Oakland nonprofit helps California women locate reproductive health services

Since the Supreme Court’s Roe v. Wade decision in 1973, abortion has been legal in the United States. But all over the country, and even in states like California where abortion laws are among the nation’s most lenient, many women, particularly low-income women, still have trouble accessing abortion clinics and other reproductive health services, including finding birth control providers or prenatal care.

Some live in rural areas miles away from the nearest reproductive healthcare provider. Some are constrained by a lack of money for travel, or aren’t sure how to leverage public benefits (like Medi-Cal) to pay for a procedure. Many can’t take time off of work, have children to care for, or face pressure from their families and partners to carry a pregnancy to term.

At ACCESS, a nonprofit located in downtown Oakland, practical assistance is there for the asking. ACCESS serves women throughout California, connecting them with health resources and information about sexual health and reproductive rights. Unlike Planned Parenthood, for example, ACCESS doesn’t perform abortions or prescribe birth control. The organization’s primary focus is running a toll-free phone line that women anywhere in California can call for help for issues ranging from finding testing for sexually transmitted diseases to locating the nearest abortion provider. ACCESS volunteers can help them plan out the trip, or explain the Medi-Cal system, which covers abortion procedures.

“Many of our callers are from rural areas and need to travel for a procedure,” said ACCESS’ executive director Erika Scott. “So, we provide a practical support network—we help house women, give women gas money, pay for BART tickets, provide childcare. And we have a Women In Need Fund—on some occasions, we can help subsidize the cost of abortion. That’s the heart of our work.”

ACCESS also provides services to women who want to carry their pregnancies to term—the nonprofit offers guidance on where to find prenatal care, and connects women interested in adoption to local agencies.

The call line is open Monday through Thursday from 9 a.m. to 4 p.m., and on Friday from 9 a.m. to 1 p.m.—it is operated in both English and Spanish, and interpreters can be sourced for women who speak other languages.

Scott said that the number of callers has steadily increased since the nonprofit was launched in 1993, and most women who call are seeking abortion-related information. Women do call, however, to talk about birth control, gynecological exams, adoption, or just to discuss their decision process with an impartial party, said Scott. Since ACCESS’ opening, well over 20,000 women have dialed the nonprofit and used its services.

The phone line is staffed by volunteers and interns working out of the Oakland office. Currently, ACCESS has 9 interns and about 60 volunteers all over the state who work on a variety of projects, including lobbying for reproductive rights.

“We have our health line and a practical support network of volunteers,” said Scott. “But we also try and affect policy through activism and do a lot of community education and outreach—for example, we’re training the next generation of reproductive justice activists.” Scott said that people on the margins of society, like immigrants and the poverty-stricken, particularly benefit from the work ACCESS does connecting them with resources.

Project manager Lisa Banh, who started as an intern herself, says the work ACCESS does feels personal to her. “My parents were immigrants from Vietnam,” said Banh. “My mom had six kids—well, she actually had seven, but she lost one in Vietnam due to a lack of transportation to the hospital. We were on welfare there. I just saw how it affected my mom, not having these sorts of resources.” Banh said that if her mother had been given more education on reproductive health, more information on birth control, and had broader rights, she might have had better control over her reproductive life.

Banh and Scott both noted that while California has some of the least restrictive abortion laws in the country, some women still aren’t able to locate the services they need, particularly if they live in rural areas. On a map pinpointing California’s abortion providers, you’d find three major clusters of dots: one around the Bay Area, one around the greater Los Angeles area, and a smaller one in the south around San Diego. The rest of this vast state has a smattering of clinics, but 41 percent of California’s counties have no abortion providers whatsoever.

In addition to dealing with the difficulty of finding a clinic at all, women who live outside of metropolitan areas are often stymied if their local provider doesn’t take Medi-Cal, California’s public health insurance program for low-income individuals and families, or if they’re uninsured. Even in California, providers willing to perform an abortion on a woman in the second trimester of her pregnancy are also scarce, and those who accept Medi-Cal for second trimester abortions are the rarest of all.

“We don’t end up working with the private doctors, because they don’t take the right insurance,” said Scott. “And there are plenty of Catholic hospitals that don’t provide abortions. So sure, there can be plenty of hospitals in a rural area, but if they’re Catholic hospitals, it doesn’t do you any good.”

Most of the providers ACCESS works with are clinics, like Planned Parenthood, Women’s Health Specialists, Family Planning Specialists, and Choice Medical Groups, and hospitals, like the Women’s Option Center at San Francisco General.

Even women who know where these clinics are located can have difficulty getting to them—issues like money for transportation and getting time off work often stand in the way.“Women call us all the time, and they face all these practical barriers,” Scott said. “Every woman’s personal experience is so different, and it’s important for us to recognize the differences and not to judge. We just need to be there to give any kind of support that we can in order for her to be able to make the most informed decision that is best for herself and best for her family.”

Scott also noted that while ACCESS, which is funded by grants and individual donors, will give financial assistance if necessary, the non-profit attempts to help women leverage their own resources. For example, with the help of a phone line counselor, women might think of options that hadn’t occurred to them initially—a cheaper mode of transportation they could take, an area of their budget they could readjust to save money, or a person they know who could provide childcare while they’re away getting treated.

“What we do first is try to get women to take control of their own choices, and to think in creative ways about how to use their own resources,” said Scott. “This builds their power.”

According to the Alan Guttmacher Institute, a leading sexual and reproductive health research group, nearly half of all pregnancies in America are unintentional. Of those, 40 percent end in abortion, and around 1.2 million abortions are performed in the U.S. each year. According to figures from the institute, over half of the women who get abortions are in their twenties, at least 70 percent consider themselves affiliated with a religion, and, as the phone line volunteers at ACCESS know, the majority of them are poor.

Barbara Hoke and Jacqueline Barbic pose with their Access to Justice awards.

Because so many of the women who seek abortions are low-income, ACCESS staffers are particularly concerned about new legislation efforts that might reduce funding for reproductive health clinics. During the group’s International Women’s Day celebration on March 8, held to honor two local reproductive rights activists with Access to Justice Awards, Scott used her opening remarks to speak about the legislation circulating in the House of Representatives that proposes cutting federal funding to clinics like Planned Parenthood. This would be particularly damaging to the health of low-income women, as Planned Parenthood doesn’t require insurance and is a low-cost health services provider. Proposed by Indiana Republican Rep. Mike Pence, the Title X Abortion Provider Prohibition Act would stop all funding to clinics that perform abortions, and would eventually force many of them to shut their doors.

Two other bills are also circulating that would make similar cuts to federal spending on reproductive health. While most political observers don’t expect any of the bills to become law, Scott said she is frightened. “I didn’t see this coming when we elected a pro-choice president and I didn’t see this coming when the Republicans took back the House in the last election,” she said. “The legislation that is being introduced in the house right now is anti-choice, it’s anti-woman, it’s anti-family.”

A collective grumble rose from the crowd. Later, Jerrie Meadows, a longtime ACCESS board member, echoed Scott’s sentiment. “They’re throwing women under the train,” she said. “We’re fighting all the battles we already won all over again.”

Along with funding issues, another problem abortion clinic clients face is harassment going into and coming out of clinics. Protestors have a long history of standing outside providers while carrying threatening signs or using physical intimidation tactics to try to stop women from going inside. Vandalism to the facilities themselves is common, and in the worst cases, violence has been used against clinic staff and doctors.

For the past ten years, Barbara Hoke, one of the two women honored at the ACCESS celebration, has trained and organized escorts who stand outside of Oakland clinics and walk those patients who want their help to the entrance. Escorts often work in teams of two—one person moves toward the clinic with the patient, and one stands by the door, to see that it is unlocked at just the right moment.

Hoke, a lively woman wearing a vest dotted with red, green and yellow chili peppers, talked to the group in her distinct Texan drawl about her work. “It requires the tenacity of the devil and the love of a mother,” said Hoke of what it takes to escort clinic clients. “We put ourselves between the women walking into a clinic and the people that might humiliate her.” Hoke said escorts must always be mindful of the patients’ feelings—a woman heading to a clinic is going to be wary of strangers who approach her, even if they’re offering kindness.

Fellow honoree Jacqueline Barbic, who has managed abortion clinics for 30 years, played a major role in a lengthy battle to pass a “bubble ordinance” in Oakland, or an order that dictates what protestors can and can’t do outside of abortion clinics. The 2008 ordinance, which took fifteen years to pass, applies to anyone standing within 100 feet of an abortion provider. In that space, protestors cannot come within 8 feet of a patient. Oakland’s bubble ordinance prohibits “the use of force, threat of force, or physical obstruction to intentionally injure, harass, or interfere with any person providing or obtaining constitutionally-protected reproductive health care services.” Several other states, including New York, Florida and Massachusetts, have passed similar laws over the last twenty years.

According to Scott, the bubble ordinance has made a world of difference for clinic clients.  “The bubble ordinance is very important,” said Scott. “Without it, protestors can get right up there in clients’ faces.”

Barbic’s career has been closely aligned with ACCESS’ main mission, particularly the idea that women cannot always find an abortion provider near home. Barbic founded her Oakland clinic, Family Planning Specialists Medical Group, in 1982, after noticing that women in Oakland were coming to her Redwood City clinic for treatment. “We felt that there wasn’t a clinic serving the Oakland community well,” Barbic said. “We wanted to bring in excellent, experienced doctors.”

But in addition to the possibility of cuts in government funding, those who work in reproductive healthcare are also facing possible losses of funding from other sources affected by the recession, like endowments that give them grants, for example. The recession hit nonprofits like ACCESS hard, said board chair Reichi Lee, and the organization relies on individual donors now more than ever because grant funding has decreased. “One of my jobs is to look forward and plan for the future,” said Lee. “Women will always need to have a place where they can go and not be judged, and where they can get timely, appropriate care.”

For Scott’s part, she says that whatever the state of the economy, the services ACCESS provides will always be important to women in California—although she wishes that health services were widespread enough that most women could find them easily in their hometown, instead of having to dial an Oakland help line.“That’s our goal, of course, to make our work obsolete. But I don’t see that happening,” she said. “A bad economy hasn’t created these problems, and I don’t see them going away anytime soon.”

For more information on ACCESS, visit whrc-access.org. To reach the ACCESS hotline, dial 1-800-376-4636 for English and 1-888-442-2237 for Spanish.

Lead photo: Intern Catherine Guerlac talks to a woman in need of reproductive care on the ACCESS healthline. Photo courtesy of ACCESS.