lindsey, you can add your caveats.

Lindsey: What you're saying is totally right. Just, immediately after Dobbs, we saw a big influx in funds, actually bigger than our capacity as an organization had been prior to that. As I mentioned, our primary role was a practical support fund. So, we were providing abortion doula support at a clinic in our area. So, we were at this difficult place of course, of like having this influx of funds and then also having a legal landscape, like I said, that was hostile. Part of the tactic of that legal landscape is to be confusing. So, just to have a long time to even understand what is a risk, what do we mean by risk, and then to have those changing both in our states and the states around us. So, there was a, one of the ways of like, of keeping up was just a lot of strategizing and relying on resources like the Lawyering project to help us understand the context. And you're also right that, that we've seen from our fund that support waning, as I said, we know. So, we are a reproductive justice organization. For us, that means that we are looking at a more broad context of people's right to parent, right not to parent and right to decide whether or not to carry a pregnancy. We see these as all connected. So, what we've done as a fund is focused on maintaining our infrastructure, paying attention to this legal landscape, and being ready to act as we can. And then funding other reproductive justice programs. With that support waning, what makes that difficult of course is just meeting the needs that are here. And again, also maintaining our infrastructure because we are constantly looking for ways that we can play a part and stay, keep our doors open to keep supporting the people in Alabama who need access to this essential healthcare. And that's a lot of times just gonna involve like, you know, two steps forward, three steps back as far as what we're able to do in terms of, like, producing numbers. At the same time, I think what I see funds doing is working together. I mean, it's just incredible to be a part of this movement and the thoughtfulness and the courage and just the tenacity that folks are working in the South to protect our communities and to get people where they need is still happening. So, that's something that I just never wanna not say. There are definitely people showing up and giving funds right now is a huge help to our organization and to any abortion fund. It's a big part of what we need to keep going. Natalie,

Jennie: Do you have anything you would like to add?

Natalie: Yeah, so I just wanted to start by giving some context on the Choice Fund. So, like I said earlier, the Fountain Street Choice Fund has been in operation since before Roe v. Wade was passed. And not only is it the largest abortion fund in Michigan, it's also the oldest. So, we're super proud of that. But one of the caveats of the Choice Fund is that it's operated through a church, which is something that's really unique to abortion funds in general. And something that's really special about the Choice Fund is that because it's so community oriented, we have that baseline, that foundation of donors that was there prior to the Dobbs decision. So, we had people in place, a donor list, people that were already giving, which really made it key to funds to be able to keep abortions funded. Even though Michigan wasn't critically affected, we were able to fund more people traveling. One of the caveats about the fund too, that is good to know is that we don't fund direct travel. So, we don't pay for, like, airline tickets, but we will pay for that out of state abortion if that is what the patient needs. But what has been really instrumental for the fund this year is the participation in Fund-A-Thon which has been really great in getting us publicity and just informing more people in the West Michigan area and the country of our existence and acknowledging that, that we are here to help the people of West Michigan, especially for those who do need to travel, who do need to receive care outside of the state. So, I think it's been a really great opportunity to be part of Fund-A-Thon and to join that anchor fund so that we're able to stay in the loop and continue to serve the patients that we do. Another thing that I wanted to note too is just the need to focus on lower income and people of color and trans and non-binary patients as well. That is something that I'm personally trying to highlight for the Choice Fund is just expanding the knowledge of the Choice Fund to people that really, really need it most and making sure that people are aware that the Choice Fund is not religiously affiliated. Like we're not going to turn any people away because of their beliefs. It's not tied to that, but we're open doors that we do field calls every day. So we get callers, we're able to direct you to the care that you need and you're able to receive those funds. So, it's a community effort and this Fund-A-Thon is going to do so much hope for us.

Jennie: I have to say, like with all the things that are happening, it is easy to be overwhelmed and get down and feel really negative and worry about what the Supreme Court's going to do next, but the place I always look for hope is abortion funds and all of the amazing work that y'all are doing, like the community-based care, the joy with which the work is being done, the ways that abortion funds work together to ensure that patients can get access to the care they need. Like those are the things that give me hope even on my darkest days where I'm really frustrated with all the things, I am always excited to talk to abortion funds and highlight the amazing work that y'all are doing.

Lindsey: Just thank you. Thank you so much for that. And yeah, I just wanted to mention that Alabama Cohosh is also participating in Fund-A-Thon. This is our first year doing that. And so, an exciting part of that for us is learning that all of our donations between now and May 31st are being matched by the National Network of Abortion Funds. So, between now and May 31st at alabamacohosh.org, we're linked there to give, and all donations are doubled. So, that can make a huge difference in what this next year will look like for us.

Jennie: Yeah, make sure to donate, like, always donate to abortion funds, but also Fund-A-Thon is when historically abortion funds have raised the bulk of their money. So, like, now is the time to support your local abortion fund. Honestly, every day is a great day to donate to your local abortion fund, but right now is the time that we're especially asking. Okay, so I always wrap up with, we can't just talk about the bad things, although we talked about abortion funds, it wasn't all bad today, so I always wanna give the audience actions they can take. So, what is something that the audience can do to get involved? I know, you know, donating is important, but I'm sure you have other ways that they can get involved and let's start with Natalie this time.

Natalie: Yeah, I mean besides donating to your local abortion fund and participating in awesome Fund-A-Thon, I would say just attend those local events. I'm going to My Body, My Festival next week and I'm super excited to be able to go to that. So, just support those local events that also help fund abortions and get outside and become a part of the community for that. Talk to your local lobbyists and advocacy groups and don't be afraid to have suggestions and just talk about abortion as much as possible. Share your abortion story and read literature about abortion. My personal favorite’s The Turnaway Study and I just started reading that this year and it's an amazing read. I just love data and statistics too, so that has all of that in there. It's so amazing. But just talk and donate and spread the word would be my biggest tips.

Jennie: Love The Turnaway Study. We also have an episode talking to the author. I always get it backwards, so like I hope fingers crossed Dr. Diane Foster Green or Green Foster. I always get it backwards. I don't know why my brain always inverts it. Okay, so we'll make sure to link to that in the show notes, the study and the episode. And then let's turn it to Lindsey.

Lindsey: Yeah, I would echo all of those things. Like I mentioned earlier, I think confusion is a tactic of those folks who are trying to limit these rights. And so, taking the time to try to educate yourself as much as you can about what's going on in your state, what your local abortion fund is, who they are, local clinics too. Planned Parenthood is great, but local clinics are such a key part. So, just knowing what's available in your area and what's available as far as things like telehealth as well. It is easy to get discouraged and we shouldn't ever underestimate the urgency of what's happening in our country. And at the same time, abortion is safe and medication abortion is extremely safe and really is very accessible in many ways. So, knowing those resources are out there, I'll just say we also have, and I know many funds have free access to Plan B or emergency contraceptives. And something I just encourage people is just to keep that in your medicine cabinet, whether it's for yourself or for someone else. Protecting access to contraceptions and sex education in general. Again, keeping that lens on reproductive justice being really all of these things that being prepared to be a community care person for the people that are closest to you. It's like, of course we want this infrastructure. We wanna have these funds so that everybody has a resource they can look up on the internet. But also, the reality is your neighbors, your people that you know, your, your family, those are the people that folks are gonna turn to first when they need to access this healthcare in this era. And so, whether you're a person that is personally, you know, has the possibility of having a pregnancy or you just know people that are just thinking of yourself as being a responsible community member by knowing what's out there. And being prepared to support people I think is important.

Jennie: And, like, that doesn't mean you need to know all the things. It means you may know where to point people so that they can look it up to find the right answers.

Lindsey: Right. And at the very least that we're not replicating, repeating things that aren't true or creating a culture of fear that's bigger even than the realities there.

Jennie: I think I would add my one other favorite thing and you know, is look, maybe your local abortion fund has this, maybe they don't, but a number of them have like Amazon wishlists where you can go and get things that they need, whether that is like care packages that they are sending patients home with you know, like sweatpants or like whatever. And so, it's a great place to like, again, rage donating it. I'm telling you this is how, how it happens. I, like, go and see someone has, they have an Amazon gift list and order a bunch of Plan B, or they have treats for patients after they get abortions or whatever. And like, it's like those little things that really make a difference in somebody's experience of getting an abortion. So, I'm also a big fan of going and looking at the Amazon gift list.

Natalie: I love that. I think all abortion funds should have an Amazon wishlist so we can just send everybody home with a care package.

Jennie: Yeah, like sometimes it's just nice to, like, get those, like, tangible things and I don't know, I have really enjoyed doing that. Well Lindsey, Natalie, both of you, thank you so much for being here today. Like I said, I always love getting a chance to talk about abortion funds and the work that y'all are doing, so thank you so much for your time.

Lindsey: Thank you so much. Thanks for this conversation. It was great to learn from you, Natalie, and just, I appreciate the opportunity to talk about what we're doing. So, thank you.

Natalie: Thank you, Jennie, and thank you Lindsey for sharing everything. It was so interesting to hear about another abortion fund, especially like a local one and one that I haven't heard of. So, thank you both.

Jennie: Okay y'all, I hope you enjoyed my conversation with Lindsey and Natalie. It was great to hear about what abortion funds need going on two years post-ops. I think, you know, it's really important to keep in mind that they got such a big influx of money right after Dobbs because of all of the rage donating and the need has only increased since then and the rage donating has really slowed down. So, it's really important if you are able to donate to your local abortion fund and Fund-A-Thon is a great time to do that. So, if you can donate to your local abortion fund, I know I will be this month. And with that I will see y'all next week.

Jennie: [music outro] If you have any questions, comments, or topics you would like us to cover, always feel free to shoot me an email. You can reach me at jennie@reprosfightback.com or you can find us on social media. We're at @RePROsFightBack on Facebook and Twitter or @reprosfb on Instagram. If you love our podcast and wanna make sure more people find it, take the time to rate and review us on your favorite podcast platform. Or if you wanna make sure to support the podcast, you can also donate on our website at reprofightback.com. Thanks all!