Oakland, CA — UPDATE 9/23/19: When this story was first published in February, the fate of the movement to offer medication abortions, or “the abortion pill,” on college campuses in California was uncertain. In September 2018, as one of his last acts as governor of the state, Jerry Brown vetoed SB 320, a bill that would have required student health centers at public universities to stock the medication; he called the bill “not necessary.”
As California prepared to usher in its new governor, Gavin Newsom, the authors of SB 320 introduced a similar bill, SB 24, for consideration. In the nearly ten months since, the national debate about abortion has grown louder and more contentious. A spate of highly restrictive abortion laws in red states and the conservative tipping of the Supreme Court have raised questions about the future of abortion access, even in solidly blue California.
Then, on September 13, the state Senate voted to approve SB 24, with a margin of 29-11. The bill then moved to Governor Newsom, who has one month to make a decision. Newsom has been vocal about his support of abortion rights, and he is expected to sign the bill. If he does, California will become the first state in the U.S. to offer medication abortions on its public university campuses, furthering its strongly pro-abortion rights reputation.
Abortion will undoubtedly be a key issue in the upcoming presidential election. Depending on the outcome in 2020, Governor Newsom’s decision next month may position California at the forefront of a larger national shift — or, on the far side of a deepening political schism.
When the bouts of nausea began in the first semester of Jessy Rosales’ junior year at the University of California, Riverside, she thought she must have caught some sort of stomach bug. As a busy student with a part-time job and lots of extracurricular activities, she hoped the symptoms would pass on their own. But when weeks went by, and the waves of nausea kept coming, she made an appointment at her college’s student health center.
After a series of tests, Rosales got some unexpected news: despite the fact that she’d been on birth control for nearly a year, she was pregnant.
Rosales remembers breaking down in the exam room. “I was thinking to myself, I’m only in my third year, I don’t have my degree, I’m not financially stable,” she said. On top of that, she couldn’t imagine telling her parents, with whom she’d never even talked about sex. And things with her partner were on shaky ground. (When she broke the news to him, he asked her not to tell anyone else.)
Rosales told her doctor on the spot that she wanted to have an abortion. She could do that, her doctor explained, but not on campus. The procedure isn’t offered at student health centers.
In order to terminate her pregnancy, Rosales would have to go elsewhere.
California has a reputation for being strongly supportive of abortion rights. While in other parts of the country, heartbeat bills are being debated and increased restrictions are forcing some clinics to close their doors, the golden state boasts some of the most abundant and widespread access to abortion in the nation. Based on a 2014 report, only 5 percent of California women lived in counties without an abortion clinic. But obtaining an abortion in the state can still be challenging, especially for college students.
Each month over 1,000 University of California and California State University students undergo abortions, according to estimates by the Bixby Center for Global Reproductive Health at UC San Francisco. Because such services are not available on any of those campuses, students must be referred out to clinics in their communities. How easy it is to access these clinics varies greatly, depending on whether the campus is located in a rural or urban area. The study found that on average, students spent 38 minutes each way traveling to off-campus clinics via public transportation. UC Berkeley is on the short end of the spectrum at 24 minutes. At CSU Stanislaus in the Central Valley, the closest provider is over an hour and a half away from campus by public transit.
However, for many students, getting to a clinic is only half the battle. First, they have to deal with insurance. Students at both California public university systems are able to get referrals to off-campus clinics through their campus health centers. But while the UC system offers students an insurance plan that covers abortion services at outside facilities, the CSU schools do not.
Even for UC students like Jessy Rosales, the process can be challenging.
Since she couldn’t obtain her abortion on campus at UC Riverside, Rosales made a counseling appointment with a women’s health specialist at her school in order to get a referral. After re-explaining all of her options, the specialist gave Rosales a list of abortion providers in her area, but when she followed up, she says one place turned out not to perform abortions, and another wasn't able to process her insurance.
Rosales said that at that point, she felt paralyzed when it came to exploring other options. “This was my first time on my own, navigating the medical system and insurance system,” she said. “I didn’t know what to do.”
When asked to comment on Rosales' experience, UC Riverside's Director of Student Health Services Julienne DeGeyter responded by email: “All of our students are told to contact us right away if they have any trouble getting in to see a specialist that we have referred them to for services. I am not sure why this student didn’t contact us, we have an insurance department, front desk staff as well as the medical assistants and providers who are always willing to help a student if they run into difficulty with a referral.”
According to those who oppose abortion, delays in the process of terminating a pregnancy create an opportunity for women to reflect on the gravity of their choice. At a recent California State Senate hearing, a representative from the group Students for Life of America, or SFLA, shared a story about a CSU Sacramento student who, while seeking her second abortion, found her school’s SFLA chapter and decided to carry out the pregnancy instead.
For Rosales, the experience did not alter her decision to have an abortion. Instead, it made her lose faith in her ability to access one.
At around the same time that Rosales’ story was unfolding, another student, Adiba Khan, began to hear similar stories of women on her own campus at UC Berkeley who were having trouble getting access to abortions. Khan is from Oklahoma, a state with some of the most prohibitive abortion laws in the country. She said she grew up “feeling like I didn’t have any autonomy, and seeing peers forced into unwanted pregnancies.”
Khan believed that California was different. When she learned that her school’s health center didn’t offer abortions and that many students were struggling to access reproductive care off campus, she was surprised. Khan didn’t have any experience in organizing or activism, but along with fellow student Meghan Warner, she founded the group Students United for Reproductive Justice, and together they set out on a mission: to make medication abortion available through their school’s health center.
Medication abortion involves taking two pills: mifepristone and misoprostol. The first pill is taken at a doctor’s office, the second at home. Medication abortions are less invasive than surgical abortions, but they are currently only an option for women who are up to 10 weeks pregnant — which means timely access to a clinic is important.
Given that abortion is covered by the UC system’s health insurance plan, Khan said it didn’t make sense to her that the prescription for a medication abortion wasn’t available through school health centers.
Building on Khan and her advocacy group’s efforts, in 2018 both the California Senate and Assembly passed Senate Bill 320, also known as the College Student Right to Access Act. Introduced by State Sen. Connie Leyva (D-District 20), the bill would have required all UC and CSU campuses to make medication abortions available in their student health centers by 2022. A fund derived from private donations would have been established to get the program started.
Even in a blue state like California, Khan said that would have been a big deal.
But the bill faced rigorous opposition from anti-abortion rights organizations on campus. “Abortion pills are not a factor in student success," said Anna Arend, the Northern California regional coordinator for the anti-abortion rights group Students for Life of America, in testimony before the California Senate Education committee on SB 320.
Opponents also raised concerns about associated costs for staff training, equipment and systems to support the bill’s implementation.
Ultimately, then-Gov. Jerry Brown vetoed SB 320 last September, calling it “not necessary.” But the bill’s drafters refused to accept Brown’s decision as final. In December, State Sen. Leyva introduced a similar bill, SB 24, and in January, Gavin Newsom was sworn in as the new governor of California.
For its supporters, the bill’s fate has high stakes. Long controversial, abortion has become an increasingly contentious topic in today’s divided political climate. In the 2018 midterms, West Virginia voters passed a measure to include language in their state constitution declaring that it doesn’t secure, protect or fund the right to abortion. The state also voted to ban Medicaid from covering abortion services, while Alabamans voted to give fetuses legal rights.
On a national level, just last week the Supreme Court blocked a Louisiana law that would have further restricted abortion access in that state, but that stay is temporary, and the confirmation of conservative Justice Brett Kavanaugh to the Supreme Court has fueled concerns that Roe v. Wade may be overturned.
When SB 320, the bill to make medication abortion available on public college campuses, went before the California Senate earlier this year, Rosales was there to testify.
As she struggled to find an abortion provider and figure out how to pay for it, she became depressed and withdrawn. “The more you wait, the more emotional trauma starts to build up,” she said. At times, she wondered if the obstacles she was facing were signs that she shouldn’t have an abortion. “I started to internalize a lot of stigma.”
Rosales told me she felt immediate relief after she was finally able to have an abortion at a local health center. That said, there are aspects of the experience she wishes had been different. She would have preferred to have a medication abortion within the 10-week window, she said, which would have allowed her to end her pregnancy in the privacy and comfort of her own home. And she wishes she’d been able to handle the whole thing through her student health center, whose services were designed to accommodate students’ schedules and streamline the insurance process.
“If I would’ve been able to have it done in that facility, maybe the very next week, I wouldn’t have had to go through all this,” she said. “It would’ve made my story something completely different.”