Abortion-rights advocates are intensifying efforts to make it easier for women to get abortions amid a new wave of state-level bans and restrictions expected to occur under a reconfigured U.S. Supreme Court.
The efforts include boosting financial aid for women needing to travel long distances to get an abortion, and raising awareness about the option of do-it-yourself abortions.
The sense of urgency stems from the retirement of Supreme Court Justice Anthony Kennedy, who sometimes provided the decisive vote in support of abortion rights, and the possibility that Brett Kavanaugh, nominated by President Donald Trump to replace him, would give the court an anti-abortion majority.
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Advocates anticipate new limits on abortion access in red states that are emboldened by the prospect of a more solidly conservative court. The Republican-led states want more latitude in the courts to impose far-reaching abortion restrictions while hoping that a lawsuit on the issue makes its way to the Supreme Court and is the case that ultimately overturns Roe v. Wade — the 1973 establishing a nationwide right to abortion.
Yamani Hernandez, executive director of the National Network of Abortion Funds, said that since Kennedy's retirement announcement on June 27, there has been a surge of donations to help the network assist low-income women in paying for their abortions. There are 70 funds in 38 states, currently assisting about one-fifth of the 150,000 women who inquire about assistance each year.
"Without a doubt we're moving into a bleaker time," Hernandez said. "People who haven't been paying attention are realizing what is at stake, and wanting to get involved."
If Roe were overturned, abortion-rights advocates anticipate that 20 or more states would ban most abortions. Women in those states might face long and costly interstate journeys to reach an abortion provider, or they could avail themselves of information about how to self-induce an abortion.
The two main abortion-inducing drugs, mifepristone and misoprostol, are legally available only through authorized medical professionals in the U.S., and numerous states have placed restrictions on medical abortions. In many places abroad, misoprostol is widely available, even over the counter in pharmacies in some countries, and has been used extensively for self-induced abortions in countries such as Brazil that have restrictive laws.
For American women, the most likely means of obtaining misoprostol is via an online purchase from a foreign provider. That method is considered difficult to prevent, even in states with laws explicitly banning self-induced abortion.
A 2-year-old California-based organization, the Self-Inducted Abortion Legal Team, is expanding its operations this summer, convinced that the ongoing push for tougher abortion restrictions will prompt more women to consider the self-induced option.
Jill Adams, the team's founder and chief strategist, said a top priority is to provide legal advice and support for any women who face possible prosecution for do-it-yourself abortions. Her group plans to launch a help line this fall that will provide callers with basic advice and, if warranted, connect them with an attorney in their area.
Her team and its allies are advocating that states avoid such prosecutions, a goal recently backed by two major medical associations.
Dr. Jamila Perritt, a Washington, D.C.-based obstetrician-gynecologist who provides abortions, says she has counseled some women who opted for self-induced abortions, and is grateful that they now have relatively safe and effective means of doing that, thanks to the abortion pill.
"Whatever happens with the Supreme Court, there are safer options now that we didn't have 40 years ago," she said.
Anti-abortion leaders are troubled by the positive talk about self-induced abortion.
"This kind of effort is dangerous and highly irresponsible," said Carol Tobias, president of the National Right to Life Committee. She evoked the potential difficulties of women who used that method and then suffered serious side effects.
Tobias said her organization does not favor criminal action against women who self-abort, and instead would prefer targeting those who make the medicine available.
Many of the abortion-related topics now being discussed in the context of the Supreme Court vacancy will be summarized in a book being written by journalist and activist Robin Marty, titled "Handbook for a Post-Roe America." It is scheduled for publication on Jan. 22, the 46th anniversary of the Roe v. Wade decision.
Marty describes the book as "a step-by-step guide explaining what any person can do once abortion becomes illegal or inaccessible in the U.S." It covers possible legislative action, ways of supporting women who need to cross state lines for abortions, and the key factors involved in considering a self-induced abortion.
"The internet will be a great way to find information, but it's a double-edged sword because it leaves a trail," Marty said. "How do you access these things online without being able to be tracked?"