Posted by: Allyson | August 18, 2008

Contraceptive Choice and Class

Right before the HHS proposal debacle occurred, I wrote a post about how fortunate I was that I could afford to see a gynecologist of my own choosing, even though the health center was not within my insurance network.  In recent weeks, concerns about choice, and who can afford choice, have become much more pressing.  Over the weekend, Amie Newman wrote an excellent post for RH Reality Check on the subject.

In my post about insurance and gynecological exams, I expressed a new interest in researching the issue of government-funded healthcare, to make sure that women who could not afford insurance had access to chocies about reproductive healthcare.  But having socialized medicine would not help women if the HHS proposal were put into place, because this proposal allows medical organizations that receive federal funding to deny women access to contraceptives.  If this proposal were in place, supposedly progressive notion of state-sponsored healthcare would leave women with even fewer choices than they had before.  That’s one of the scariest aspects of this proposal; put in conjunction with a more liberal idea, it becomes all the more powerful, pervasive, and restrictive.  Yes, I’m sure that pro-choice doctors would still exist.  They’re not going to disappear if the HHS proposal goes into effect.  But if all medical care is sponsored by the state, then many women would be stuck trying to obtain birth control pills or an IUD, because she had no legal or financial recourse. 

Of course, as I’ve written elsewhere, there are many women who are already stuck.  Those who live in rural areas may not be able to travel far enough to find a pro-choice doctor.  They may not have a car.  They may not be able to afford the abortion, and they may not have a pro-choice friend who is able to lend money.  I know that the time in my life when I was most terrified of an accidental pregnancy was when I was a broke college student with no car and living 60 miles from the nearest abortion clinic.  I admit that I was still better off than many women; I could have found a friend with a car to drive me, and I could have scraped together the money by borrowing from a wealthy friend or even taking out another student loan.  But I still had that fear of whether or not I’d be able to find a ride or get the loan.  Fortunately, my fears were never realized.  Yet there are other women who are not going to be so lucky.

And so now I find myself in a different sort of planning mode.  I can write letters and blog posts and sign petitions and protest and march in order to convince legislators and other relevant parties that abortion is not contraception, and that contraception should be available and affordable to all women who ask for it.  But what happens if the worst case scenario comes through, and this legislation passes?  What if women’s access to contraception experiences yet another roadblock?

My partner and I had a debate (okay, we had an argument) about this last week.  His position is that doctors should have conscience rights protected (for the record, he’s pro-choice, he just thinks that doctors have choices as well, which set the ground for the discussion disagreement).  I say that’s fine if you’re a woman who can afford to look elsewhere, but it doesn’t protect women who live in rural areas, and it doesn’t protect low-income women.  He took the perspective of “Well, those women are out of luck.”  At least he didn’t try to tell me that they should move to an urban area/get a better job/etc.  Then he challenged me to think of a way to help them without interfering with physician choice – apparently, the onus is on the person who thinks all women should have access to contraception.  (To be clear: my partner is pro-choice.  I think his perspective is coming from the fact that he has never had to worry about how to obtain or pay for an abortion.  I’m not saying that men cannot possibly understand this perspective.  I am saying that in this particular case, his view comes from the fact that he has never had to worry about an unexpected pregnancy, or at least, he has never had to worry about how to obtain/pay for one for me or any other significant other should the need arise.  I know that there are men out there who understand my perspective, though.)

Anyway, I realized that yes, the burden is on me (and other pro-choice activists) to make sure that all women have access to birth control, because we are the only people willing to be accountable to do so.  Okay, I had knowledge of this fact before, but it didn’t quite resonate with me until last week that even many pro-choice people are not willing to help women get they access they deserve to contraception.

It seems to me that it’s getting harder and harder to bring contraception and abortion to women.  So the only solution that I can see is to bring it to them.  That might mean spending a few days hosting a woman from a rural area, who takes a Greyhound into the city to find an abortion.  That might mean spending a Saturday picking up a woman who does not have a car, but lives outside the city where there isn’t reliable bus service.  Providing a ride, a place to stay; these are what many women need (in addition to money).  And, if you can afford it, pay for another woman’s abortion, just because she can’t.  And I don’t mean just helping your friends.  I mean starting/joining a network to help people you barely know or don’t know at all.  Get the word out even to rural areas, that there are women out there who are willing to give their time to give you a ride or a safe space to rest.  Set up a database of women willing to provide rides (although find a way to make sure that your basic troll couldn’t find out personal contact information just by cruising a website).  Even set up a donation pool, to try to help women pay for their abortions.

In my head, this sounds a little crazy – there’s no way that we could get the word out, there’s no way we could keep the volunteers safe from harassers, there’s no way that we could get women to volunteer.  But I know that’s not true.  Yes, it would be difficult to set up an organization and get it running.  Yes, it would be difficult to publicize.  But I also know that there are women who would take advantage of the help such an organization could offer.  And yes, it would be difficult to protect volunteers, but it can be done if we’re committed to safety.  And OF COURSE I could find volunteers to help.  I’m certainly not the only person who has thought of how difficult it must be for women to find a pro-choice gynecologist.  Furthermore, I am probably not the first person to come up with this idea.  With a little research, I’m sure I could find a similar organization.  Talking to them might yield some advice.

So yes, it sounds difficult to bring women to places where they can find the healthcare they need.  And no, it doesn’t solve the problem of the restrictions on reproductive choice, and it doesn’t really touch the issue of making contraception and abortion more affordable.  But it’s a way to help women with nowhere else to go actually find a place they can go.  I think this is an idea worth pursuing, especially to see what sorts of similar organizations/services are out there.

Crossposted at This is What a Feminist Blogs Like.


  1. Okay, so I’m really glad I read this for several reasons. Firstly, I’ve been cooking up a post on the pros and cons of H.R. 676, a bill that would provide universal healthcare to all Americans. I had thought about the issue of access for folks with low income, but it hadn’t occurred to me what kind of damage a state controlled system could do if sweeping anti-choice legislation is ever passed. Needless to say, I will be taking that into account when I revise the post.

    Secondly, I think the volunteer network is a great, if somewhat delicate, idea. I wonder if the best way to begin something like this is to go to local pro-choice clinics and get them involved. They could keep a list of those willing to volunteer money, transportation, etc., and if women in need call looking for services, the clinic could provide them with the phone number of a volunteer. Just brainstorming…

  2. “They could keep a list of those willing to volunteer money, transportation, etc., and if women in need call looking for services, the clinic could provide them with the phone number of a volunteer. Just brainstorming…”

    IIRC, this approach was successfully utilized by ‘Jane’, the underground abortion service network during the pre-Roe days. More about Jane at

  3. Earlgreyrooibos,
    Did you know that the National Network of Abortion Funds is working on this right now? They’re in the planning stages of putting together a practical support network to do exactly what you’ve described — get women the transportation, lodging, and other practical things that they need to get to providers. In fact, many abortion funds around the country already provide these services.
    If you’re interested in becoming involved, send me an email.

  4. Also, another helpful resource, is the Abortion Access Project, an organization specifically tailored to strategically address access for low-income women and women in rural areas. They have an initiative going on right now to work with rural doctors in order to strengthen their abilities to provide reproductive options for women.
    Hopefully there will be a day when no one has to worry about paying for or having access to abortion or quality reproductive health care.

  5. Erin –

    Thanks for the note! I did not know about that, but it’s great that it’s happening. I will definitely contact you.

  6. PS – I am so stoked about this post being featured at Feministing! *waves to Feministing readers*

    There is some good discussion going on over there. My Feministing account is screwed up, so don’t think I’m snubbing them! For some reason, the site just doesn’t think I’m logged in.

  7. Well, the good news is that you are not alone in your concerns; the bad news is that there is a lot of work to do! The National Network of Abortion Funds is a network of more than 100 grassroots groups that raise money to directly help women cover the cost of abortion. Every year, we collectively provide over $3 million dollars to help more than 20,000 women in need. The Network also fights for policies that will eliminate economic barriers to abortion and ensure all women and their family’s full health care coverage and a decent life. One of the many projects that we are currently working on at the Network is a national Practical Support Network that will be a resource for women who have barriers to accessing abortion that aren’t currently being addressed by most large scale feminist organizations.
    Practical support is concrete, logistical assistance, such as travel help, childcare, and overnight housing, provided to women and girls seeking abortion services. As was noted in the Feminocracy post, there are a number of reasons a woman might need practical support. If she resides in a rural area with no providers, a woman must travel to get to big cities where abortions are available. If a woman needs a second-trimester abortion, she will often have to travel to different states where those services are available. Teenagers often need to travel across state lines to avoid parental consent regulations. When a woman makes a trek for a multi-day procedure, or for a procedure involving mandatory counseling, she may need a place to stay, food, and possibly childcare for her kids. The concept of practical support evolved from recognizing that without these tangible supports, women and girls still experience barriers to abortion services even after they have located a provider and financial assistance for the abortion itself. Mounting restrictions on abortion services suggest that women may be doing a great deal more traveling in the years to come, so we at The Network are preparing to be ready to help them cross state lines as well as facilitate travel within their own states because the seemingly simple act of getting from Point A to Point B for a woman seeking abortion services alone can seem like an almost insurmountable obstacle.
    Right now, I am currently co-chairing the task force that will be developing and implementing the Practical Support Network. We are in the beginning stages of a very long process, and can definitely use more minds and help to execute such a huge project. If you are interested in getting involved in the Network you should check out our website: Here you can find information about how to join a fund in your area, start a fund in your area or how to donate money that will be used to pay for women’s abortions. We even have a national summit once a year to help new fund members learn the ropes and network with other feminists all across the United States who have one thing in common: a shared commitment to accessible abortions for every woman, no matter her circumstance. If after you check out the site and realize that this is something you are interested in you should contact your local fund and ask how you can get involved, or if you are interested in starting a fund contact and someone will be able to answer any of your questions and also send you a building an abortion funds manual, that is really helpful. Also, just so you know, we have a few funds which are devoted completely to practical support, and would totally be interested in more! Finally, if you want to be a part of the task force that the Network has formed to provide Practical Support on a national level, contact me at .
    While we at the Network are proud that we have funded and supported so many women, we also know that we have barely skimmed the surface of the actual need. Leading public health researchers estimate that $100 million would be necessarily to ensure that the 170,000 women a year who experience barriers in obtaining an abortion would have access. This is why we need help! Please, consider joining us either though a financial donation or through joining or forming a fund!

  8. ACCESS in Oakland and San Francisco does all this and more. I am a practical support volunteer with them and ACCESS does amazing work helping low-income and rural women obtain abortion care. Check out their website at

  9. […] Medicaid reform.  If you’re interested in financial access to abortion, you might check out this post on “Contraceptive Choice and Class.”  And then there’s this quick hit from […]

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