Two Months Post-Roe: What Does Abortion Access Look Like in the U.S.?

With the landscape of abortion access changing almost daily in the United States, hundreds of thousands of people are not receiving the basic healthcare they need. Danika Severino Wynn, midwife and VP of Abortion Access with Planned Parenthood Federation of America, talks to us about the current state of abortion access in the U.S. and how different states and communities are disproportionately feeling the harm of restrictions and bans.

It may come as no surprise, but in states where abortion bans are already in place, abortion care is extremely difficult to access. Many are having to piece together information about how and where to receive care before driving or flying out-of-state. At the same time, purposeful misinformation is pushed by anti-abortion advocates and politicians in order to shame and confuse patients. In states where abortion hasn’t been banned, providers, clinics, and abortion funds are having to overextend their capacity to provide care and support for those traveling from out-of-state. This results in longer wait times for appointments, which is particularly troubling for time-sensitive abortion care.

Other sexual and reproductive healthcare is being impacted by these bans, as well. In states where abortion is severely restricted or banned, Planned Parenthood is still on-the-ground and providing a range of sexual and reproductive health care, including birth control prescriptions, cancer screenings, STI testing/screening, and more. In states where abortion is still legal and are seeing increased volume of patients, there are some increased wait times for services, but don’t worry-- Planned Parenthood is still working diligently to ensure appointments are scheduled and kept.

Links from this episode

Planned Parenthood Federation of America on Twitter
Planned Parenthood Federation of America on Facebook
Plan C
Abortionfinder.org
Ineedana.com
Repro Legal Helpline
Repro Legal Defense Fund
Digital Defense Fund

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: Welcome to this week's episode of rePROs Fight Back. I'm your host, Jennie Wetter, and my pronouns are she/her. So before we get started, let's do a little bit of quick housekeeping. I feel like it's been a little bit since we've done anything like that. So just like a really quick one. So if you love the podcast, it would be really amazing if you can make sure that you are subscribed or follow or whatever the action is on your favorite podcast to make sure that you are getting all of our episodes when they come out. You never know if there's a bonus episode that comes out. So it's good to be subscribed so you get alerted when they come out. And if you love the podcast, it would be really helpful. If you could make sure to rate the podcast and write review, if your favorite podcast does that, it helps other people find it. And it's always good for feedback for us to know what you're thinking of the podcast. So if you could take a minute to subscribe, rate and review, that would be amazing. Okay. That's all see really super quick. Housekeeping…let's see. Right now, it has been delightful in DC. I have to say, August is generally just pretty miserable, like super humid and hot. And like, as soon as I would go outside, I would start sweating and it has not been like that recently. It has been really, really delightful. I've had my windows open. The kitties are happy sitting in the windows. It's been nice to go outside, which in August isn't usually the case. So it has been lovely. I hope it stays this way. I feel like that's not gonna be true though. It's like, it's not going to, but I am enjoying it while it lasts. So that’s super fun. Let's see what else has been going on? Oh, so recently, Rachel, who does the website and does all of the social for the podcast and you know, all of that amazing stuff, who I could not do the podcast without, has wanted a picture for something that we have coming soon, of one of the cats with one of the many amazing abortion fund t-shirts I bought recently. So, I had been having to work with Cinder, she's generally the most amenable to something like that, to try to get her picture taken with. And you'll, I'll have to share some of the outtakes because they're pretty funny. Like she was having none of it. She did not enjoy this game. She was not amused. And, uh, it, it took a while for us to get a good picture. I finally got one, I got a couple, she was finally able to do it after a couple days. And, uh, the final picture was really good, but, uh, man, there's some pretty funny outtakes where she is really annoyed and not amused by this game. It was just really funny. They're pretty hilarious.

Jennie: Let's see what else I have been, you know, with everything around abortion that's happening, you know, work has been pretty stressful as I'm sure you can guess. There's obviously just been a lot going on. And so I've been really looking for my time off of work to be really chill and low key and just trying to do stress relief. So one of my things I do is, you know, I've talked about, I do baking and I've still been doing a lot of baking and I really still enjoy that. It's been really nice to, you know, bake. I've been doing Sunday bakes during the pandemic. And so, you know, making on Sunday, what I'm gonna eat for breakfast for the rest of the week has been really delightful and something that I will probably carry on once life gets back to complete normal. And so that's been delightful, but I've also been doing a lot of reading and I'm sure I've talked about it on the podcast, plenty of times, that I'm a huge reader and a giant book nerd. And my reading generally spans… it’s pretty wide ranging. Like I'll read all sorts of different topics, like a mystery, non-fiction ,like fantasy, young adult, romance. Like true, no, not generally true crime, but like, you know, detective thrillers are like just all over the place, right? Like, but because things have been so stressful, I have been really, nothing has been making me as happy as reading like new contemporary romance. It is been my happy place and like the level of stress I can handle. Right? A lot of the other things… books can be stressful at times, but this like a romance, you know, it's gonna have a happy ending. So like that is where I have been at. And that has been what has making me happy recently. So if you have any good suggestions for books, I should check out, let me know. I have been reading a lot of fun ones. You can find my books and baking Instagram on AllBooksAndBread. That's where I talk about what I'm reading or what I'm baking. Yeah. So that's fun. And so, yeah, I would love to hear any recommendations y'all have, but that, I guess let's turn to this week's interview. I'm really excited for this one. We talk about kind of the state of abortion access right now and where we're at with people trying to access care and what it looks like on the ground. And so to do that, I'm just really excited to have Danika Severino Wynn, with Planned Parenthood on to talk about what everything looks like right now on the ground. And it was a really important conversation. And I'm glad that we are able to talk about not just the states where it's banned, but how it is also impacting states, where it's not banned and what it looks like to access care in those states right now. So with that, let's turn to my interview with Danika.

Jennie: Hi Danika. Thank you so much for being here today.

Danika: Hi Jennie. Thank you for having me glad to be here.

Jennie: Before we get started. Do you wanna take a second and introduce yourself and include your pronouns?

Danika: Sure. My name is Danika Severino Wynn. Is she/her pronouns? I'm the VP of Abortion Access with PPFA. I'm also a midwife providing gynecological and sexual healthcare across the spectrum, including medication abortion.

Jennie: Oh, wonderful. I'm really glad to have you on today. I feel like there's just been so much happening so fast that it's really hard for people to keep up with where the state of everything is right now. So maybe we should start there. There have been a lot of new abortion bans that have gone into effect or are going into effect. Can we talk a little bit about like what has happened recently?

Danika: Yeah, absolutely. Let me give you the state of play. Cause it is incredibly confusing. It's confusing for us. I can't even imagine how confusing it's for people seeking abortion care. So I'll give you some bottom lines here. So…

Jennie: …And like maybe we should flag that we're recording this on August 17th, just because things could change between now and when it comes out.

Danika: Absolutely. Thank you for saying that. So yeah, we're in the middle of an unprecedented national health crisis, for sure. We're seeing chaos and confusion and anti-abortion politicians absolutely aimed to create that. Right now, we have ongoing active litigation on state abortion bans in 18 states. As of now, 16 states have abortion bans in effect more are expected to take effect in the coming dates and weeks; the national abortion access map is changing so frequently. It's really hard to keep up, unfortunately, and this means that hundreds of thousands of people can no longer access the abortion care they need and deserve. So bottom line, the decision in the Dobbs v. Jackson Women's Health case really robbed us of our right to control our bodies and personal healthcare decisions and really gave those decision-making powers to lawmakers and leaving many, many of us without access to safe, legal abortion.

Jennie: Yeah. It's been, um, like you said, hard to keep up with and just really, I just find it really scary. Just like thinking about where things are going. You know, there was a lot I was prepared for and man, just seeing the way the conversations have turned, like some of the conversations that have been had and things that were, have been said out loud by the antis. Like I, I just didn't think they would say kind of what we all knew like out loud.

Danika: I think that's been horrifying and enlightening to see, right? Yeah. It's like all the stuff that was hidden is just really coming out now they're emboldened more than ever, you know, I, I think people need to take them at their word. There's no hiding anymore. They've made very clear that this is a war on reproductive health and that abortion is just part of the plot line. Right? There are more attacks to come. And I think this is also really a time where we are seeing what intersectionality means all the time. Right? This is not just about abortion. It's not just about healthcare. In fact, it's about voting rights. It's about housing security. It's about being supportive of communities that have been marginalized for years or not being supportive of them to be very clear. And we're seeing really… white supremacy in action and it's terrifying.

Jennie: Yeah. Yeah, absolutely. So maybe we should talk a little bit about, okay. So now that these bans are in effect, what does abortion access look like? And maybe we'll divide it into like a couple buckets. So in states where there are already bans in place, like what does accessing abortion look like there?

Danika: In states where there are bans in place? It is incredibly challenging to be able to, first of all, figure out where you can get an abortion, figure out how you can get an abortion and then actually be able to travel and have the logistical support that you need to get out of your state for care. In some states where we have a six week ban in effect, people are able to maybe get a little bit of information they need before they have to leave the state. But let's remember that somebody who is six weeks pregnant have their last period six weeks ago. And therefore, maybe only found out a week ago that they're pregnant. Maybe they have no idea yet, especially if they have irregular cycles and don't always get a period on time. So oftentimes these folks are already too late by the time they even have a positive pregnancy test to seek out care in state. Um, we know that the support for navigation and way finding for patients to help them figure out where to go for care and how to get there is crucially important right now. And that is something that we see as a way that we can really step in and support patients to get what they need. So we are really trying to beef up those resources at Planned Parenthood and work in collaboration with our partners across the abortion ecosystem, to make sure that folks are able to access an appointment as quickly as possible when they decide they need one.

Jennie: Yeah. I feel like information is like the really big, important gap to fill right now. And the antis I'm sure are trying to fill it with so much misinformation that it's really important that people are getting trusted information.

Danika: Yes. And we see that with medication abortion as one example, right? We've always, you know, for a while we've heard talks about “medication abortion reversal” or how harmful abortion is just broadly. And I think pushing back and really being proactive in our messaging about the incredibly safe evidence there is for safety rather about medication abortion and abortion writ large needs to get out there. This is a very common, very safe procedure, putting barriers and trying to prevent people from accessing this normal part of healthcare is quite frankly insane. It really is disallowing folks to have agency over their bodies and over their livelihoods.

Jennie: Absolutely. And being really clear that “abortion reversal” is not a thing.

Danika: It is not real, just not a thing. I mean the newest, I think line of attacks have been really pushing around ectopic pregnancies and have caused such concern for pregnant people everywhere because they are worried that if they needed lifesaving care from an ectopic pregnancy, which is a pregnancy that occurs outside of the uterus, it's rare, but it's deadly, and you need to act fast when it's found. And so there is this kind of line of thought that's being pushed by the antis that you can take a pregnancy from outside of the uterus and put it back in and everything's gonna be okay. The human body is not that simple. That is not how it works. An ectopic pregnancy will never be a viable pregnancy, never, ever full stop and it can kill someone. And so this type of incredibly irresponsible misinformation that's being spread is dangerous to people's lives. I can't underscore that enough. It is dangerous and we're seeing it play out and it's, it's just horrific. And I wish more people understood really what was at stake here.

Jennie: Yeah. And I think this really goes in line with the anti talking point that like abortion is never needed to save a pregnant person's life or health. And like that's blatantly not true, but like that's by them arguing that they could do this magic right? Thing that doesn't exist. They can keep arguing that. And, but that's not true.

Danika: Right. And I think we've seen in politics over the past several years, over many, many years, if we're honest, you know, true, doesn't always matter. People put out the language and the misinformation that helps them win and helps them be successful. Even if it's a bold face lie. And that's most certainly what you know, anything about abortion, not being lifesaving is all about. There are many examples of where abortions save a people's lives and that can be physically, that can be mentally and emotionally. That can be financially. It's all of those things. But most certainly there are incredible medical implications. Pregnancy can be exceedingly dangerous for people. We know that we've seen our horrific maternal mortality and morbidity statistics across this country. And we've seen those disparities and we know who is suffering more from those disparities. Yet we continue to push that continuing of pregnancy is the best option and the right way forward. I cannot reconcile those two things. I'm sure many people have a struggle there, but that continues to be the narrative that's pushed.

Jennie: And I also hate that like so much of the conversation feels like it has to be around... I don't wanna say extreme examples, but like the examples where somebody is going to die. And while like those are important, but like somebody needing an abortion because it's not the right time to have a child for them right now. Like that's a valid reason. And like we should be fighting just as hard for those. And I really hate that. So often the stories that are getting covered are like the like “good” abortions. And I really hate that. That keeps kind of being portrayed as, as it often does with the media.

Danika: Yeah. That stigma, right. That stigma is there, that there is a right and a wrong reason to have an abortion or there is a right or wrong reason to have more than one abortion. What we really need to focus on is that the only person who gets to make those decisions and the only person who has to justify them to themselves is the person doing it. And there is no good reason that we should say that people should have limited or no access to abortion care. It's just, you know, other countries have gone through struggles with this and have come out the other side and recognized abortion as healthcare. And there are some that never even questioned it because again, abortion is healthcare. I can't say it enough. So I agree with you entirely. No one should have to justify their abortion. There's no bad reason to have an abortion. There's no good reason to have an abortion. An abortion is just part of the normal reproductive health cycle that we have. We get to decide when our bodies become pregnant and when they don't, full stop.

Jennie: So, you know, a lot of the focus on abortion bans is obviously on the states where there is a ban, but it has ripple effects, right? Like if one state bans abortion, we already saw with Texas, right? The people are gonna go somewhere else to get access. So what are some of the effects we're seeing in states where abortion hasn't been banned?

Danika: Yeah. This is a great question. It's where we spent a lot of time preparing and how we continue to work really closely with these places. I mean, first there is not a way in such a short amount of time and really maybe ever for half the states to handle the other half of the state's volume of folks needing abortion care. And what that means is that we see increasing amounts of patients seeking care in states that have maintained access, which then in turn means longer wait times and potentially pushes people out further and further away from their homes to be able to get access to care. And another big worry is, it makes it take longer for people to get care. And then they're pushed out further and further into their pregnancies to be able to access abortion. I think it's really important to put yourself in a pregnant person's shoes. If somebody has decided that they cannot continue to be pregnant for whatever reason it is every day, they are waiting to end that pregnancy for feels like years, you know, like that, that can be incredibly challenging and it can also increase danger if that person has health conditions that make that pregnancy unsafe for them. And so we are trying to think through how we can support our affiliates in expanding out their access. So doing things such as increasing access to abortion pills by mail in states that it's allowed so that the patients in state that have access to that service, if that's something that they're interested in can choose that. And don't even have to go into the health center, which opens up access for other patients who are traveling in from out of state or who need that care or desire that care in the health centers. It's also making sure that we have the providers needed to ramp up our ability to see more patients. You know, we are in increasingly, like I was mentioning before, also investing in patient navigation. So abortion patient navigators, actual people in our health centers who are able to do the high touch support that some of our most vulnerable patients might need to get to care. So booking hotels, helping them with travel costs, seeing if they need funding to help pay for their abortion and making sure they have those connections, doing the education. It takes a lot of time, but it's so crucially important for people who have to travel long distances to be able to have that support, to figure out how to get to care in a place where they may have never been before and overcome so many of the barriers that we know people face. And then also just thinking more about what are the educational opportunities, what are the needs for, you know, a synchronous education outside of calling somebody in the health center? What about our chat text on our website? How can we bolster that up to provide more support to patients so that if they're searching for information about an abortion, they have somebody that they can talk to, to dig a little bit deeper and get the right referral. So we're working at multiple angles to try to do all we can to support these folks.

Jennie: Yeah. I just think like when Texas first had their six week ban and seeing like how that impacted the surrounding states and people trying to access care and now thinking of how that is vastly expanded to so many other states, like the system just isn't equipped to take up all of those people traveling.

Danika: Yeah. And that's right. And I think that it's incredibly hard for, I think, especially from the provider angle to think about that, right? To know that this is my life's work, this is the job that I love doing. And I know that I'm not gonna be able to serve all of the people who need me right now. That's incredibly hard. I think additionally, when we consider what it means for our future state, what does it look like moving forward? I think we'll, you know, time will tell, but are we gonna see more and more people who have carried pregnancies that they didn't plan to or didn't want to, or couldn't are we going to see an increase in maternal mortality? I think research has shown that yes, we probably will. We're also going to see many more patients turning to self-managing their abortion, which I think, you know, the one maybe silver lining here is that different from before the times of Roe v. Wade, we now have abortion pills, which is a very safe and effective way to end a pregnancy in the privacy of your own home. And so while, you know, we want people to access safe, legal abortion. We want them to access it wherever they choose, including in a health center-- for some folks that might not be an option-- and this might be the next best thing for them. And so we wanna make sure that we have the systems in place too, to make it as safe for them as possible, make sure that they have a place to go to if they have questions before, during, or after the process and make sure that they don't feel stigmatized.

Jennie: Yeah. This just feels like, you know, connecting two of the points we talked about earlier, like abortion is healthcare. You should be able to access healthcare easily and in your neighborhood. And this is just, I, I, to me, it's just so devastating. And like, there are people who will be able to travel, who will be able to get the support to travel, but there are people who won't be able to do that. And like that is just to me, it breaks my heart. And like, I can't focus on that part because like, it, it's paralyzing to just think of all of those people who need this access to care and aren't gonna be able to get it.

Danika: Yeah, it's paralyzing. And I would also just draw line too to the fact that while abortion was legal, everywhere, previously, there was still a deep, deep divide between legality and access in many places. And that was especially felt in marginalized communities where maybe there was availability of abortion in terms of the legal right. But we had big swath of the country that didn't have access to providers, where the cost made it prohibitive for many, many people to access the care, being underinsured, being uninsured, these things all made a big difference. So for some people let's be really clear, this didn't change too much. Right?

Jennie: For sure.

Danika: But what I think it does is spotlight the problem. It, it forces us to think bigger and bold about how we resource people and communities to be able to access the full spectrum of reproductive healthcare that they need. It really allows us to think about what the barriers were before, what they still are and forces us as a country to meet their needs in a different way. And to continue to fight back. You know, we have successfully blocked laws in five states so far, we're going to continue to keep fighting litigation is part of the strategy. But we saw, for example, Kansas, with a ballot initiative, you know, amazing little glimmers of hope will think about constitutional amendments, pushing for proactive legislation where we can expand access whenever possible. Really all options are on the table. All options are on the table at this point.

Jennie: I see it. I try to see it as an opportunity to build everything back stronger and better and more just…

Danika: Yeah, it's so hard to think of a crisis as an opportunity, but I think that is exactly the sentiment that I am trying to take here. Yeah. It was broken before. And now that we're, you know, kind of in this horrific situation, how can we look at that and make a plan to push forward and redesign a world that looks different? I think we can see that in many different parts of the American political scene right now, where do we have opportunity to grow and fight and come back stronger? So I am trying to do my best to think of it that way. It's really painful to think that we are almost at a year of SB8 in Texas being in effect and to know what a dramatic impact that has had on the people of Texas. And to know that we don't even know how much of an impact it's had, right. Because people have been so frightened and kind of driven to hide their decision making because of fear of pregnancy criminalization.

Jennie: Yeah. That all feels completely right. Right. Like seeing it as an opportunity, but like the middle, middle, the gap of the people who had always fallen outside of the system to access care, even when it was legal. And now all of the people who are being impacted until we get to the place where it's better, it's, it's hard to like reconcile the two, cuz like again, not powerlessness cuz we, we have a lot of power, right? We've already seen ways that people are fighting back. But just thinking of all of the people who aren't able to access basic healthcare to me is just heartbreaking. And I really, it's really hard to think about all of the people who need care now while talking about building it back in a stronger, more, just way. Holding those two things at the same time.

Danika: Yeah. Feels really hard. And I think we continue to try to remember the ways that we do have agency and we do have power and try to encourage and empower others to step into that. So just thinking of some things that listeners might do to try to help and to try to fight back, write letters to the editors of your local newspapers or your favorite newspaper about why they support abortion access, visit our site bansoff.org, where you can learn more about how to fight back or text access- a ACCESS to 22422. Invite folks that you know, or yourself to speak up using a hashtag, whatever the reason, on social media or sharing your story at together.plannedparenthood.org. There is power in storytelling and it really helps to reduce stigma. So we wanna truly encourage people to think about doing that. And then if you are able, donating to PPFA and to abortion funds who are really helping close the gap for people who are seeking out care would be a great use of your money.

Jennie: Yes. Always love having actions that people can take. You know, I had one more thing that I have been thinking about and you know, there's a lot of focus rightfully on abortion, but I can also assume that this is impacting other access to sexual and reproductive healthcare. How is other sexual reproductive healthcare services being impacted by these bans?

Danika: Yeah, we are doing our best to minimize any impact to the other services. We of course still want people to be able to access the preventative healthcare, the birth control, the cancer screenings, all of the other things that Planned Parenthood needs at the same time as they have increased access to abortion in states where it's still legal. So a couple of things, there in the states where abortion is severely restricted or banned, Planned Parented health centers are committed to providing patients with necessary information and resources to access care in other states, but also will still remain there and in place to provide sexual and reproductive healthcare. So they're still providing those services. I think in the states where they're increasing access to see more abortion patients, in some places we're seeing some longer wait times for other services, but like I said, we are working diligently to prevent that from happening whenever possible, people are still exceptionally committed to making sure that the folks who rely on Planned Parenthood for all types of healthcare are still able to get into see their providers of choice in their local communities.

Jennie: Yeah. It just felt really important to talk about that part cuz I, it, it's just not, I feel like as big a part of the abortion conversation as we're having, and it's really important that people know that they can still access those other services.

Danika: Yes. Thank you for saying that. And I think it's also important to point out here that we have independent, uh, provider colleagues who provide abortion care in these states where they've kept access as well. Working really hard also to ramp up care. So I don't ever wanna portray it that Planned Parenthood is the only abortion provider and some of those folks also provide other reproductive healthcare services. So I think it's really crucial just to make sure that folks know that if they are seeking out care, abortionfinder.org is a great place to go, to see kind of a full spectrum of where they can access services for abortion. And we also have information about abortionfinder.org on our PPFA website as well. So if people go to search for appointment, they'll get information about that. They'll also see information about a great site called Plan C, which is an organization that provides information about accessing abortion pills. And so we just really want folks to feel empowered and know all of their options.

Jennie: And again, so important in this time when disinformation is going to be rampant. And you'll, you wanna make sure you're going to a real clinic that you can trust and not a crisis pregnancy center, right? Or you're getting pills you can trust. It's really important to use these trusted resources.

Danika: Absolutely.

Jennie: Well, I mean, we already hit the last question of what the audience can do. So Danica, thank you so much. I really enjoyed our conversation today.

Danika: Thank you for having me and thank you for bringing light to this issue. It's it's really important that everybody gets to hear about it.

Jennie: Thanks for listening everyone. And we'll see you on our next episode of RePROS Fight Back. For more information, including show notes from this episode and previous episodes, please visit our website at reprosfightback.com. You can also find us on Facebook and Twitter at RePROS Fight Back, or on Instagram at reprosfb. If you like our show, please help others find it by sharing it with your friends and subscribing, rating and reviewing us on iTunes. Thanks for listening.

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