The Loss of Abortion Rights Will Send Reverberations Through Many Spheres

As the future of Roe looks increasingly shaky, the implications of its overturning could result in a number of outcomes-- some of which may not immediately occur to many of us. Pamela Merritt, Executive Director of Medical Students for Choice, talks to us about what the likely overturning of Roe v. Wade may mean for criminalization, health outcomes, and abortion education and training for medical students and residents.

As the fall of Roe looms, the criminalization of pregnancy outcomes, sexual and reproductive health, and self-managed abortion may become more commonplace. Already, criminalization has crept closer and closer; Texas’s SB8 allows for anyone to sue for those who “aid and abet” in abortion access or care. In a country in which people of color are already hyper-surveilled, these outcomes will be disproportionately felt by Black communities and other communities of color. In an international context, Poland is currently seeking to create a registry of pregnant people using self-reported and investigated information. 

For so many, being able to decide whether or not to carry a pregnancy to term may be a life-or-death decision or can result in extreme health outcomes. For Black pregnant people in the U.S., maternal mortality rates are four times higher than the general population. Putting abortion out of reach means contributing to the persistent maternal health crisis. Abortion bans also impact fertility, access to invitro fertilization, and the ability to treat fibroids, endometriosis, and polycystic issues. Miscarriage management and treatment of ectopic pregnancies may be up for debate among risk-averse hospital ethics boards.

Roe’s future will have an unknown impact on abortion training and education among medical students and residents. In states that are poised to ban or limit abortion, will residency programs teaching on abortion care and family planning may lose accreditation? Will accrediting programs change their standards of care based on the American Academy of Obstetricians and Gynecologist’s best practices? Likely, in 5 to 20 years, patterns of geographic access to care may become clearer, where providers are legally safer practicing abortion in some areas of the country compared to others.

Links from this episode

INeedanA.com
Abortion Fund Donation Finder
Repro Legal Helpline
Medical Students for Choice on Facebook
Medical Students for Choice on Twitter
National Advocates for Pregnant Women
Policing the Womb
Personhood Documentary

Transcript

Jennie: Welcome to rePROs Fight Back, a podcast where we explore all things reproductive health, rights and justice. I'm your host, Jennie Wetter, and I'll be helping you stay informed around issues like birth control, abortion, sex education and LGBTQ issues and much, much more – giving you the tools you need to take action and fight back. Okay, let's dive in.

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Jennie: Hi, rePROs. How's everybody doing? I'm your host, Jennie Wetter and my pronouns are she/her. Y'all, I am back and mostly refreshed and ready to face all of this stuff. I mean…mostly. It was so delightful to take a week off and just do nothing. I did nothing, y'all! I did nothing. I did some fun reading. I read, you know, light, fluffy books that are, like, beach-read style books. I watched some trashy TV and movies. I did some baking. And I didn't think about work, or deal with work, or I didn't really think about repro too much. It was just so delightful to take the time away and do nothing and do what I needed to do to recharge a little bit. I know June and July are going to be really…they're gonna be a lot. They're gonna be a lot, right? We're expecting Roe to come down, and it's gonna be a lot, and there's gonna be a lot to do, and I needed to take a break to prep myself for that. But, you know, I think I…I talked about as maybe one of my New Year's resolutions of just being better to take time off and to take a step away. Y'all, we know that this fight for bodily autonomy is…it is, uh, definitely a marathon, maybe an ultra-marathon, right? Like, it's long and hard and it is not a sprint. So, it is definitely something that you need to do, what is best for you to be able to do best for the fight. So, I know that means taking a step away every once in a while and taking a step back and then coming back when you are able, and that's fine and we all need to do it. And so, I'm very glad that I took the week off. I, uh, I think I had mentioned I wanna be better about this, so I will definitely be taking more time off, even if it is just to do nothing and just…to exhale and take a deep breath and relax and be ready to come back in and keep fighting. Because gotta keep fighting, right? Like there is a lot of fighting to be done, and I am ready and I am more ready now that I took a week to recharge. So, with that, let's turn to this week's interview. Y'all, I had such a wonderful conversation with Pamela Merritt, the Executive Director of Medical Students for Choice. It was so wonderful talking to her. We had a really great, far-ranging conversation, and we talked about everything from criminalization around abortion, to talking about more of the intersectional issues we need to think about when Roe comes down, to thinking about what it is gonna mean for medical schools and for people who need education around abortion or training. It was a really wonderful conversation, and I hope you all enjoy it. Oh, and I just wanna flag one thing. I recommend a book while we were talking, but I think I forgot to mention the author. So, I just wanna throw that in here, so that if you look to find it, you can find it. So, I really recommended around criminalization that people read “Policing the Womb” by Michele Goodwin. So, I just wanted to throw that in here. Okay. With that, let's go to my interview with Pamela. Hi Pamela! Thank you so much for being here today!

Pamela: Thank you so much for having me! I'm excited.

Jennie: Me too. Do you maybe wanna take a quick second and introduce yourself, and include your pronouns for our audience?

Pamela: Of course. So, I am Pamela Merritt. My pronouns are she/her and y'all, and I am the executive director of Medical Students for Choice, which is an international nonprofit that has a very clear mission to help build the next generation of pro-choice physicians and abortion providers.

Jennie: Oh, that's so great. I don't think I knew it was international!

Pamela: Yes. Yeah. We actually have chapters in 28 countries.

Jennie: Oh, that's so amazing. Even more amazing. I am excited to talk to you about a number of things, but I thought we would maybe start with, you know, the fall of Roe is imminent or may have happened in between the time we record this and y'all are hearing it. So, we're recording this on Wednesday, June 8th. So, there may be…there's probably maybe two decision days between now and then

Pamela: Mm-hmm.

Jennie: So…things could have changed. But, as of right now, it's, it's imminent. And one of the things that I think people are going to need to worry about is criminalization.

Pamela: Mm-hmm.

Jennie: Can you maybe talk about how that's…how that works?

Pamela: Yeah. So, I've given a lot of thought to criminalization, and as a reproductive justice activist, I've definitely approached it from several different angles. And, there's the criminalization that we see on the books. Then, there's the discretion that law enforcement and prosecutors have. And then, there's the reality that certain populations are more vulnerable and…than others. So, um, the evil light of reality is that there will be criminalization of self-managed abortion. There will likely be attempts to criminalize, aiding and abetting. And when we talk about self-managed abortion with pills, we're talking about a, you know, a phenomena that, that presents exactly like miscarriage. So, because we're an international nonprofit, we are currently monitoring things on the ground in Poland, where they are creating a registry of pregnant people, and they are doing it, some with self-reporting and some of it with investigation. And, you know, we're not that far away from that. So, when you have criminal penalties, when you have felony penalties for the person who administers or performs the abortion, and it's a medication abortion, then…that is done outside of a medical environment, then you are criminalizing the pregnant person. And, we have reached the point, as you said, with the imminent fall or fall of Roe ¬– we're operating as if it's already gone – and we've reached the point where we no longer are gonna be, you know, we, we no longer should allow for people to try to spin this. It is illogical to have a criminalization, to have a, you know, charges on the books for law enforcement that doesn't also have a mechanism for evaluating crime scenes and evaluating situations and then also has a mechanism for enforcement. And, what we're seeing in Poland is that they're developing a mechanism for enforcement, for monitoring. It's no different than a Sudafed database that exists so that they can monitor a, you know, for methamphetamine use. So, when, when I think of criminalization, I really think of it in, in an intersectional, broad scope. So, the United States has the worst pregnancy outcomes in the developed world. And every single state that is listed on the Guttmacher map for going dark on abortion access also has particularly bad pregnancy outcomes within comes within a country that is failing people who experience pregnancy. So, they suck within a country that sucks. When we talk about, and in terms of criminalization, many of those states in the Midwest and in the South are also in the midst of a movement for criminal justice reform, for defunding, you know, the police, and trying to establish some mechanism of accountability for State violence against Black and Brown people. And, the hyper-surveillance of communities of color is already in place. What we're really talking about from an intersectional lens is criminalizing abortion in an environment where Black women and people who experience pregnancy are, are making very, very time sensitive, critical decisions that are best for their family and are now gonna be doing so under threat of first degree murder charges, manslaughter, or aiding and abetting charges that are akin to manslaughter. So, criminalization is real. And how it happens is something we already have experience in. Like, we don't need to speculate about whether or not they're gonna go through trash cans. We know that they go through trash cans. You know, I know people who have had social workers go through their drawers and through their personal items on home visits. So, you know, this is not a drill, and I'm not catastrophizing when I say that criminalization is a very real threat. Now, the movement has set up some really awesome resources. The trick is making sure that people are aware of them. So, If/When/How has a hotline that has been in place for a while that people can call if they need legal help, but also, can call if they just wanna understand their legal liability. And, I know that, that National Advocates for Pregnant Women has been working on the criminalization of pregnancy outcomes and the eroding of, of civil rights for pregnant people for…forever. And now, you know, they are a continued resource and a wonderful champion for people who get caught in this net. But the reality is that my experience has shown that people get…who are incredibly vulnerable to criminalization are also, you know, incredibly vulnerable to pleading out and trying to negotiate for the best possible outcome of a bad situation. So, I'm deeply concerned. I, I think that, you know, we've done a lot of work, and we've put together a lot of resources, but the reality is that my community and communities throughout this country are…are living in a different reality than, than some folks think. And, I'm not as optimistic about criminalization as some of my colleagues in the movement.

Jennie: Yeah. I, I think that's, that's especially true for people who aren't as familiar with everything that's been going on. Like, they don't see that criminalization of pregnancy outcomes has already been happening for a long time.

Pamela: Mm-hmm.

Jennie: So, to them, this is, like, this whole new, like, “they're not gonna put someone in jail for a pregnancy outcome!” But they already do. And so, this is not new. And, and again, it's gonna disproportionately impact Black and brown people.

Pamela: Right. Right. And then, the tradeoff that, that we're asking…a great example is the case that just, that just happened in Texas, where you had a woman who, or I should say a, a, a person, who was reported by a medical professional. And then you had an overzealous sheriff who, you know, went ahead and, and went outside of the scope of the law. But the reality is that people…they tried very hard, I think, to not have this be a very public situation because there's a lot of stigma, and in, in communities ‘bout what she's accused of versus what she might have actually done. And I, I think that, you know, people who are in marginalized communities are often boxed into corners where they, where they just try to keep it hush, hush, and tried to resolve the situation as best they can, and that…a lot of prosecutors and law enforcement are banking on that.

Jennie: Yeah. I mean, her name was everywhere in, in ways that she probably didn't want.

Pamela: Oh yeah. I can't imagine…you know, I, I live in a small town in, in a…

Jennie: I’m from a small town.

Pamela: Everybody knows everybody. You see everybody in the, in the Walgreens, and in the…yeah, I can’t imagine, just the pressure and, and of having your private, you know, medical decisions being debated, and then also trying to make sure that people are being accurate about your personal business. But amplify that across 30 states, and the threat of being publicly humiliated, the threat of losing the respect of your peers and your community is a part of the oppression that exists when they take away your bodily autonomy.

Jennie: And I think it also plays really big into another thing we know is that a lot of people seeking abortions are already parents. Like, having to negotiate not putting your kids through that. Or like, dealing with, “what will happen to my kids?”

Pamela: Right. When I, um, my previous job was co-founder and co-director of Reproaction, which is an awesome organization I'm still a part of, on their advisory council, and so proud of the work that we did, particularly in Wisconsin, where we ran a campaign, um, to educate people who were vulnerable to enforcement of the Unborn Child Protection Act there. And that is an act that is based on the flawed information we have around drug use in pregnancy. It dates back to the days of the crack baby myth, and it shouldn't be on the books. It shouldn't be enforced. Unfortunately, it is. And, of course, it is enforced in, uh, Milwaukee way more than in other places.

Jennie: Surprise, surprise!

Pamela: Surprise, surprise. And that act is one where, you know, if you, if you go to the hospital or to your doctor to get a pregnancy test to confirm a pregnancy, and you fill out your form intake form and admit on the form, as we're supposed to, that you either use drugs or have recently used drugs, that you have a history of alcohol use, or anything, then again, within discretion, they can, they can report you to the state. The state will have a rapid response, meaning that they call a hearing immediately. They could take you into custody, appoint a lawyer for your fetus, and they run this entire investigation and the court proceedings through the juvenile court system under this act. So, you can't even publicly try to, try to talk about it because of the privacy rules that are in effect. And, you know, there's thousands of cases of people who have been faced with either treatment or incarceration and…have lost their families. As you said, they’re already parents, they lose custody of their children. They lose custody of the child if they carry the pregnancy to term. And, all of this is built on outdated and thoroughly debunked myths because, first of all, people should talk to their doctor about, you know, what medications they're on. And second of all, we know that, you know, people can have very healthy pregnancy outcomes despite being, you know, heavy drug users, or, they just need to make sure that they're being honest in getting medical information and in consultation. And a lot of people don't know about this law until they are sitting there in front of a judge and trying to figure out, you know, who's gonna pick their kids up from school while they're being accused of intentionally trying to harm “the unborn.” And, you know, so it's just a broader example that there are communities in states across this country where people have been criminalized for their pregnancy outcomes and for their, their behavior. And as Lynn Paltrow, who of NAPW, National Advocates for Pregnant Women, often schooled me that, you know, it's about…it's about creating a different class of citizenship for people who are pregnant.

Jennie: Oh, man. I could talk to you about criminalization for so long because it is such a big issue. Um, if our audience wants to learn more, I definitely recommend checking out “Policing the Womb.” It's such a good book. Okay. But we should move on cuz we had other things we wanted to talk about. Yeah.

Pamela: And I can, I can also recommend the documentary, “Personhood,” which is actually based on a case in Wisconsin.

Jennie: Ooh. I have to check that out. I don't think I've seen that one.

Pamela: Check it out! It's really good.

Jennie: Okay. So next, we talked about one area that the fall of Roe would impact, and that's criminalization. And I think we often talk about health, but it…the fall of Roe can have much broader impacts that aren't quite talked about as much. Do you wanna, maybe talk a little bit about that?

Pamela: Absolutely. Absolutely. So, as I mentioned, you know, we, we have really just begun to make some sort of inroads in, in maternal mortality rates and particularly among Black women and people who experience pregnancy, where the rates are four times higher than the general population. And so, for, for my community, you know, being able to determine whether to continue a pregnancy to term or not is a life-or-death decision. And…so, when we think about not having access to a, to abortion and, and potentially, I, I predict also having threats to access to hormonal birth control, what we're really talking about is the…what I like to call the bullet points under bodily autonomy. So, we talk about it, and I often talk to people who don't do this work on a daily basis, under that, it's being able to go to the doctor and find out that you're at high risk for stroke and make a call that will save you from either a catastrophic health outcome or potential death. And that's not, you know, again, not me being dramatic. I personally know people who have had catastrophic pregnancy outcomes, and I taught at a shelter where every single one of my students, 10 women, knew somebody who died or lost an infant. And, you know, it's very real. So that's the first bullet. The second bullet being, you know, being able to space out your pregnancies and also being able to be, you know, the parent that you need to be. As you said, most people who have abortions, um, are already parents. And then, you know, we're also talking about fertility, and, you know, one of the things that I've learned just from the fact that we have chapters all over the world, our fastest growing chapters are in Africa, in South America, and Central America, nothing makes the case for access to abortion and reproductive healthcare, like a lack of access to abortion and reproductive healthcare. So there's a reason why med students in Africa are forming chapter after chapter so that they can get resources and training to advocate for their patients. And it's because, you know, it, it impacts fertility. It impacts, you know, the ability to properly treat fibroids, endometriosis, polycystic issues, and so many issues that impact fertility that, you know, are treatable, but require that you not be pregnant while you're getting treated. We're also talking about, you know, uh, risk and the reality of medicine. And in the United States, hospitals are like their own little city. And they are incredibly risk averse. They have an entire legal team that determines whether or not they can do certain things and they can perform certain things. Most of us are lucky enough to have never had a medical procedure that we need done go before a hospital ethics and liability board. But, I can personally tell you that when it does, and I’ve…had met people who it does, the last place you want your healthcare and your life being determined is in that boardroom. But hospitals are risk averse, so we are already seeing people who are miscarrying being turned away from hospitals and sent back home, when they should be given a procedure that helps ensure that they complete the miscarriage and that they have…that in, ensures their future fertility because, uh, they don't want, they don't wanna risk the liability of getting sued, or criminally charged, or having their license pulled. We've seen cases already. And this is just with Texas and Oklahoma going dark, of people with ectopic pregnancies, having doctors and lawyers and medical ethicists sit around and debate when your life is in danger versus when your fertility's in danger. And I'll go ahead and answer the question. They aren't worried about when the fertility is in danger. They don't want the liability. So, they're worried like, “will, will this patient sue me because I created a, you know, a situation where they no longer will be able to get pregnant, or will I face, you know, losing my license in a series of lawsuits in criminal liability?” which is very different than what we've ever seen in this country. So, the big issue that's been popping up in discussions in my world is about, you know, in vitro fertilization, and the fact that it does, you know, it just doesn't make any logical sense that people would be able to continue in vitro fertilization the same way in a post-Roe world. What that means? I don't know. But, you know, the idea that you can just easily hop around when you're in the middle of, for many people, a many year, long process, pretty daunting. And the, the idea of the State appointing a lawyer for a series of fertilized eggs is also daunting. But as I said, you know, there's precedent for this. And, you know, there's, it's deeply disturbing, but we really could see people having access to certain treatments, and, in people having a certain status of health care based upon their geographic location. And then the broader concern is that for people who are high risk pregnancies, and you know, those of us who are Gen X, you know, know what it's like to have a friend say that they have a geriatric pregnancy. Uh, but for high-risk pregnancy, the having felony penalties around, uh, healthcare decisions means that there's a long-term threat of losing providers who are willing to take high risk pregnancies. I don't know anybody who goes to med school and is comfortable with the idea that their patient might die or have a catastrophic outcome that is completely preventable. Um, so, I have met these physicians or physicians-in-training that the Supreme Court seems so confident are out there. Physicians go, even reluctantly, where they can practice medicine and live up to their ethics and their oath. And, I can't imagine being a high-risk obstetrician in a state that, that doesn't give you the option to do what's right for your patient.

Jennie: Yeah that's pretty horrifying. There are just so many implications and so many things that need to be thought through. I, I've been particularly horrified around some of the conversations that have been happening around ectopic pregnancies, and talking about like, reimplanting…like just like all this bonkers stuff that is not a thing.

Pamela: Not doable.

Jennie: Right. It, it's not a thing. You can't do it. And for a pregnancy that you're not gonna be able to carry.

Pamela: Right. Right. There's a real, kind of bizarre eagerness to experiment with people who are capable of pregnancy that is, is really quite disturbing.

Jennie: That and, like, the “abortion reversal,” and just…y'all, that's with heavy air quotes.

Pamela: Yeah. Heavy, heavy air quotes, and it's just not a thing. And…but you have people who profess to care and profess to, you know, value life, who also are supportive of felony penalties for healthcare providers, but are willing to commit what could essentially be a felony, with like abortion pill reversal. Like, you could hurt somebody. So, yeah, I, it, the whole thing is really macabre, and, and dark, and twisted, but it…you know, I woke up this morning and I, I just couldn't believe this is where we're at. But I'm calling it The Great Regression. So, that's my term for the time and space and era we're about to enter into.

Jennie: That sounds right for so many things like around women repro, like that, kind of…LGBTQ rights, kind of, it feels like too. Like, it just feels like…all of it's gonna be taking a giant step back…and very…

Pamela: Yeah. Potentially, yeah. You know, so many rights rest on the privacy determinants in Roe. It's terrifying.

Jennie:Okay. So…I think this led us really, kind of, neatly to like the next bucket of things that's pretty related, as I think something that a lot of, like, people in the broader movement maybe aren't even…aren't thinking about and definitely not the general public, but I know you've spent a lot of time thinking about. And that's how this is gonna impact abortion bans and, and overturning Roe will impact abortion training and education.

Pamela: Right. Right. So, Medical Students for Choice next year will be celebrating 30 years. And, I came on board January of 2021, but the organization was formed by med students in 1993. So, you know, there's a lot of years worth of data, and research, and surveys that go into, you know, my thoughts on the matter. And, you know, what we do know is that residency programs, which a lot of people conflate residency and med school. Residency programs are the next step after med school. And residency programs are accredited with the expectation they have to either offer abortion training and family planning training and education or connect their residents in an easy, fluid way. If it's not fully integrated into the hospital, then they have to find a way to, to get them that training and education. That's not the case for med schools. And one of the things that Medical Students for Choice has really filled the gap over the years with, is that, you know, it's really hit or miss. It depends on what med school you're at, whether they're religiously affiliated, but for the most part MSFC (Medical Students for Choice) chapters are the way that med students make sure that they're getting the most accurate, up to date, abortion training and family planning training and education, and also how they advocate for curriculum reform within their universities. So, that brings us to the imminent fall of Roe. And if…right now we have not received any guidance to my knowledge on what is going to happen with residency programs that are based in states that are about to ban and criminalize. Will those residency programs lose accreditation? Or will the accrediting body change their accreditation, which is based upon the ACOG (American College of Obstetricians and Gynecologists) standard of care and best practices to meet a purely political and not medically guided ban? So, that is on the table. We don't know. And what we do know is that many of these hospitals are really anchors for their community, and my board, which is 50% med students, the med students on my board have already, in this last round, were ranking residency programs based upon their geographic location and the likelihood that they would be able to easily receive training, or access to opportunities for training in hours in a clinic. So, it's already impacting what, you know, how people rank where they wanna go. The same is true for med schools. And, our first ask is going to be our chapters all over the country. Every single med school are gonna be asking their deans to publicly declare their intention around abortion training and education. I think it it's a bare minimum that they owe to students who are currently enrolled and also to people who are considering them for application that, you know, do you intend to continue abortion training and education or not? MSFC has received legal guidance that, you know, it is protected, particularly because it's speech, we're not actually at the med school level. We don't actually walk people through performing on an actual person. It's on an apparatus. They use the instruments of, but they don't…they have, like, an apparatus that allows for them to see what they would be doing. So, you know, for us, we have the right to train and to educate people on this, particularly because if you're in med school in Georgia, that doesn't mean you're gonna go to residency in Georgia, and that certainly doesn't mean that you're gonna continue to your career in a state. So, our members are deeply concerned about their ability to gain the skills they need to be competitive, but most importantly, to be good physicians. So, we don't know. And I know…what I do know is that the last thing you wanna hear when you're about to spend eight years in a residency program, or when you're about to, you know, spend $250,000, and med school is “we're not sure.”

Jennie: Yeah. I mean, it's…like you said, for good physicians, like it's an important part of their training, but it also just makes me think of, like, this next generation of abortion providers we need to be coming up. Because, while Roe may go down the fight does not end. And there will be abortion access again. We will keep fighting.

Pamela: Exactly. But, like, exactly.

Jennie: If there are all these people who haven't been able to get the education around abortion or skills, like, that's a real setback as well.

Pamela: Right. Right. And, we're working hard with partners at clinics and at med schools in what I'm currently calling, you know, reproductive liberty states, like my state of Illinois, to make sure that people have as much access to training, education. It is, it's a skillset. And so, you, you wanna have the hours in, in the clinic, you wanna be able to do it as possible, but I can't stress enough that even with the wonderful gift that medication abortion is, even with that, people are going to need in-clinic abortion care, either because medication abortion isn't right for them, or because that's the procedure that they need. And, you know, we need to be able to have physicians who have that experience and, and have that skill set. And the other thing that I wanna point out is that, you know, most of our members, lots of our members don't plan to go into obstetrics and gynecology. You know, they either wanna become family medicine practitioners, which is one of my favorite disciplines, and, or, you know, I, I met somebody who, you know, plans to go into podiatry, or something like that. They know that there isn't a single area of medicine that doesn't have to factor in whether or not somebody's pregnant and offer that advice. And each one of my members wants to be able to give medically accurate information, and a lot of them wants to be able to have the skill set to provide if needed and definitely be able to walk their patients through what that's like, whether it's a patient who is, you know, seeking medical support for a pregnancy, or whether it's a patient who thinks they might be pregnant and is about to get their knee surgery done. They want to be able to answer these questions and provide them with, with access and care. And so…it, there's a great unknown. The other thing that I see if, if we don't close this gap and we don't fix this manmade disaster quickly, then it won't take more than 5 to 10 years for us to start seeing, really, a geographic breakdown of access, and, in seeing providers move to where they can go. And that breaks my heart. You know, I grew up in Missouri, what was a purple state and is now deeply red. I spent 15 years of my life fighting for my fellow Missourians and for people who live in marginalized communities, so that this would not happen. You know, I can't even fathom what could happen to a state that's already struggling and already has bad health outcomes when you start thinking that, you know, high quality obstetrics and gynecology is something you travel for. Yeah. It breaks my heart.

Jennie: Yeah. Especially when you look at the map, and so…if you're in like St. Louis, you can travel over the border to Illinois, fairly easy. Where I'm from. I grew up on Wisconsin-Illinois border, so, like, people there can fairly easily travel to Illinois, but like, if you're in Texas or like…you're gonna have huge gaps in the country…Where there's not an easy way to travel, and then you'd have to be able to afford to travel. Like. there's just so many complicating factors.

Pamela:Yeah. Yeah. And it's also, you know, the fact that this decision is being made based on 1700s philosophy and interpretation, that it is being made by people who do not represent the majority of Americans, even though, you know, as a Black, queer woman, I definitely feel that my rights should not be limited by what's popular. But it is incredibly popular.

Jennie: Rights are rights.

Pamela: Right. Rights are rights. And, that we should be, you know, we should be thinking in terms of bodily autonomy and, and precedent. The fact that all of this is about to happen, and the opposition hasn't thought through the consequences is incredibly frustrating, and, you know, they, they're gonna have a parade and celebrate, and we're all gonna be scrambling trying to clean up what is an unbelievable mess. It's like this…. Yeah. It's hard to wrap your head around. And, and obviously I, you know, I'm invested in, in making sure that the harm isn't too great, and I'm invested in making sure that, you know, we support med students however, we need to. Uh, you know, Medical Students for Choice is prepared to send med students to England if we have to, to get access to training. You know, we're not, our mission is not going to change and our work is not gonna change, but it is a damn shame that, that this is where we're at. And, the best example, I was just talking to somebody earlier, the only examples that I can think of are like when, when we passed Prohibition and, you know, it took 10 years to right that wrong. And…the, it changed the landscape of our country radically and for the worse, and, you know, people were incarcerated, people died and, and all of that was avoidable. But, you know, a bunch of people were really happy for about, I think it was like 48 hours before the first illegal beer run was made.

Jennie: Again, being from Wisconsin, lots of the history of that is in my state.

Pamela: Yup. Yup. Yup. I'm from a beer city. So, lots of Prohibition analogies.

Jennie: And I'm sure you can relate. Childhood field trips to a brewery.

Pamela: Oh my goodness. Yes! And then asking, “why can't we do the tasting?”

Jennie: Yes. Uh, okay. That…it's nice to have a nice light note after all of that, uh, seriousness. But we always like to end with an action item. So, is there something that our audience can do?

Pamela: Mm-hmm. Absolutely. The first and most important thing that all of us can do is remember that we are going to organize ourselves through this. This sucks. And I…am, I refuse to let anybody deny the fact that this sucks, that people are gonna be harmed, but that we are gonna organize ourselves through this. And, just remind yourself that we have examples in, in South and Central America, but we also have examples in Ireland that people will organize for justice. And like I said earlier, nothing makes a case for abortion access, like an abortion ban. The second thing is that folks need to reprioritize where their energy, support, and money goes. I have been doing so for the last year, and my number one monthly donation is to the Missouri Abortion Fund. I highly, highly recommend that people set up that monthly donation. Make it something that's a little bit of a stretch, but not too much. But, you know, if everybody who, you know, had a pro-choice button also had a recurring donation to an abortion fund or to the National Network of Abortion Funds, that would make a huge difference. They are doing incredible logistics work. They are really mapped together. The kind of network they're working is inspiring, and we need to fund and support the heck out of it. Yep, yep. Support that fund! Support it! And you can actually find your local fund on the National Network of Abortion Funds. And yeah, I think it, it's a must. Whenever I see somebody with, with pro-abortion paraphernalia, I'm always, like, “you supporting a fund?” Do it! And then the other thing…

Jennie: My rage donating when things happen, and then I have my couple monthly that go to, I think, DC, somewhere in Wisconsin, and then national.

Pamela: Yeah. Yeah. The DC abortion fund is awesome. So, the Missouri abortion fund is near and dear to my heart. And then the other thing is, if you are able, and it logistically makes sense, be a clinic escort. We are about to see the kind of anti-abortion organizing that I grew up watching, but a lot of people who didn't grow up in the 80s might not necessarily be familiar with. But as Midwesterners, we were very familiar with clinic blockades and escalating, menacing behavior, throngs of people that you see outside of clinics in the South, that's what we're gonna see after June. So, you know, be a clinic escort. Be a driver. Be the person who helps drive somebody from the airport to where they're staying. Help the helpers, and, and be prepared to do so going forward. As we look at the rise in, in gas prices and inflation, that impacts our funds and our logistics people. So, we can help that.

Jennie: Oh. I love that. I think this is maybe the first time somebody has talked about escorting. So, very important. And, you're right. Like I can remember…I mean, my origin story starts with somebody actually inviting me to go protest at a clinic in Madison…cuz I went to Catholic school.

Pamela: Ah.

Jennie: Uh, when I was, when I was little. Obviously I did not go. My mom helped me think through the implications of that.

Pamela: There you go.

Jennie: But yeah, I, I remember that. I remember seeing the people on campus when I was in college at the University of Wisconsin, like…

Pamela: Yeah. Yep. It's something. And I often, if, if anybody ever asks me, like, “how do, how do you step your toe into politics in this movement?” I always tell them…I tell the med students to do, at least do the training. If you, if you don't do anything, go to your state capital, and do a lobby day because nothing, nothing will kill imposter syndrome like actually going to state and local government and realizing, “whoa, this is, these people are making sausage.” The other thing is to do the clinic escorting and do the training at the bare minimum, but if you've done a day of escorting, you have, you will talk about this movement in abortion access in a completely different way.

Jennie: Well, Pamela, thank you so much for being here. I had so much fun talking to you!

Pamela: This has really been a pleasure and thank you for your work and for this opportunity.

Jennie: Okay, y'all. I hope you enjoyed my conversation with Pamela. I had a wonderful time talking to her. It was a really great conversation. If you all have any questions or anything you would like us to talk about, you can always reach out to me at Jennie and that's J-E-N-N-I-E@reprosfightback.com, or you can reach out to us on social media. I'm @JennieinDC on Twitter, or you can find RePROs Fight Back at @reprosfightback on Facebook and Twitter and @reprosfb on Instagram. And with that, I will see y'all in two weeks, unless we need an emergency episode sooner. For more information, including show notes from this episode and previous episodes, please visit us at our website at reprosfightback.com. You can also find us on Facebook and Twitter at @reprosfightback and on Instagram at @reprosfb. If you like our show, please help others find it by sharing it with your friends, and please rate and review us on Apple Podcasts. Thanks for listening.

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