In 1973, the iconic Supreme Court case Roe v. Wade decided in a 7-2 ruling that the 14th Amendment to the U.S. Constitution provides a “right to privacy” that protects the right to choose whether or not to have an abortion.
Since January 2021, however, 561 abortions restrictions have been introduced in 47 states, with 83 percent focused in just 16 states. With more than 100 abortion restrictions being enacted this year alone, 2021 is now the worst year for abortion access since 1973.
With the passage of Senate Bill 8 in Texas on September 1, reproductive rights have been at the front of the national conversation.
In a Power Talk hosted by Power to Decide earlier this month, Ms. digital editor Roxy Szal spoke with four leaders in the reproductive health field about the acute threats to abortion and contraception across the country and how to improve access.
Panelists included:
- Dr. Raegan McDonald-Mosley, CEO of Power to Decide, a practicing ob-gyn and a former senior leader at Planned Parenthood.
- Rachel Fey, vice president of policy and strategic partnerships at Power to Decide.
- Jennifer “Jenny” Blasdell: vice president of public policy and strategic partnerships at Physicians for Reproductive Health who has worked in reproductive health and policy for 15 years.
- Jennifer Driver: senior director of reproductive rights at State Innovation Exchange (SiX) who has also been in the reproductive field for 15 years.
In a 45-minute conversation on Oct. 5, McDonald-Mosley, Fey, Blasdell and Driver shed light both on how things got to this point, but also what reproductive justice advocates can do to turn things around and shore up the major gaps in abortion and contraception access that persist in the U.S.
Watch the conversation here, or catch the full transcript below.
This transcript has been edited for clarity.
Roxy Szal: If Roe v. Wade has been the law of the land for almost 50 years, why are we seeing such a big push of anti-abortion legislation now?
Jenny Blasdell: Roe has been the law of the land in an unbroken line of cases for nearly 50 years—but for almost as long, there’s been a very laser-like focus on the federal courts by opponents of abortion. They’ve had a long-standing campaign to change the composition of the federal judiciary and we see additions of Justices Gorsuch, Kavanaugh and Coney Barrett in the last administration that has really tilted the makeup of the Supreme Court.
In this term, the Supreme Court is going to hear a direct challenge to Roe v. Wade in Jackson’s Women’s Health Organization v. Dobbs and there are briefs on the other side explicitly calling for the overturning of Roe. So, this moment has been a long time coming. We’ve seen it coming but it is here, and this is the time that the people are going to test the Supreme Court and the federal courts across the country.
Jennifer Driver: Jenny hit a big piece of it. Conservative legislators at the start of 2021 were really hedging their bets on the new makeup of the Supreme Court. You had many of them who were saying: ‘We’re going to push these laws. We’re going to introduce these bills. We know they’re not constitutional, but our goal is ultimately to get to the Supreme Court.’
You actually heard governors—like Arkansas’s Asa Hutchinson—who said, ‘We know this law isn’t constitutional. That’s not the point. We just want to see what the court will take up and we have this new makeup and here’s where the anti-abortion legislators are getting their say.’
As you mentioned, this has kind of been the most restrictive that we’ve seen—Arkansas being the most restrictive state this year, followed by Oklahoma. It didn’t happen overnight. This was a conservative plan for a decade or so of laying the foundation to ultimately try to overturn Roe.
It happened through gerrymandering, redistricting, gutting voting rights, and it’s not going to stop at abortion. I think that’s really critical, that these are efforts to really gut what we hold really true and value—anything from LGBTQ rights to where we are right now with the abortion fights.
“It didn’t happen overnight. This was a conservative plan for a decade or so of laying the foundation to ultimately try to overturn Roe. It happened through gerrymandering, redistricting, gutting voting rights—and it’s not going to stop at abortion.”
—Jennifer Driver
Rachel Fey: I just want to second everything that Jennifer just said.
In addition to that there is a reaction to some efforts to advance abortion access that are happening nationwide. You know, we saw the very first appropriations bill pass on the House floor without the Hyde Amendment, which when we talk about Roe v. Wade, it’s important to remember Roe is the floor. It created a legal right to abortion care‚but that’s a right in name only for a lot of people across this country because if you depend on a federally funded health insurance program for your care, you are at the mercy of your state when it comes to whether or not that care includes coverage for abortion.
So, I think as we have advanced things to get rid of the Hyde Amendment, to expand abortion access there’s been a contraction and an emphasis among those that are seeking to ban abortion outright. So, I think everything that Jennifer just said, and then, on top of that, a reaction as we know this is out of step with what the average person out there wants, and so, there is a feeling of we got to get it now, otherwise we might not be able to restrict abortion access. The tide may have turned.
“When we talk about Roe v. Wade, it’s important to remember Roe is the floor. It created a legal right to abortion care‚ but that’s a right in name only for a lot of people across this country.”
—Rachel Fey
Roxy Szal: We see this anti-abortion push happening in statehouses across the U.S., but these threats are felt very acutely in this moment, in Texas—which is where I happen to live. While many states have come close, Texas achieved something last month that no other state has, which is the banning of abortion at just six weeks gestation.
It’s been over a month since the law went into effect on September 1. The Supreme Court couldn’t stop it. The Biden administration is trying to slow it down but so far unsuccessfully. All the while, Texans of reproductive age and their families hang in the balance.
What is it about the Texas law, in particular, that keeps it from judicial scrutiny?
Jenny Blasdell: Bans on abortion as early as six weeks in pregnancy are not new. They’ve been introduced for several years, and all of the pre-viability abortion bans have been universally blocked by the courts. But this law has a novel enforcement mechanism that has made it hard for the courts to review and they’ve not taken the opportunity yet to review it.
Most statutes are enforced by the state, but this law incentivizes private citizens to bring lawsuits against abortion providers and people helping people to get abortions after six weeks of pregnancy, and anyone who brings a successful lawsuit can get at least $10,000 in damages.
Usually, when a statute threatens prosecution by the government, you can go into court and get what’s called a pre-enforcement injunction—a preliminary injunction—and in this case, the federal courts have declined to intervene. The law, as you said, went into effect on September 1 and on that date, healthcare providers and others had to make the really hard decision whether to comply with the law or to risk these really ruinous lawsuits. We hope that the courts will take action soon.
As you mentioned, the Department of Justice has brought a lawsuit. There were arguments in that case last Friday, so that court could take action. There’s also still litigation in the Fifth Circuit and it’s in state court—so we continue to wait. But that’s what’s made it hard for the federal courts to intervene, this very novel and very sinister enforcement mechanism.
Roxy Szal: Was that intentional, Jenny?
Jenny Blasdell: Oh, I think so. In the oral arguments last week, the judge asked the state of Texas, ‘Why have you gone to such great lengths to kind of avoid this judicial scrutiny and this judicial review?’ And they didn’t have a really good answer for it—because that’s exactly what they wanted to do.
Roxy Szal: I want to share a stat that will kind of shed some light on the impact of this Texas law that we’re talking about: One in 10 U.S. women of reproductive age live here in Texas. So, as you can imagine, the last month in Texas has been pretty dire.
Right now, Texas abortion clinics are essentially operating as trauma centers. One abortion provider based in Fort Worth said she and her staff members are seeing “absolute shock, … anger, fear and sadness”—both from themselves and from those coming to the door or on the phone seeking abortions.
Can you shed some light on the reality on the ground for Texans seeking abortion care? What is happening to people and families and abortion providers in Texas?
Dr. Raegan McDonald-Mosley: It’s critically important as we dissect the law and think about the machinations of it and why it’s so hard to overturn that we also center the actual real lives and experiences of what’s happening on the ground in Texas.
As an ob-gyn who’s incorporated abortion care in my practice from the beginning, there have only been a handful of times that I couldn’t take care of a patient because of medical or legal reasons.
In those rare circumstances it was heartbreaking and felt completely hopeless for the person who decided that, for whatever reason, they did not want to or could not continue that pregnancy. I’ve spoken to some providers in Texas about what they’re going through and it’s absolutely horrible. Having to tell dozens of people every day that you cannot help them and that they may need to travel hundreds of miles away, arrange childcare, rearrange their finances to travel to Oklahoma or New Mexico or even further away to get care.
And while this has to be utterly heartbreaking for the providers and clinical administrators and staff who’ve dedicated their lives to helping people, to have to turn away people over and over again, that says nothing for the despair and difficulty, again, for the actual people on the ground who need abortion care, whose lives will be momentarily turned completely upside down and whose finances will be impacted and who undoubtedly feel completely dismissed by policymakers in Texas.
“I’ve spoken to [abortion] providers in Texas about what they’re going through and it’s absolutely horrible—having to tell dozens of people every day that you cannot help them and that they may need to travel hundreds of miles away, arrange childcare, rearrange their finances to travel.”
—Dr. Raegan McDonald-Mosley
Roxy Szal: I live in Texas, and frankly I’m scared—but that said, I do recognize my privilege as someone who works remotely with access to a working car, with the ability to take time off from work. If I needed to, I could arrange an abortion road trip. I could take several days off of work. I could spend multiple nights in Louisiana, a state that’s still considered very hostile to abortion rights, with a two-visit requirement for abortion patients. I could head up to Oklahoma, another hostile state. This one has a 72-hour waiting period.
But a lot of women and people just do not have that luxury. This is, of course, why we hear all the time about how abortion restrictions and bans such as the one in place in Texas, disproportionately affect low-income people, people of color, rural women and young people.
Can you explain more about the impact of these bans as a whole and how they contribute to systemic racism.
Dr. Raegan McDonald-Mosley: It’s such a critical, critical point. This country has a very troubling and pernicious history of reproductive oppression, particularly of people of color, from the forced breeding of enslaved individuals to the violent history of unauthorized sterilizations that persist even until today. This nation has employed policy and procedure, and frankly, shame to control the fertility and reproduction of women of color and people of low incomes.
Moreover, we know that people of color and people navigating the world with lower incomes will be uniquely impacted by this law, as you state, because there have been natural experiments that have taken place in Texas. Back in 2013, there was another nefarious abortion restriction law called H.B. 2 that was passed, and then, more recently, during the early days of the pandemic, there was an executive order that made it much harder for people to get abortion and care, and in many cases, impossible in Texas.
And what we found during those times, researchers documented that many people had to travel out of state. People were pushed later into pregnancy to get the care that they wanted or needed, and fewer Hispanic women were able to get care at all.
Our systems should be working to get people in for care as early as possible, because although abortion is safe at all stages, it’s safest at the earlier stages, and it’s also unjust to push people later into pregnancy before they can get the care that they need.
It’s also unjust to put unnecessary roadblocks and barriers between people and their families and the care that they need, especially when those barriers will disproportionately impact people of color and people with low incomes, and that within and of itself, makes this law demonstrably racist and classist.
Jenny Blasdell: Last week in Congress the House Committee on oversight and reform held a hearing about abortion access and really looked at what’s going on in Texas. One of the doctors that testified is named Dr. Ghazaleh Moayedi of Dallas, and she’s been providing abortion care in Oklahoma. She talked about the types of barriers that people are having to overcome, just like Dr. Raegan described. Driving as far as eight hours from San Antonio to get to Oklahoma City.
She also noted that Texas has an abysmal maternal morbidity and mortality rate, particularly for Black women, and this scheme, this S.B. 8 just makes pregnancy more dangerous, especially for people who are already subject to the disparities of our racist and classist healthcare system.
So, she’s had people calling her, you know, unsure of what they can do in instances of miscarriage and ectopic pregnancy, and that does have an impact on people’s health and it’s unfair to add this burden to people who have already been marginalized by our systems and are not going to be able to easily travel. And then, there’s also people in the Rio Grande Valley—if they don’t have ID, they can’t travel past these checkpoints that are in place all around South Texas, as you probably know, Roxy—so they can’t go anywhere for their care. It’s just such a tragic and horrifying situation.
Roxy Szal: For now, this extreme and unprecedented law really only affects or impacts those trying to get abortions in Texas. But in the days following the law going into effect, it looks like at least 11 state legislators have indicated their intent to pass similar or exactly the same legislation.
Jennifer, you and your team at SiX are following this so-called copycat legislation pretty closely. Can you speak to copycat laws in other states? Is this coming to a state near you?
Jennifer Driver: That is frightening—”coming to a state near you.”
You’re right. I think right after S.B. 8, there were anti-abortion state legislators who were really excited. They started going on Twitter. They were putting out statements, saying, ‘We’re bringing this.’ They’re wanting to really show themselves as the most conservative, anti-abortion state legislator that there were or that there’s out there. What we know is that it’s not always going to be a copy and paste. I don’t think that that will necessarily stand up in some states.
But what we are seeing, you know, Arkansas, already the most restrictive this year, Senator Jason Rapert had actually said he’s running for lieutenant governor and has said he’s going to push for a copycat type bill in Arkansas. He also was the co-sponsor of that Arkansas Unborn Child Protection Act that was signed this year.
Florida has already introduced a piece of legislation—it mirrors but is not quite exactly like Texas. So we should be concerned, especially in Florida, which was also a state that if you were in Alabama or Georgia, Florida was that other place that you could kind of look to possibly get to and they have introduced that bill and state legislators there—the protected state legislators, those pro-abortion state legislators have already gotten together to strategize how do we push back in 2022.
South Dakota was another state where the governor had mentioned, ‘I want to see something like the Texas bill’ in her state.
Indiana. We’re also looking at Ohio and Pennsylvania. And so, we’re seeing a wide swath of state legislators, those anti-abortion state legislators who are really pushing it. Some states have hinted at it. Georgia is one state that has mentioned it.
Some of it is messaging, so that they can rile up the base. But I think it’s just really important that we’re paying attention to all of the states that are even signaling gutting abortion access for people in their states.
Roxy Szal: Rachel, if the experts are right and if more and more states begin to pick up these similar or copycat laws to S.B. 8, what can we expect the future of abortion access to look like?
Rachel Fey: So, I think unchecked we can expect it to look dire and a lot like it did before Roe and even like it does for low income and people of color today, where it dramatically depends on your resources whether or not you can get access to what should be and what is constitutionally protected care. But I would say that it is not going unnoticed by the federal government as well.
So, two weeks ago the House of Representatives passed the Women’s Health Protection Act, which is a bill that would block medically unnecessary state restrictions on abortion care and protect people’s right to access abortion care. Leader Schumer said that the Senate will take it up as well. So, one thing that you can do is contact your senators and tell them to pass the Women’s Health Protection Act.
The second thing that we can do is we cannot stop going on the offense as well when it comes to these issues. Roe v. Wade was never enough.
There is a bill, the EACH Act, which has been introduced in the House and Senate that will ensure regardless of how you are insured—whether it is Medicaid, employer-based insurance or some other public or private program—that you have coverage of abortion care, therefore making it possible for everybody regardless of how they are insured or how much money they have to get access to what is a basic part of reproductive healthcare.
So, we’re not going to let up on the gas at all on these things and I would urge your listeners and the people watching this today to get engaged in this, both at the federal level and as Jennifer said, at the state level because that’s where a lot of this stuff starts.
Roxy Szal: I think right now is a really good time to remind listeners too that these bans on our bodies being enacted by anti-abortion lawmakers and Congress and across statehouses, they simply do not reflect where the nation is at. Polling shows again and again that abortion bans are not supported by a majority of America.
Some recent stats: 81 percent of the country thinks that this Texas bounty system is wrong. Sixty-nine percent of Americans do not want the Supreme Court to overturn Roe.
So, what movement have we seen start to fall into place to respond to this public demand? Jennifer, could speak to the movement happening at the state level?
Jennifer Driver: I also would flag, a lot of these anti-abortion lawmakers have even questioned have we gone too far. Like, they know that it’s too far and any tapping or gutting or adjustments to Roe is too far in my mind, right. At the state level, this is the part that I get really excited to talk about, the things that are proactive, that are working, that we want to celebrate. As Jenny mentioned, the Jackson Women’s Health case out of Mississippi, the amicus briefs that were filed. We were really proud of the state legislators who signed onto a state legislator amicus brief supporting keeping Roe in place.
Nearly 900 state legislators across the country signed onto this brief saying that Roe must be protected. This was a huge turnout. This is one of the largest state legislator amicus briefs for an abortion case in history. So, to have 900 state legislators sign onto that was a really big deal. So, I am proud of all of the state legislators who signed onto that. Now, I’m going to shout out a couple of states. There are so many states who are doing some great work, I’m not going to be able to cover all of them but there are a couple that I wanted to pay attention to.
So, Michigan, Senator Erica Geiss in Michigan and Rep Bolden in Michigan are leading this bill S.B. 70 and H.B. 5289 that would protect Michigan and it would repeal the century-old law in Michigan that would criminalize providers not patients if it was enforced. So, Senator Erica Geiss is leading this effort to repeal and remove that Michigan law.
Minnesota, I also want to shout out because they just established their first reproductive caucus, and so, what they have done, they saw the Texas bill, they said oh, no, this isn’t happening in Minnesota. We are going to come up with this caucus. They formed this caucus. They are going to work on anything from protecting abortion rights to sex education, access to contraceptives, ending disparities, help disparities for BIPOC women and folks in Minnesota, so I’m really happy to shout them out.
Georgia is another state. You know, we often think of these southern red states. Georgia is a state that is working on proactive legislation. There’s also legislators in those states…I think this was a moment where legislators said oh, just because I am in a quote blue state, my work isn’t done. I actually have more work to do, and so, you’re seeing more and more legislators that were in those states that say what’s the next step that I need to do to ensure abortion access for folks in my state?
Do I need to work with providers? What does that look like and how do I ensure that the maximum number of people in my state have access to abortion? And so, we’re seeing that from Washington to Vermont, all across the country. And so, I’m really proud to talk about some of the proactive legislation that legislators are doing.
Roxy Szal: Rachel, you could follow up with movement happening at the federal level?
Rachel Fey: In addition to the Women’s Health Protection Act and the EACH Act that I mentioned, Jenny mentioned the upcoming Supreme Court case Dobbs v. Jackson’s Women’s Health Organization and we had 236 members of Congress sign onto an amicus brief in that case affirming the fundamental right to abortion access and that that right needs to extend to everyone.
That’s really critical that federal lawmakers are making their voices heard both in these cases and with the laws that they’re introducing in Congress. In addition to making their voices heard in those ways, it was really powerful at the hearing that Jenny mentioned that several members of Congress told their own abortion stories, and I think that’s critical. When we talk about what policymakers who are at large can do, it is to lift up the stories of people who’ve had abortions.
We know one in four people in this country have had an abortion. And then, also to tell their story, to destigmatize what is a basic part of reproductive healthcare. If you haven’t had a chance, I really urge you to listen to the stories of Congresswoman Bush, Congresswoman Jayapal and Congresswoman Speier—they are incredible, incredible legislators. Congresswoman Lee, whose abortion took place before Roe v. Wade.
You know, these are really powerful stories and they put human faces on this, and I think it’s important to remember that these legislators are just like everybody else in this country. Some have had abortions. Some have struggled with that choice. These are things that are ordinary and part of reproductive healthcare. So, I think in addition to the strategy around how can we push back on that, I think they are joining the overall movement in saying we need to tell our stories. We need to emphasize that abortion care is essential, is a basic part of healthcare and needs to be protected as such.
Jennifer Driver: Rachel mentioned Representative Bush. The other thing that I’m seeing state legislators really do more of is reclaim the faith-based narrative across the country. So, for a long time, we’ve ceded this faith-based conversation about why folks don’t have abortions—and you’re actually seeing state legislators and congressional leaders reject that. You saw that with Senator Warnock when he was running for election. You’re seeing it at the statehouses, with legislators who say, ‘No, it’s actually not because of my faith, it’s because of my faith that I support abortion access, not in spite of.’
And so, I think that that’s a really critical shift that I’m starting to see a lot at the statehouses across the country, and it’s really important to reaffirm that faith actually can guide you and be like, ‘This is why I support abortion access for millions across this country.’
Roxy Szal: In addition to unprecedented attacks on abortion care, we have also seen efforts to limit access to birth control in recent years. More than 19 million women of reproductive age living in the United States are in need of publicly funded contraception and they live in contraceptive deserts—which are essentially areas that lack reasonable access to a health center that offers the full range of contraceptive methods. That was 19 million women, and of those women, around 1.3 million live in a county without a single health center offering the full range of methods.
So, this means of getting contraception is more than just showing up to an appointment for too many people across the United States. And so, I want to talk a little bit about what we need to do to increase contraceptive access at the same time. What proactive steps can states take to improve contraceptive access?
Rachel Fey: I love getting to be the bearer of good news when it comes to our issue. And so, I want to share that late yesterday the Biden-Harris administration released a new regulation that will eliminate something called the domestic gag rule. That rule has been in place for the last couple of years and has forced roughly over 900 clinics out of the Title X family planning network.
This is the only federal source dedicated family planning dollars that help support clinics to serve people who don’t have any source of insurance, who may or may not be documented, who might be young people who need confidential care, really a critical underpinning and helps keep the clinic doors open for many people who depend on other publicly funded sources of care.
And the gag rule, by denying the providers ability to refer for abortion care, or if they provided abortion care at the same physical location as they provided Title X services, they were basically forced out of the program, and we saw, like I said, almost 900 clinics leave. So, that was decimating to the family planning public safety net. And so, one of the things that this rule will do is pave the way to bring those clinics back in by lifting those restrictions. It does a lot to strengthen the program in terms of its focus on health equity as well as allowing for telehealth, which is obviously critically important during the pandemic.
It’s a great rule and it goes into effect November 8. So, what I think we will see over the next six months or so is a revitalization of the Title X network in terms of how many clinics are in that network and able to serve. So, that’s one important way that this administration is helping to make the contraception access picture better.
The other thing is whether you look at legislation that tries to cover folks that are not currently covered as part of Medicaid.
I think you know, there are debates right now about closing the Medicaid coverage gap, about covering undocumented people and ensuring that they have health insurance, all of those things do a lot to solve contraceptive access gaps because without coverage, it’s like your face is pressed up against the glass. You might know where you need to go but if you can’t afford the care, it sort of doesn’t matter. So, those are all things that we can do.
Some other places where we can improve contraceptive coverage include over-the-counter contraception. So, I want to let Dr. Raegan talk more about this, but you know, birth control pills are incredibly safe and incredibly common and it’s time that we get them on a pharmacy shelf so that we don’t have the barriers of access to a healthcare provider or the need for prescriptions standing between people getting the care they needed. So, I’ll pivot to Dr. Raegan here.
“Without coverage, it’s like your face is pressed up against the glass. You might know where you need to go but if you can’t afford the care, it sort of doesn’t matter.”
—Rachel Fey
Dr. Raegan McDonald-Mosley: As Rachel alluded to, during the pandemic, when it’s been harder and harder for people to navigate to healthcare centers or health centers had to limit the number of people that were in their facilities due to COVID precautions and restrictions, there was a huge increase in access to contraceptive services and other sexual and reproductive health services over Telehealth. And so, that’s one huge thing that states can do is look at their telehealth laws, ensure that it’s not prescriptive in terms of which type of provider can provide that care, can advanced practice clinicians provide that care via telehealth, ensure that the state laws require Medicaid to cover relehealth in the same way that it does for private payers, and then, also to navigate the very tricky situation of treating minors and those below 18 years old via telehealth.
Also, pharmacist prescribing is something that folks can do on the state level. Thirteen states allow pharmacists to prescribe hormonal birth control already, which could be the pills, the patch, the ring or even Depo and another 10 states are working to implement this.
And then, as Rachel alluded to, ultimately, we’re hoping that birth control pills will be available over-the-counter. There are two companies now working through the process with the FDA. One is sort of in the final stages of their last big research study and we’ll hopefully have an application in front of the FDA in the next year or so. So, that could mean that birth control pills for the first time ever in the United States, could be available over the counter but that doesn’t ensure access, right, because what if someone has insurance that doesn’t cover it.
And so, that’s something that states can be doing right now is looking at what their state laws are about insurance coverage for over-the-counter contraceptive methods like emergency contraception today in preparation for a birth control pill being over the counter in another year or so. And that’s another year or so, and then ultimately, we could add other methods like the patch and the ring to be available over the counter.
So, there is, although a very dire situation, there is a lot on the horizon that can really democratize access and make access much more real, especially for people in rural areas or people who struggle to navigate the healthcare system as it stands today.
Rachel Fey: Some additional proactive state policies that are happening: A lot of states are requiring insurance plans to cover 12 months of birth control at one time, eliminating some of the gaps that happen. I think speaking to a lot of people of reproductive age, we all remember when you go to the pharmacy and that next refill isn’t due and you’re traveling and suddenly you’ve got to do this big dance to try and keep on your birth control.
So, that’s a really important thing that I believe over 20 states are doing. Power to Decide has a state contraceptive access tool where you can check out what your state is doing on this. And then, a lot of states are taking actions to either codify or even go beyond what the ACA requires in terms of contraceptive coverage, which is really great to see.
So, it is not all doom and gloom at the state level when it comes to contraceptive access—but I think we need to continue to be vigilant in the same way that we are about abortion care, that there are folks out there trying to conflate contraception and abortion, trying to limit what methods are covered or make decisions that are really best left between people and their healthcare providers.
Roxy Szal: When we have this conversation, a lot of it is presented to us through the media. And the media plays such a role in shaping the way we discuss reproductive healthcare, contraception, abortion…
Jenny, I know that Physicians for Reproductive Health is keenly aware of this fact—which is of course why you all recently released these Resources for Journalists Reporting on Abortion, which has been so helpful to me as a journalist reporting on abortion. It’s essentially a how-to guide for members of the media. My favorite part are words and phrases to avoid.
I’d love for you to speak a little bit on how this resource came to be. What are the most common mistakes that you see people making who are new reporters to this space?
Jenny Blasdell: Thanks for bringing up that guide. We first created it in 2019 during the Trump administration when they were using a lot of misleading and inaccurate rhetoric around abortion later in pregnancy, and we thought it was really important to set the record straight and encourage people in the media to be guided by medicine and actual evidence instead of this political rhetoric.
We updated it this year, recently. It was a good time to do it. You know, language is always evolving, and we’re always trying to improve it and make it more inclusive and helpful to people and it is designed in part for the media—but I think anybody can use it, whether you want to talk about it in a policy setting or with your friends or family.
It’s got some different sections. There’s an Abortion 101 section to kind of explain the basics of abortion care. We have some “Say this, not that” guidance, as well as a section specific to Texas—which turned out to be very timely. We still talk about abortion later in pregnancy. Inclusiveness and representation. Voices to select and center as well as voices to avoid. We’re continuing to adapt it.
We’ve got a lot of feedback from our community members that have helped improve it and we continue to tweak it and we hope that everybody will take a look at it because language really, really does matter. The words we use have an impact on the listener and when we’re centering the voices of those most impacted and we’re being led by those experiences, that’s when our language is really the most accurate and I think the most compelling.
Roxy Szal: What do you wish people understood about abortion? How can the language we use play a role in that?
Jenny Blasdell: Well, I’ve been thinking about this a lot because we just had this hearing in Congress last week where a lot of people talked about their abortion experiences before Roe and those are such an important part of our history and how we came to legalize abortion in this country—but it’s also really critical to understand that abortion today is very, very safe. Medications like mifepristone and misoprostol end pregnancies. They’ve been extensively researched. They’re safe and effective but because of politics, they remain over-regulated and out of reach for a lot of people.
So, I think the terminology that I would like to see us discard is when we use terms like “back-alley” or coat hanger imagery to describe what’s going on today because that just doesn’t reflect the reality of how safe abortion care is and how medications have really changed the landscape.
“Medications like mifepristone and misoprostol end pregnancies. They’ve been extensively researched. They’re safe and effective but because of politics, they remain over-regulated and out of reach for a lot of people.”
—Jenny Blasdell
Roxy Szal: What are some other harmful phrases or tropes that you think it’s time to retire—that are doing the movement a disservice?
Rachel Fey: Particularly with the Texas law and some of the really outrageous laws that have been passed, people have a tendency to focus on the fact that there’s no exceptions for the victims of rape or incest—and yes, that’s outrageous, but it negates the fact that people should have access to abortion care for whatever the reason they need it, and making it seem like someone is more worthy or less worthy of abortion care depending on the circumstances in which they found themselves pregnant really does a disservice to a basic part of reproductive healthcare.
So, my wish is to see fewer policymakers and fewer reporters focusing on rape and incest either being covered or not covered because a ban that had exceptions for that would still be unacceptable and it would still deny people a basic part of their reproductive healthcare.
Dr. Raegan McDonald-Mosley: It’s important to acknowledge that the root of all these bans is stigma. And to Jenny’s point, words matter—so we all need to make sure that we’re not employing language and stances that exacerbate stigma, particularly around abortion. For example, many well-meaning folks often will say like we need to increase access to contraception so that we can reduce the number of abortions—but inherent in that statement is that abortion is bad.
So, how about: We need to increase access to contraception because no one should have to jump through unnecessary hoops and because people should be able to have access to the care and services they need—whether that’s contraception, or abortion, or miscarriage management, or prenatal care or delivery services… whatever it is that they need in their reproductive life course.
Abortions aren’t inherently bad or wrong. In fact, they are a common part of the reproductive life course for many people. So, language matters and we have to make sure that we are not exacerbating that.
Jennifer Driver: I appreciate Dr. Raegan’s point around “well-meaning.” That’s often where I hear a lot of some of the conversations, especially with state legislators coming from those well-meaning state legislators. We’ve also used Physicians for Reproductive Health’s guide for state legislators and their messaging. One of the things I really want people to stop doing, is using language that is racist. So, we work with state legislators on how to talk about Roe and not be racist at the same time.
So, how do we not say, “What is our underground railroad if Roe is overturned?” Well, we don’t need to hearken back to slavery. We can say all of these things and be really terrified about what could happen to Roe and not be a racist in your statehouse.
We know when there’s an underrepresentation of Black women and state legislators across this country and just because you lead your community and go into the statehouse, that microaggression and those racist tropes don’t go away—and so, we’re just working with state legislators. How to talk about these issues. How to really use positive messaging, like the Physicians for Reproductive Health guide, to talk about these issues. So, I think that that’s really important.
Oh, and those Handmaid’s Tales. Please stop with the Handmaid’s Tales outfits. That’s got to go.
Roxy Szal: Jennifer, can you talk just like 30 seconds about why you find that imagery particularly offensive. I saw a lot of it this weekend at the Women’s March, and I saw a lot of hanger imagery. I tried to avoid that in our Ms. magazine round-up of the best signs.
Jennifer Driver: This idea that someone else is birthing your child—that’s the whole image from the show. I keep thinking about all of the ancestors who were having to take care of these white women’s children, having to breastfeed their children, having to birth even the slave owners’ children.
For me, it’s too much. It’s not too much, it’s racist. Stop doing it. I’m sure somebody else has a better take on why you should not do it. That’s for me what it conjures up, and so, I am open to others. Rachel was at the Women’s March with me and went all-in on someone who came dressed as a handmaid, and so, I really appreciated her being that co-conspirator for me in that moment of calling out kind of this dress.
Roxy Szal: Anything to add, Rachel? How can we call in well-meaning folks who we want in our tent—but can we talk a little bit about why Handmaid’s Tale imagery, in particular, is jarring?
Rachel Fey: This idea that we are only now restricting people’s reproductive access really erases the ways in which we have, as a country and in our systems, denied reproductive autonomy to people of color since before this country was a country. So, I think, you know, I kind of cringe when I see a group of white women in Handmaid’s Tale outfits talking about how this is just now happening—instead of acknowledging the long and systemic history of this that Dr. Raegan talked about a little bit.
I will say someone behind us, when Jennifer and I were having this interaction, said, “But they mean well.” I said I don’t think that’s enough. If you mean well, then it’s your job to educate yourself on how to talk about these things in ways that are not stigmatizing. You may fall short—but this march sent out a lot of emails about why those things were harmful and please do not use them. So, I think there’s an onus on us, particularly as privileged white women to do our homework and to educate ourselves and to not perpetuate things that frankly our movement has perpetuated for a long time.
“There’s an onus on us, particularly as privileged white women to do our homework and to educate ourselves and to not perpetuate things that frankly our movement has perpetuated for a long time.”
—Rachel Fey
Jenny Blasdell: Another trope I think is troubling that I’ve seen with Texas and other abortion bans is this comparison of Texas to the Taliban—and it’s the same thing. You know, using a prism of something foreign or something fictional instead of examining our own roles in the racism that has allowed these systems to continue for generation after generation.
Dr. Raegan McDonald-Mosley : That’s exactly what strikes a nerve for folks, right, is relying on this science fictional thing when actually this has been the real lives of people in our own country—not just since September 1 but for a long time, particularly people of color, people who are navigating our world with lower incomes and people in rural areas. Access does not look the same for those people than it does for others and the reality is your ability to receive essential health services like an abortion or contraception or others should not depend on your race, what state you live in and your income—but that’s exactly the case in America right now.
Jennifer Driver: Also, Roxy, it’s just a message that I hear people say. I’m from Alabama and generally, when something bad happens they’ll say, ‘Let’s boycott Alabama.’ That doesn’t help us. It still doesn’t give me abortion access and it hurts the working people in Alabama who need all of these services and rely on our support. And so, the boycotts for me is something that has never quite set well, being from those states who really need the resources and struggling. So, that’s just another one that I will throw out there.
Roxy Szal: That reminds me too of dramatic generalizations about the South—”Oh, this is how the South is. This is how people in the South are. Why don’t you move out of the South?” It’s not as easy as that.
I know a lot of people listening and reading this talk are concerned about these issues and want to take action. What can a normal everyday person do?
Rachel Fey: So, you can contact your members of Congress and tell your senators to support WHPA and your members of Congress to pass the EACH Act and you can donate to something called BC Benefits, which is Power to Decide’s birth control network that helps support people that otherwise cannot afford their birth control right now. So, you can give five dollars and pay for a month’s worth of birth control for someone.
I personally love this because it’s a very real way I can impact someone else’s life right now. And then, finally, we have an entire resource page of folks on the ground in Texas who are helping people, led by Texans that you can donate to. So, consider giving to some of the abortion funds and other great groups doing work on the ground in Texas.
Dr. Raegan McDonald-Mosley: I would say just go back to the stigma thing—we all just need to be talking about and supporting abortion access and contraceptive access as a part of the full life course of what people need, right. Not sort of specialty services, not something different, just a part of the normal healthcare system because that’s exactly what it is. It’s all of our jobs to combat this stigma. That’s the only way that we’re going to get through this and for bills like this to not even exist.
Jennifer Driver: First thing would be to donate to an abortion fund. That would be the first thing that I would mention.
Remember that state elections matter. So often do we pay attention to the federal and we overlook what happens at the state and state is where things move quite rapidly. So, I think it’s really important that we’re paying attention to what’s happening on the ground in states.
The last thing that I will say is a reminder that these things don’t happen in a vacuum, right. This is a concerted effort. We have voting that’s being gutted and districts and maps that are being redrawn, and so, paying attention at the ways that these issues really intersect with each other is critical for what’s going to come in the future.
Jenny Blasdell: Ditto to that, donate to abortion funds in Texas that are helping people travel out of state. I guarantee you there’s an abortion fund where you live. Look into the abortion funds in your area. They all need help and resources, especially as Texans have to travel farther and farther afield.
To build on Dr. Raegan’s point, say abortion. Talk about abortion. The holidays are coming up—don’t shy away from it as this political football. It is not a politics issue. It is a health and dignity and autonomy and justice issue, and we should all welcome the opportunity to talk about it if that happens around your dinner table.
And then, also listen to those that are most affected by these laws. The patients are trying to seek care. The funds that are helping them get their care. The providers providing that care. The more we can listen to the people most affected and center them in our conversations, the better off we’re all going to be.
Roxy Szal: Topics of reproductive justice and the limiting of abortion and contraceptive access can be pretty bleak—so, to wrap this up I want to end by asking all of you: What is the silver lining here? You know, what’s giving you hope? What’s helping you sleep better at night on this topic?
Rachel Fey: I was going to say the kids are all right. I am so blown away by Gen Z, by millennials. Folks younger than me for whom being advocates is a natural stretching of the muscle and using gender-neutral language and centering people most harmed and really lifting up the ways in which these issues are intersectional just comes naturally, and that, to me, is so hopeful for the future of the movement and of our progress.
You know, these are today’s and tomorrow’s voters. They are today and tomorrow’s policymakers and you know, for them, this is a duh issue. So, they give me hope every day and I will just say I saw an incredible number of them at the rally this weekend and it was great.
Dr. Raegan McDonald-Mosley: I would say what gives me hope is what’s happening. The downside of the pandemic is so many lives lost and the downside of all these laws are what we’ve been talking about today. The upside is that it’s really pushed and fostered innovation, particularly around access to medication abortion in ways that, I have been doing this for decades and never thought possible.
So, the expansion of use of innovation and more patient-centered and person-centered care gives me hope and I think that it is really important but it’s also important to recognize that it’s not the only answer, right, because if you still live in a state where even medication abortion access at a very early stage is prohibited, it’s not going to solve everything. But it does give me hope and I think can really make abortion care and access look very different in a matter of years.
Jennifer Driver: I think what’s giving me hope is the determination of state legislators who are committed. We set out with the amicus brief of just trying to, you know, have more than what the antis of 396 and I said okay, if we can get to 400 it will be okay and we got to almost 900 and I’m still getting emails from state legislators that are saying can I sign on and I’m like, oh, that’s not how that works. So, you know, I’m really inspired by their determination and their drive to say this is unacceptable and we won’t stand for this and we’re going to ensure that people in this country have access to abortion.
Jenny Blasdell: We mentioned this earlier, but it really was a big deal, was it nearly two weeks ago, a week and a half ago when the speaker of the house Nancy Pelosi gaveled the passage of an abortion rights bill in Congress, a stand-alone abortion rights bill. It’s the first time it has ever happened. I think it happened in large part due to the storytelling that’s been going on in our community, the patients who’ve had abortions, the people who’ve cared for them, their families who’ve supported them and the work of groups of like We Testify.
We had abortion storytellers in Congress last week alongside members of Congress sharing their abortion stories, as Rachel mentioned, and the conversation feels very different than it did 10 years ago and that’s a really, really good thing.
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