Abortions Cost More as Laws Become More Restrictive — Can Donations Keep Funds Afloat?

EMW Women’s Surgical Center in Louisville is one of two abortion clinics in the state of Kentucky, and its last independent clinic. With physicians who also serve as OB-GYN professors at the University of Louisville, the clinic has performed over 100,000 abortions since opening its doors in 1981.

This summer, the clinic was open, then closed, then open again. It temporarily ceased offering abortion services when the state’s “trigger law” went into effect following the Supreme Court’s overturning of the Roe v. Wade decision. Then, abortions were allowed to resume after a state judge halted the ban.

Despite the uncertain situation, abortion seekers continue to travel (often hundreds of miles) to and from Kentucky to receive their care, according to a statement from the A Fund, an abortion fund in the state.

A Texas woman recently traveled to EMW, according to the A Fund. (The clinic is more than a nine-hour drive from the closest point on the Texas state border.) And many Kentuckians have already driven at least five hours to a clinic in Durham, North Carolina, or about three hours to Granite City, Illinois, the A Fund said.

With many states already down to one clinic, and appointments hard to come by for many, long travel for abortions is not new. But the fight for access after the Supreme Court overturned Roe v. Wade presents a new, huge challenge for abortion funds, the volunteer groups that help patients pay for procedures and travel for the care they need.

While the work is arduous and the fight ahead is long, there have been huge spikes in donations, staff from the funds told LX News.

Still, there’s a huge need to fill and ensure people get the care they need, organizers say. There are over 300,000 pregnant people in “trigger law” states immediately or near-immediately affected by the decision. Travel and logistics arrangements will only get more necessary and more complex, and one group says the total need could amount to millions of dollars.

Apiary, a practical support organization that helps fund the logistics involved in obtaining an abortion like travel, estimates 100,000 people need help paying for abortion care or the associated costs (on average, assistance per person is $1,000). If that estimate is accurate, then the total unmet need would be $100 million.

But leaders of the groups say it’s not just patients’ financial needs that are increasing. Wait times for appointments will go up, as appointments will be more difficult to schedule due to a decrease in the number of clinics and states where abortions can be performed.

At least 43 clinics in 11 states have already stopped providing abortions, according to the Guttmacher Institute. And clinics are already seeing influxes of patients from neighboring states where the future of abortion rights is uncertain. 

The New Orleans Abortion Fund says it pledged $170,000 to people seeking services in the 30 days since the Supreme Court ruling, and over $46,000 in the first week after the ruling. In 2021, the fund, which covers a broad region including the state of Louisiana, averaged about $11,000 per week provided to callers.

In Kentucky, the A Fund spent $220,000 to fund abortion pills and procedures in the last fiscal year, and expects that to double this year.

But other funds have shifted or paused their work to avoid legal crackdowns.

In Texas, the Lilith Fund said it cannot cover abortion costs at this time, mentioning in a blog post the law SB8, establishing a $10,000 bounty for tips on abortion providers. The state also has a trigger law set to take effect Aug. 25, 2022. According to the Texas Tribune, the Texas trigger law allows a maximum penalty of life in prison for abortion providers, and requires the state attorney general’s office to levy a civil penalty of at least $100,000 per abortion performed.

Abortion care is already difficult to afford, and costs will go up

Not all abortion seekers can afford the procedure or the travel to the clinic, but they can turn to networks of groups to help with access. There are abortion funds, which tend to focus on paying for the procedure, and practical support groups, which can provide grants for “wraparound” needs like child care, meals, lodging or other related costs. (Some abortion funds also offer this practical support.)

Traveling for an abortion was common even before the Supreme Court decision, organizers said. According to the Guttmacher Institute, in 2017, 89% of counties did not have a clinic. And in 2019, there were six states that had just one clinic, according to CNN. When Jackson Women’s Health Organization — the clinic at the center of the Supreme Court case — closed in Mississippi, the state lost its only clinic providing abortions.

Organizers interviewed for this article say the demand for travel will increase as clinics close. People will need to travel farther and a car trip may not cut it.

Apiary estimated the average cost to help a person needing wraparound care for their abortion at $1,000 to $1,200. That number does not include the cost of the procedure.

“People just do not have the expendable cash to be able to pay for any pieces of this,” said Marisa Falcon, the founder and co-director of Apiary, a practical support organization.  “[$1,200] statistically is not a number that people have in this country to just spend on a quick getaway.”

And previously, some people just needed help paying for gas before a long drive to a clinic — something a $50 gas card might be able to cover. But as access decreases, financial needs are going to increase even further. Travel that was once “local,” or within a half-day’s driving distance, will turn into regional or national travel, Falcon said. More people will need flights, which are getting more expensive too. And taking longer trips out of state could mean the person seeking an abortion could also miss wages for missing work.

“On a practical level, that means that those $50 gift cards don't really exist anymore, or that is not going to meet the need for the vast majority of people who need to travel anymore,” Falcon said.

“There's just more time that needs to be accounted for and covered and paid for,” Falcon added. “All of these sort of cascading effects mean that costs, both emotionally and financially, are just going to keep going up and up.”

Beyond that, people seeking abortions have to contend with a lack of available appointments as clinics close and more people travel to crowded clinics. “Access is just going to become more limited for everybody, because that’s what happens when you only have a select number of places that are able to support your care,” says Falcon.

Groups hope for ‘dignified access,’ and committed folks in it for the long haul

Amid legal battles in several states after the Supreme Court decision, none of the sources interviewed for this piece plan to stop their work. But all of them urged volunteers who are new to the cause to connect with groups already doing the work, rather than going it alone.

Immediately after the Dobbs decision, TikTokers in blue states offered their homes for anyone going “camping,” a euphemism for traveling out of state seeking an abortion.

People working at abortion funds found the trend unhelpful.

AJ Haynes, an artist and leader of the New Orleans Abortion Fund, detected a sense of panic on social media in the aftermath.

“Oftentimes in emergent situations, a lot of folks default to what their muscle memory is,” Haynes said. “Clearly, a lot of people’s muscle memory is panic, and panic in a way that is not generative…working in a frenzied way to find a solution of your own volition, instead of looking into your community.”

Devin Simpson, communications director of the DC Abortion Fund, said those interested in helping should look to organizations already working on the issue.

“Tap into those networks and uplift those networks, give them the support they need,” Simpson said. “This moment is not about creating something new. It’s about expanding the things we already have and supporting the things we already have.”

Haynes doesn’t want to talk in code about abortion either.

“I feel like people should have dignified access. This isn’t a secret,” Haynes said. “If the impact is that people are more confused, then it is not helpful.”

Falcon hopes interested volunteers understand that they won’t be able to help immediately — there are crucial trainings needed before volunteers can help someone seeking an abortion. Volunteers are trained on trauma-informed response, racial sensitivity and avoiding microaggressions. While the upfront commitment is not for everyone, there will be a need for help for a while. Organizers say they will fight for abortion rights for a long time.

“We are in this immediate crisis, and in an immediate crisis, people just want to help in however way they can think about helping,” Falcon said. “But it’s actually OK if it takes you a couple of months to get grounded and get on your feet, because this is going to be a crisis that is going to continue for years. And we need people who are in it for years.”

“We don't need no more camping trends,” Haynes added. “We just need people to know precisely where to go, what number to call, who's going to help them. And if they can't, then we'll direct them, you know?”