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How Philanthropy Can Protect Access to Abortion in a Post-Roe World

This article originally ran in The Chronicle of Philanthropy, May 12, 2022.

Chronicle Photo by Michael Theis

Last week’s leaked draft Supreme Court opinion overturning Roe v. Wade represents the culmination of a decades-long effort by abortion opponents to systematically dismantle access to reproductive health care. As we await the court’s official decision, we must use this grim preview as an urgent call to action.

The stakes couldn’t be higher. An analysis by our organization, the Guttmacher Institute, shows that 26 states are certain or likely to ban abortion if allowed to do so by the Supreme Court. People will be forced to carry unwanted pregnancies to term and suffer other harms as a result of these bans. A disproportionate burden will fall on those already harmed most by societal inequities — women of color, young people, LGBTQ+ individuals, immigrants, people with disabilities, and those with low incomes. Philanthropists of every stripe have a critical role to play in protecting access to care as we enter this perilous new era. Thankfully, we don’t need to create new organizations that would take years to get off the ground. An established network of highly capable, but often underfunded, groups is already in place and has been preparing for this moment. All that is missing are the resources to set their plans fully in motion. And to be sure, this will require significant resources.

How can individuals, foundations, and other donors meet the moment? Below are several areas — among many — where investments can make a real short- and long-term difference.

Support abortion funds. Guttmacher research shows that 75 percent of abortion patients are poor or low income, and many are prohibited from using their insurance coverage for abortion. With the typical abortion at 10 weeks costing $550 — and rising — thousands of people turn to local abortion funds for financial and practical support. Without these funds, many people would have no recourse but to carry unwanted pregnancies to term.

People of color and those with low incomes make up the vast majority of individuals served by abortion funds and will be hit hardest by the increased cost and logistical hurdles of obtaining abortions in the post-Roe landscape. While many individual donors have stepped up with contributions to abortion funds since the Supreme Court opinion leaked, support must go beyond the typical crisis-response giving scenario.

Individuals should consider making recurring donations, and foundations should give multiyear, unrestricted grants to sustain abortion funds’ work for the long haul. Donors can find a fund in their community to support or give directly to the National Network of Abortion Funds, which supports funds across the United States.

Fund practical support such as travel and lodging. A recent Guttmacher analysis shows that as abortion is banned or further restricted, travel distances to obtain reproductive care will jump sharply for people in many states. For example, if all 26 states considered certain or likely to ban abortion in the absence of Roe were to do so, the average distance a person in Texas would need to drive to reach the nearest abortion provider would increase from 17 miles to 542 miles. With abortion care likely to become far less geographically accessible in much of the country, those with limited resources will depend increasingly on volunteer networks and nonprofit organizations to help them with practical support such as travel, lodging, meals, and, in many cases, childcare. The most recent data shows that six in 10 abortion patients are already parents. The Brigid Alliance is one of the few national organizations that provide this type of support. The nonprofit works with a large network of groups and volunteers on the ground in every state and will need much more support in the post-Roe era.

Support grassroots, state-based organizations. A Supreme Court decision that places abortion regulation firmly in the hands of states will intensify state-level policy battles — and battles for hearts and minds of voters and legislators.

In states hostile to abortion, advocates are fighting not only abortion bans but also a cascade of related laws, such as those prohibiting the mailing of abortion pills. In states such as Virginia that could tip in either a progressive or regressive direction, advocates on the ground will face fierce policy battles with high stakes for those who need abortion care. And in progressive states, advocates are leading efforts to pass laws protecting and expanding access to care.

Regardless of the political context they operate in, organizations working to protect abortion rights, affordability, and access at the state level urgently need an infusion of funds, especially chronically underfunded reproductive justice groups led by women of color. These groups are deeply rooted in the communities most affected by abortion bans and are doing the on-the-ground organizing necessary to build long-term political support for abortion. They need unrestricted gifts and other predictable and flexible forms of support to maintain a readiness posture in a rapidly shifting landscape. A good place to send philanthropic dollars for this work is the Groundswell Fund, which supports reproductive-justice groups around the country.

Invest in abortion-services infrastructure. There is already wide regional variation in the number of clinics providing abortions. As abortion bans become more widespread, investing in the nation’s abortion-care infrastructure will be critical. In states where abortion is not under dire attack, more clinics and providers will be needed to care for those traveling from states where abortion is illegal. After Texas’s six-week abortion ban went into effect last year, clinics in surrounding states saw a dramatic surge in patients seeking care, offering a glimpse at what the future could hold for states where abortion remains legal.

One way to meet this demand is to open clinics in progressive states that border those hostile to abortion. Planned Parenthood is preparing to do this in Oregon near the border of southwest Idaho. That doesn’t mean funding for providers in states that ban abortions should come to a halt. The abortion services they are able to provide, while severely limited in some cases, will remain critical, and many of these clinics also provide birth control, reproductive health care for transgender patients, and other basic reproductive health services that could not easily be replaced if they went out of business.

Giving to the Keep Our Clinics campaign is a good way to support independent abortion clinics across the country. These clinics serve 60 percent of patients who have abortions in the United States each year, and donations to the campaign help keep their doors open.

Support abortion-decriminalization efforts and legal defense funds. Last month, a 26-year-old Texas resident named Lizelle Herrera was arrested and charged with murder after a hospital reported her to law enforcement on suspicion of having had a self-induced abortion. Although the charges were ultimately dropped, this episode is part of an alarming uptick in arrests and charges related to pregnancy loss, including miscarriage and stillbirth, in recent years, and it portends what is likely to be an increase in such prosecutions following a decision to overturn Roe. The effects of this trend toward criminalization are certain to be felt unevenly. Black, Indigenous, and other people of color, who experience higher incidences of miscarriage and stillbirth, will be at increased risk of prosecution for actual or suspected self-managed abortions. The Repro Legal Defense Fund is already hard at work on these issues but needs more support to cover bail and provide a strong legal defense for people targeted by law enforcement.

Invest in understanding the impact of abortion bans. Research documenting the harm caused by abortion bans and restrictions will play an important role in efforts to restore access to reproductive rights. Lessons can be drawn from countries where scientific evidence played an important role in bolstering abortion rights. Just in the last year, courts in Colombia and Mexico issued landmark rulings decriminalizing abortion, based in part on scientific evidence demonstrating the damage caused by restrictive abortion laws.

National and state-based research centers are well situated to measure the impact of restrictions and bans. For example, the Texas Policy Evaluation Project at the University of Texas at Austin is conducting research on the impact of abortion laws in that state. To build a critical mass of research evidence, centers of this type will require generous investments from foundations, individuals, and other donors.

For too long, many grant makers have avoided funding abortion because of the stigma and controversy around the issue. But the silence in the funding community has served only to exacerbate the stigma, while resulting in chronic underinvestment in organizations working to protect abortion rights and access. Meanwhile, anti-abortion donors have not balked at building an extremely well-financed network of activists fighting to roll back reproductive rights.

The leaked Supreme Court opinion makes clear that now is the time for philanthropists who believe in social justice and human rights to support abortion access, protect those likely to be harmed by bans, and work toward restoring strong policies. This is a marathon, not a sprint. Donors will need to take the long view and make funding plans that are sustainable for years, and possibly decades.

Grassroots activists, litigators, advocates, and scholars in the movement for reproductive health, rights, and justice have spent years preparing for this moment and are ready to lead the charge forward. It’s time for the philanthropic world to stand with them.

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