Francine Thompson has been working on the front lines of abortion access for decades. As the director of a reproductive health clinic in Iowa City, she said the overturn of the Roe v. Wade decision last month was devastating.
“There’s a lot of confusion, there’s a lot of fear from clients,” Thompson said. “There’s a certainly a level of stress from staff about what’s going to happen also. But we’re just really working hard to continue to provide abortion services since they are still legal in Iowa.”
The Emma Goldman Clinic opened shortly after the 1973 Roe decision legalized abortion nationwide.
Thompson said the number of people visiting the clinic may actually be increasing since Roe was overturned, as abortion bans in other states push people into Iowa.
But it’s not clear if abortion will remain legal in Iowa for very long.
“It’ll look different, but we’re going to continue to be here,” Thompson said. “But the whole reproductive justice community is really hurt, outraged, devastated, and at this point, mobilizing.”
Recent court decisions have opened the door to abortion restrictions in Iowa and across the country. Abortion is still legal in Iowa up to 20 weeks of pregnancy, but the governor is asking the courts to reinstate a ban on most abortions as early as six weeks into a pregnancy.
Thousands of Iowans havejoined protests in recent weekscalling for abortion to remain legal. Some abortion rights activists are also preparing to preserve access for Iowans, no matter what happens.
“There’s lots of meetings to kind of coordinate care between states because so many people are going to have to travel across borders in order to receive abortion access,” said April Clark, a board member for the Iowa Abortion Access Fund and a nurse at Planned Parenthood.
The fund has seen a recent spike in donations, and Clark said that has allowed the group to more than double its financial support for people who need help paying for their abortion.
“People are really scared about what’s going to happen and if they’ll still be able to get care or not,” Clark said. “So this will also help people who, you know, if we do lose abortion access in Iowa, that bump in funding will help them to be able to afford to go to another state where it is still legal, like Minnesota or Illinois.”
Iowans have been holding raffles, bake sales and other fundraisers to support abortion access. Clark said there’s even a new group of pilots volunteering to transport people in their private planes to abortion appointments.
“It’s been pretty amazing the amount of collaboration and time that people are putting in, because most of us are all volunteers,” she said.
Clark said she has already seen Iowans traveling out of state to get abortions because bans in other states are pushing people into Iowa and filling up appointments.
Iowa has five clinics that provide abortions. Three clinics offer procedural andmedication abortions, and two only offer the medication option, which is a two-pill regimen used early in pregnancy. Nearly 80 percent of abortions in Iowa in 2020 were medication abortions, according to data from the Iowa Department of Public Health.
There’s also a telehealth service for medication abortions operating in Iowa and 14 other states called carafem.
“We see telehealth as a kind of pressure release valve for in-clinic services,” said carafem Chief Operations Officer Melissa Grant.
She said people seeking an abortion can set up a video appointment with a physician. The patient would also have to get an ultrasound as required by Iowa law.
“Once we see that, as long as the client is indeed less than 11 weeks pregnant, then the physician goes ahead and sends an order to an online pharmacy, and the medications go shipped directly to the client’s home or any Iowa address of her choice in a confidential and discreet box with full information about how to use them in order to have an abortion at home,” Grant said.
She said this option doesn’t work for everyone, but it can be more affordable and help people avoid traveling, while leaving clinic appointments open for those who need them. Grant said carafem will watch for any law changes in Iowa and will provide as many options as possible within the limits of the law.
If abortion is banned in Iowa, telehealth abortions would also become illegal.
A new group has been posting on social media offering to provide abortion pills to Iowans who request them for self-managed abortions, regardless of the law. The group declined to speak with IPR for this story.
Medical experts say abortion pills are safe and effective, and they’re easier to obtain in some other countries than in the U.S. But Grant said there can be legal risks to getting your own pills, and that it’s better to have a medical provider to check in with when getting an abortion.
“People shouldn’t have to settle for getting medication that is safe, effective, been used for over 20 years in this country—you shouldn’t have to seek it outside our country in less than desirable circumstances,” Grant said. “But I think we’ll see more of it.”
Abortion rights advocates said Iowans who want to maintain abortion access should donate to groups that are working on that, vote for people who support legal abortion, and share accurate sources of information about where abortions are available.
They also said it’s important to continue efforts to ensure everyone has access to affordable birth control.
“A total abortion ban in Iowa doesn’t end the need for abortion, and it doesn’t end the need for the Emma Goldman Clinic,” Francine Thompson said. “We’re going to continue to be here. We provide critical and essential reproductive health care services, and those are really going to be needed even more when there isn’t abortion access.”
