NY abortion clinics prep for influx of patients, but access may be an issue for some
The pregnant person saw the New York abortion clinic as the lifeline they needed.
They planned to fly from Texas to New York and back in the same day to get an abortion, prohibited in their home state six weeks after conception. But the pregnancy was farther along than they thought. They’d be forced to stay overnight before receiving care, with no money or housing lined up.
Stories like this one — a patient account as told to a New York City abortion provider — aren’t new, especially in New York, where abortion has been legal since 1970. In the past year, more states have implemented restrictive abortion laws, underscoring New York's visible position as a haven where abortions are protected.
Now, New York abortion providers are preparing to help an influx of out-of-state patients after the Supreme Court on Friday overturned Roe. v. Wade, the 1973 ruling that established a constitutional right to abortion.
But New York is far from a utopia when it comes to abortion care, said Merle Hoffman, the founder of Choices Women’s Medical Center in Queens. Not everyone, even New Yorkers, can afford travel expenses, time off work, childcare and other costs needed to get to the nearest clinic.
Choices is part of a hub of abortion providers in New York City, but fewer resources are available the farther the state stretches from the metropolitan area. And with a wave of patients on the horizon, some voyaging out of state or from the rural reaches of New York itself, the state's major abortion clinics could face a crowded road ahead.
"I think it's really all hands on deck in our field," said Peg Johnston, the owner and director emeritus of Southern Tier Women's Health Services in Vestal.
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Inside finding an out-of-state abortion
Johnston and Hoffman anticipated over the past several decades that the Supreme Court would overturn abortion rights allowed by Roe. They opened their clinics in 1981 and 1971, respectively. Choices’ first patient traveled from New Jersey, where abortion was illegal at the time.
Johnston said Southern Tier was “the place to go” for people living in upstate New York as well as northeast Pennsylvania who wanted an abortion.
Now, both medical centers have started to see patients traveling from beyond neighboring states. They recently helped patients from Texas, Alabama, Georgia and other states with restrictive abortion laws — and they're waiting to see what overturning Roe means for their capacity and ability to handle the influx of people.
“If things go the way we think they’re going to go, half the country’s states are going to be without or have severely restrictive services, and the other half will be open. They’re not real close to each other, those halves,” Johnston said.
Getting people where they want to go for an abortion is an issue, Johnston added. Some people want to go where they can be seen soonest, others want to stay as close to home as possible. Some people want to travel far but will not fly. Parents might not be able to leave work or find childcare to make time for the procedure.
Clinics partner with the New York Abortion Access Fund, the National Abortion Federation and other, sometimes local funds to secure financial assistance for patients. They also turn to logistical support groups, like the Brigid Alliance, which helps pregnant people get where they need to go by booking tickets, finding them housing and checking on them until the procedure happens.
New York is a “high access state," said Brigid Alliance Executive Director Odile Schalit. Laws protect abortion access, and politicians vowed to keep it that way. About 250 facilities provide abortions in the state, according to the Guttmacher Institute.
The reproductive health-focused research and policy nonprofit reported 105,380 abortions were provided in New York in 2017, the most recent year the institute collected data. That number includes New Yorkers who traveled to a different state as well as people who came to the Empire State for an abortion.
Still, abortions and other reproductive health services are not accessible for everyone. Costs add up. First trimester abortions start at about $600. Airfare has soared, and the average cost of gas hit an all-time high at more than $5 in June, according to AAA. The cost of living for those who already reside in New York is prohibitive for many people.
"I think it's impossible to put New York on this access pedestal when it's also extremely inequitable and unaffordable, in the city especially," said Chelsea Williams-Diggs, a board member of the volunteer-run New York Abortion Access Fund.
As costs of needs skyrocket, and access to abortions in many states diminishes, providers and support organizations are braced for what's next: the overturning of Roe. To prepare, they're ramping up their staffing, fundraising and facilities to serve the flood of people they expect will need their help.
"The war continues, but these are just different battles," Hoffman said.
Protests, staffing issues hinder NY clinics
Southern Tier Women's Health Services never had security cameras until now. Along with invisible barriers, their patients and staff often face physical walls blocking them from facilities.
Choices deals with frequent visits from anti-abortion protesters. A group routinely gathers outside Choices, wielding signs and hollering "you're killing babies." The center plans to add security guards to handle "more aggressive protestors," Hoffman said. That's in addition to volunteer escorts who help patients enter the facility every Saturday morning.
Security is among several areas the clinics are expanding within their practices "as the need grows," Hoffman said.
“We’ve been a beacon, but this attitude and anti-choice activism has metastasized throughout this country and we have it in Queens,” Hoffman said.
Choices and Southern Tier coordinate with each other and other local hospital systems to ensure there are enough providers, capacity and time for sessions. Hoffman doesn't foresee capacity issues in Choices' large physical space, nor does Johnston. Another barrier, though, is time.
Hoffman explained not many physicians are trained in late pregnancy abortions, a more complicated procedure that presents a higher risk to patients. Late pregnancy abortions require different skills and equipment that are found at hospitals, but earlier abortions can take place at licensed medical centers. Both Choices and Southern Tier are working to train and eventually hire people who can perform abortions later in the gestation period.
Providers at Choices and Southern Tier do not perform abortions for people who are 24 weeks pregnant, or more. Late pregnancy abortions are legal in New York, but very few clinics offer that procedure, "certainly not upstate," said Karla Salguero, another New York Abortion Access Fund board member.
"While [some] are saying we're a safe haven, we are actively needing to send folks outside of the state to access care, sometimes going as far as Colorado, and that's not uncommon and is extremely expensive," said Williams-Diggs, of the New York Abortion Access Fund.
The Fund team typically refers patients traveling outside New York to providers in Washington, D.C.
While that's closer than Colorado, Williams-Diggs added " no one should have to leave their state or leave their 10-block radius to get any type of health care."
Southern Tier only welcomes patients two and-a-half days each week, but Johnston is ready to adapt in case the clinic yet again becomes "the place" for abortion-seekers in upstate New York and northeast Pennsylvania. She's well-connected with other abortion providers if Southern Tier has to refer people out, but even so the nearest clinic within the state is still around an hour's drive.
It's long been common for Pennsylvania residents, including many from the Poconos, to travel to New York for reproductive health services. Only one county, Luzerne, in northeast Pennsylvania, offers abortion services. A patient in Susquehanna would have to travel well over an hour to visit Luzerne's Planned Parenthood location, or nearly two hours to seek services at the Allentown Women's Center. But that patient could arrive at the Southern Tier Women's Health Services in less than 45 minutes.
Lauren Peterson, executive director of Women's Resources of Monroe County, Inc. noted that reproductive healthcare options for women in the area have decreased, and depending upon the outcome of Pennsylvania's fall elections, it could lead to patients crossing state lines for care.
In New York, abortion access will continue to be protected if Gov. Kathy Hochul stays in office after the upcoming election. She vowed to maintain protections for abortion providers and patients, calling New York "a beacon for those yearning to be free" after she signed several related laws.
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The Reproductive Healthcare Act, signed into state law in 2019, protects providers and patients while ensuring people have autonomy over their reproductive healthcare decisions.
Hochul added to that following the leaked Roe document that hinted it would be overturned earlier this year. She signed six laws into place on June 13 that shield abortion providers from legal and physical threats. Last month, she announced a $35 million investment to support abortion providers.
Most of that funding would go toward the Abortion Provider Support Fund, which would help clinics expand and provide ample access. The remaining $10 million would fund security grants for reproductive health centers.
State legislators proposed an additional bill to help fund abortion providers and nonprofits who support them, known as the Reproductive Freedom and Equity Program. Attorney General Letitia James and the New York Civil Liberties Union, among others, have advocated for passing the legislation. It did not make it out of the Senate Health Committee before the end of New York's legislative session in June.
Planned Parenthood Hudson Peconic President and CEO Vincent Russell anticipates protests to pick up in New York as other states restrict access to reproductive healthcare, including abortions.
On the local level, Westchester County is also focused on security. Police have been called to intervene at Planned Parenthood Hudson Peconic clinics in Westchester, Rockland and Suffolk counties, said clinics' President and CEO Vincent Russell. There, protesters similarly block staff and patients from entering roadways.
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Westchester County officials are working on the Reproductive Health Care Facilities Access Act. The legislation would create an 8-foot “floating zone” for protesters approaching individuals and create other regulations designed to ensure clinic access would not be impeded. Legislators say their law could be a model for other localities and the state.
Moving forward, Brigid Alliance and New York Abortion Access Fund staff pointed to two main factors that could increase access further in New York: affordable prices for reproductive healthcare, and implementing laws without limitations.
Schalit, the Brigid Alliance's executive director, wants a New York "free of restrictions," opening the doors for people 24 weeks pregnant, or later, to be able to access abortions. Salguero, the Fund board member, added that no one should have to leave New York to get such care because of gestation limits.
In the meantime, groups and providers are ready for the flood that could come when the abortion access dam breaks.
Nancy Cutler and Brian Myszkowski contributed reporting for this story.
Sammy Gibbons is a culture reporter for the USA TODAY Network's Atlantic Region How We Live team. Email: firstname.lastname@example.org | Twitter: @sammykgibbons. For unlimited access to the most important news, please subscribe or activate your digital account today.