Rural residents in the United States West have historically faced barriers to abortion access, such as long travel distances and a lack of transportation.
The sole Planned Parenthood clinic serving the eastern half of the state, in Bend, Oregon, is bracing for an influx of patients, particularly from neighboring Idaho, where a trigger law prohibiting most abortions is set to take effect this summer.
“We’ve already started hiring,” said Bend Health Center Manager Joanna Dennis-Cook.
Many abortion providers serving rural areas in the United States West were already struggling to meet demand in a vast region where staffing shortages and long travel distances are barriers to reproductive services for women. Geographically, Oregon is larger than the entire United Kingdom.
Some facilities serving rural communities in states where abortion is still legal are concerned that the overturning of Roe v. Wade will exacerbate those pre-existing challenges, as more patients will travel from states where the procedure is prohibited or severely restricted.
In anticipation of an abortion ban in Idaho, Oregon lawmakers established a $15 million fund to increase access to abortion services earlier this year.
The first $1 million will go to the Northwest Abortion Access Fund, a non-profit that assists patients with travel and the procedure itself. For the past 20 years, NWAAF has collaborated with the Bend clinic to meet the needs of an increasing number of patients.
Dennis-Cook says her clinic is increasing staff training and modifying schedules “to ensure that we can accommodate increases in patient numbers” as people travel farther for care.
According to 2014 data analyzed by the Guttmacher Institute, a research group that supports abortion rights, which published its findings in The Lancet Public Health, 20 percent of U.S. women had to travel at least 42 miles to the nearest abortion clinic before the Supreme Court overturned Roe v. Wade. That distance can increase to nearly 180 miles across much of eastern Oregon. As more states pass trigger abortion bans, distances for many patients may grow even further.
According to Dennis-Cook, the Bend health center has seen patients from as far away as Texas.
Bend’s clinic has six exam rooms and averages 600 visits per month. Dennis-Cook stated that because it is “on the smaller side,” it is “limited” in what it can provide.
“We only do procedures in the first trimester here,” she explained. She also stated that the clinic does not perform procedures requiring general anesthesia. “We don’t have a large pool of nurses who can do that type of work from which to draw.”
Smaller abortion clinics, particularly those in rural areas, have historically struggled with a lack of qualified staff and doctors. This, in turn, has an impact on scheduling availability.
According to Riley Keane, NWAAF’s Practical Support Lead, the group’s planned operating budgets for this year have already been depleted due to increased demand for travel funds.
“Last year, we gave away about $1 million in total,” Keane explained, referring to grants given to clinics to cover abortion costs and patient travel funds. She stated that the NWAAF is “on track to potentially double that this year.”
Keane anticipates that the $1 million from Oregon’s new abortion access fund will make a “huge difference” for NWAAF, which is typically funded by individual donors. She claims that this is the first year the group has received government funding.
NWAAF expresses concern about providing travel funds to patients in states where abortion is illegal or severely restricted, but adds that it is working with legal professionals to assess the changing landscape.
“They keep us informed about things we should be concerned about,” Keane said.
In response to laws allowing private individuals to sue abortion providers, such as those passed in Texas, the governors of Oregon, Washington, and California announced a joint commitment to protect patients and doctors “against judicial and local law enforcement cooperation with out-of-state investigations, inquiries, and arrests.”
The three Democratic governors also stated that they will refuse “extradition of individuals for criminal prosecution” if they receive or support abortion services that are legal in their respective states.
Oregon, Washington, Idaho, and Alaska are among the states served by NWAAF.
According to Keane, the NWAAF will continue its operations for the time being. “At the moment, our legal counsel has not advised us that we should cease operations,” she explained.