As the battle over abortion once again dominates the public sphere, the arising questions about access in a new era of abortion law have been especially important to consider for college students. Though college students have always been at a greater disadvantage in terms of abortion access, recent abortion bans have heightened existing worries about college students’ access to abortion. Advocates worry that such restrictive laws will not only worsen logistical barriers but also intensify the stigma surrounding abortion and other topics related to reproductive justice and sexuality.
College students make up a large portion of those seeking an abortion. According to the CDC, 20-24 year-olds alone make up 28% of people who have abortions in 2018, just barely less than 25-29 year-olds, who make up the largest portion at 29%. In a 2012 study, when women were asked why they were getting an abortion, one in five cited “interference with future plans.”
Joanna Grossman, a professor of law at Southern Methodist University, wants people to recognize the wide range of issues that accompany the rights of women and families, including abortion. She pointed out that “if anyone cares about the gender equity of students, then those people ought to be building in a full panoply of reproductive care into the campus health offerings because we know that access to birth control, to abortion care, to screenings — all of those things have significant consequences for people’s ability to fully participate in civic life and pursue their education.”
As college students have cemented themselves as a substantial subset of those seeking abortions, activists have sought to improve students’ ability to access these services on or near campus.
For students seeking an abortion, their options for methods look relatively similar to those of any pregnant person seeking an abortion. Based on a consultation with their provider that takes into account medical history and how far along the pregnancy is, people can either use surgery or medication for the abortion.
For those choosing the surgical option, more campuses are unlikely to have this method available directly through their university health plan. At college campuses that include abortion care in their student healthcare plans, they will often refer students to outside providers nearby, such as Planned Parenthood, and subsidize the costs of the procedure. At Yale Health, abortion care is covered under the basic student health package, but students are referred to providers near campus, such as Yale Family Planning or Planned Parenthood of Connecticut for both the pill and the surgery.
However, since some campus university health centers do not have the resources to provide surgical abortion, medication abortion offers up another option for students. Though abortion is indeed depicted as a surgical procedure and discussed as such, medication abortion accounts for a significant amount of abortions in modern times.
The FDA first approved the medication in 2000, and since then, the method has increased in its popularity. This two-pill medication of mifepristone and misoprostol taken in succession accounted for 42% of abortions in 2019 alone, according to CDC data.
However, state policies can dictate what abortion availability can, can’t, and should be on college campuses. Up until 2019, the decision on providing abortion services on campus was largely left up to university discretion, a decision in which most chose to refer students to external care. In 2019, activists in California began to advocate for a bill that was later signed into law that requires the state’s public universities to provide access to medication abortions on campus. The law was motivated by research conducted at the University of California, San Francisco, which found a majority of students lived at least 30 minutes away from a provider. Advocates argued for the bill on the basis that students would not be able to easily make time for a journey such as that, thus necessitating having the pill on campus.
California’s groundbreaking law inspired other activists working for college students’ access to abortion, one of them being Carrie Baker ‘87. Baker had already been active in supporting pro-abortion legislation when she got involved in college students’ specific problems related to the issue. When Massachusetts State Representative Lindsay Sabadosa took up abortion access for college students in legislation, she turned to Baker to do some research on the subject. Baker eagerly took the opportunity and, working closely with researchers from UCSF, conducted a study of the distance between Massachusetts’ public universities and abortion providers. In her study, she found that travel time to the nearest abortion provider was between 18 and 400 minutes across the state.
“If you’re at the Maritime Academy out on the cape, you have a really long way to go to get to a clinic. If you have a car, you can do it in a couple of hours. But if you have to take a bus, and make connections and go back and forth, it can be really burdensome,” she said. “Just to sit down and imagine what it’s actually like for college students to get abortion healthcare and what it means for the typical student who’s balancing classes and work and all these other obligations.”
While emphasizing the importance of having abortion care available on campus for students, Baker’s focus within the movement has shifted to the emerging industry of telehealth abortion. The phrase might at first seem impossible, and Baker recognizes people’s initial hesitation and confusion about it — but she also sees telehealth as the next frontier for abortion care, something that could greatly expand access. Telehealth abortion functions by sending the required medication pills in the mail and having medical professionals available to call for consultations and mental health counseling. Baker explains that for people who do not have access to traditional clinics nearby, telehealth allows them, even across the states, to get quality access to medication abortion.
“It’s wonderful because it’s easy, it’s more affordable and very accessible,” said Baker.
Though many telehealth abortion providers have now established themselves, Baker points out that the industry’s largest growth came quite recently when the FDA changed its regulations for the medication during the COVID-19 pandemic. As people sought a way to receive this care without having in-person interactions, in April of 2021, the FDA temporarily changed its previous rule that the first dose of the medication had to be dispensed in person and instead said that providers could send the medication by mail. Then, in December of 2021, the FDA made this rule change permanent, ensuring federal protection for mailed abortion pills.
With permanent FDA approval, Baker is now focused on helping to highlight this new type of provider, hoping to show people that they can receive the care they need in perhaps an easier format. And despite the prospects of having deliverable abortion pills, Baker still stressed the importance of having in-person care available on campus for students who may still want the traditional physical interaction.
While Baker continues to push for legislative change in Massachusetts, abortion care elsewhere in the country is not only unavailable on campus but largely banned in the state. In these states, activists have had to readjust their policy priorities and attempt to expand reproductive rights for students on campus in whatever medium the laws allow.
On the campus of the University of Texas at Austin, student activists recognize the reality of the situation in which they advocate for women’s justice issues. Isha Parikh, who helps lead the Women’s Resource Agency in UT Austin’s student government, spoke with frustration about the lack of resources and support for students in Texas.
“With all the new laws coming out, it’s already harder to get an abortion in Texas… so taking a Plan B is more important than ever right now,” Parikh emphasized. “It’s a problem that it’s super important to do that and you can’t find it anywhere on your campus. WRA is currently pushing legislation to the UT administration to provide some kind of subsidized Plan B on campus.”
Parikh reflected realistically in her expectations for a reproductive support system in Texas. Because of their strict laws, Parikh and other activists recognize that legal standings limit their ability to push for certain resources on campus but look for opportunities to work within their current legal framework.
The latest development in the legal protection of abortion has been Texas Senate Bill 8, often called S.B. 8, a topic that has dominated the national conversation. Passed in the Texas state legislature in May of 2021 and taking effect this past September, the law takes a new legal approach to enforcing abortion restrictions. The law allows any private citizen to sue anyone who “aids or abets” someone getting an abortion in Texas after cardiac activity is detected in the embryo. Thus, those obtaining the abortion cannot actually be sued, but the law instead targets those that “aid and abet” them, a term that has not been specified in scope and thus could be interpreted as not only the doctor who performed it but also the person who drove them to the clinic.
The law has garnered heavy media attention with legal scholars and activists trying to predict the decisions of the courts, and many familiar with the issue suspect that the law could be left standing at the end of its long litigation battle. The law has notably been allowed to stay in effect while it makes its way through the courts. A study done by researchers at UT Austin in October of 2021, found that in the month since the bill took effect in September, the number of abortions in Texas had already decreased by half.
Those familiar with abortion law also point to abortion restrictions in other states that could hold implications for people not only in the affected state but also those surrounding states who travel there for the services. Mary Ziegler, a professor at the College of Law at Florida State University, spoke on the existence of certain “haven” states that could now be vulnerable, such as Florida, in which a bill is moving through both houses of the state legislature to shorten the viable time for abortion from 24 weeks to 15.
“There’s usually sort of regional outliers in the Midwest and the South where people are traveling from out of state to get an abortion… The real question in Florida, and in other conventional battleground states, is: Is this going to stop at 15 weeks? Or is 15 weeks just the opening salvo and they’re going to move towards banning abortion earlier in pregnancy, which we would expect to have an effect on a larger group of students,” Ziegler explained.
In states that have less-restrictive abortion laws compared to others in the regions, abortion restrictions would restrict students’ access not only in Florida but also in surrounding Georgia and Alabama. Ziegler noted that Iowa also stands out as a regional haven for comparatively fewer abortion restrictions. While they have stricter abortion laws than more progressive states, states like Iowa and Florida can serve as regional havens for those seeking abortions — though a policy change could hold implications for individuals throughout their various regions.
Even telehealth abortion, Carrie Baker’s hope for expanding abortion access, faces threats of bans, she says. Five states currently ban the use of telehealth abortion, with other states attempting to put in similar restrictions. Many of these states also happen to lack a significant number of clinics, thus making telehealth abortion services even more vital to students there.
Facing these restrictions, student activists still hoping to connect students to resources have turned to external organizations when lacking university support. While these groups recognize the importance of getting contraception on campus, they also realize that sometimes students’ situations may lead them to want an abortion. However, in states like Texas when state law does not allow for universities to provide these services, students have turned to external organizations.
Krithika Shamanna, a junior at Rice University in Houston, helps to lead Deeds Not Words, an organization helping students make these connections. Shamanna and other student organizers have to work within the legal limits in Texas while finding ways for students to cope with the reality of their situations. Because such work can be sensitive, Shamanna could not name the external organizations that help students get the care they need elsewhere.
“Most of the support that happens is outside of the administration and more through student groups. It’s that type of grassroots system that we’re relying on rather than looking for administrative support,” said Shamanna.
With external organizations handling the logistics of connecting students to abortion services, student groups have been working to attack another overlooked yet consequential barrier to abortion: stigma.
Talking to both professors and students in various parts of the country, a desire to avoid the topic altogether permeates not only the restrictive campuses of Texas but even extends up to Smith College where Carrie Baker teaches.
In Texas, Parikh described a tendency to avoid the subject of abortion and women’s health among the students, largely because of uncertainty around how friends and classmates may react.
Even those outside of the student circles have noticed it, as the stigma surrounding abortion permeates class discussions. In Ziegler’s law classes at FSU, she often finds students to be hesitant to talk about it purely in the context of a legal discussion.
“In my classes, people just don’t want to talk about it at all. Even if you’re talking about it in class, and you have to talk about it, people don’t ask questions,” Ziegler lamented. “This is more in a context where people ordinarily would ask questions, but there’s a sort of sense of people just wanting to get through the class and leave because, on a lot of campuses, it’s not clear what your classmates think about abortion, so people don’t necessarily want to talk about it.”
Up north in states such as Massachusetts, where abortion has solid legal protection, such a stigma around abortion still prevails, according to Baker. When an unwillingness to discuss abortion openly persists, even people in states like hers are at risk for misleading abortion resources despite having abortion legalized. Baker points to “crisis pregnancy centers” as places that benefit from people not talking about their situation and trying to find resources on their own.
These centers are places that give the appearance of an abortion clinic by using traditional buzzwords and phrases and by situating themselves near medical facilities. However, their services do not offer any abortion care and aim to convince women to continue their pregnancy, and they often lack staff with accredited medical and clinical training. According to a study done at the University of North Carolina at Chapel Hill, there are currently more than 2,500 crisis pregnancy centers in the United States, which outnumbers the number of actual abortion providers currently in the United States.
“By public university health centers not offering this care, students don’t go to them for it, and students go to the internet… The students don’t know what real medical care is or how to find it. By not having this care readily available on campus, they’re making students vulnerable to getting targeted by the anti-abortion movement,” Baker explained.
Those seeking abortions who enter crisis pregnancy centers go in thinking the counseling and ultra-sounds promised will result in an abortion consultation, but the goal of these centers is to convince them otherwise. In the UNC Study, they found that 13% of respondents who had abortions visited one of these crisis pregnancy centers. Abortion activists worry that these centers promote a false conception of pregnancy options by omitting the ability for people to get an abortion.
In seeing all the danger that can come from students not addressing these issues together, student groups have taken on breaking down this stigma as another method of easing the situation of those needing an abortion. By hosting various town halls or student discussions, leaders such as Parikh at UT Austin and Shamanna at Rice hope to openly discuss the issue rather than ignore it.
While these discussions represent a step toward more openness surrounding abortion on campus, activists still want to see this attitude grow as abortion becomes not something that people see as a necessary evil, but as just another facet of their healthcare. Grossman of SMU sees this as a time for the pro-choice movement to reframe the conversation. She pointed out that campaigns relating to sexual harassment have begun to pick up on college campuses, but various campaigns around the country to acknowledge and support the decision to get an abortion still have yet to fully take hold on campuses.
“The reality is, Roe was a very necessary, essential, minimum protection, and that’s all it was. Really what we should have been doing instead of spending all the energy trying to save Roe is trying to build the rights and the policy and the attitudes and the infrastructure that would have guaranteed abortion access more securely and for more people.”