Everything You Need to Know About Abortion Later in Pregnancy
After personal experience with severe pregnancy complications and requiring a later abortion among a labyrinth of state abortion bans, Erika Christensen and Garin Marschall co-founded Patient Forward, a national strategy and advocacy organization. Erika and Garin sit down with us to talk about why people need abortions later in pregnancy, what barriers exist to accessing that care, and why government interference in pregnancy outcomes is overwhelmingly unpopular.
Further into pregnancy, the cost of care goes up, the number of providers goes down, and more and more restrictions go into effect. People require abortions later in pregnancy for a host of reasons, but often they are needed after 1) they learn that they are pregnant later in gestation or learn new information about the pregnancy, or; 2) they know care is needed earlier in pregnancy but are delayed by TRAP laws, abortion bans, economic reasons, and more. Many experience a combination of these factors which impact their access.
Links from this episode
Patient Forward
whonotwhen.com
AbortionJusticeNow.com
Fund-a-Thon
Plan C
Abortionfinder.org
Ineedana.com
Repro Legal Helpline
Repro Legal Defense Fund
Take Action
Transcript
Jennie: Welcome to rePROs Fight Back, a podcast on all things related to sexual and reproductive health, rights, and justice. [music intro]
Read More
Jennie: Hi rePROs. How's everybody doing? I'm your host Jennie Wetter, and my pronouns are she/her. So y'all, I am back from my trip. I had such a great time traveling with my mom. Like I said, we took a Viking cruise from, we started in Oslo and took the train from Oslo to Bergen, and it was gorgeous. Y'all, like, just absolutely stunning. And then we left from Bergen and hit Shetland, and then we did some stops in Scotland, and then we went to the Orkney Islands. And then we had a quick stop and we had some more in Scotland, and then we went to Belfast. And then we had a couple stops in Wales. And then we were supposed to go to Dublin, but the weather was not cooperating, so we didn't do that. But we then had a couple stops in England and ended in London. And it was two and a half weeks. It was so much fun, saw so many wonderful things. Took so many pictures. The weather, y'all, the weather gods were smiling on us the whole time. It might have been, like, a little cold or windy, but it did not rain on us at all. And considering the places we were, that is like an utter miracle. Like most days it was gorgeous and sunny. Maybe a little windy, maybe a little chilly, but like nothing like I just had like a sweater most days. Like, it wasn't cold and it was just so much fun. And it was just a great time. I saw so many wonderful things. It's hard to pick a favorite. I really loved...Shetland was gorgeous. Like I got to see the Shetland ponies and I don't know, it was just so much fun. I don't know that I have a favorite. I really liked Edinburgh and I'd like to go back. I would like to go back to Bergen at some point. I feel like there was a bunch of Scotland I really enjoyed. It was just wonderful. Oh, and it was lambing season, so there were just little baby lambs everywhere, which was delightful. We have so many pictures of lambs. My one, I guess two bummers is: I didn't get to see a highland cow, which I was super excited to see, but I did not get to see a Scottish island cow, which made me very sad. And then two, our trip to Dublin being canceled. I had been before, so it wasn't like a huge deal. But I had plans for when we were in Dublin of, like, things I wanted to buy. And we had a really fun trip planned that day, but that's okay. It was still so much fun. I did a lot of reading. I did not check my email. I mostly stayed off social. It was just so delightful to get away from everything and not deal with everything happening. And I had such a wonderful time and yeah. Oh, oh, the other thing I really loved, we went to Bodiam Castle, which was super cool. It's only, like, the outer parts of the building are still intact, but it's got like a moat. It was just gorgeous. Maybe I'll share some pictures with Elena that they can post on social about my trip. It was a lot of fun. It was also a little surreal to be in the UK when there was a court ruling that was anti-trans that came down. But, so that was, that was, that was sad and hard to see that happen. But it was also very exciting to be in London on the day, on the, on the Saturday where there were the big rallies. We had stuff planned, so I did not get to go to the rally, but we were around it and it was so wonderful to see so many people who turned out to support trans rights in the UK. Very sad that the case came down in a negative way. But it was great to see the energy and all of the people who turned out for trans rights. So, I was glad to be able to at least see that part but yeah, overall I had such a fun time. My mom and I did really well together. I was a little nervous that two and a half weeks in one room might be complicated, but I think overall I think she would agree. We did really well. Thanks, mom. I had such a wonderful time. I can't wait to look at all of the pictures that are still on my camera at this point, but maybe that's what I will do over the weekend is start doing some editing of pictures and stuff because y'all, I took so many, it's outrageous the number of pictures I took, but it was a wonderful time. Okay. With that, I'm not even gonna talk about anything that happened while I'm gone 'cause I'm still trying to live a little bit in that bubble of like, ignore it all. But I'm very excited for this week's episode.
Jennie: We are doing a six-month series, so one episode a month talking about abortion later in pregnancy. It is such an important issue that we have done episodes talking about, but we haven't done a deep dive in a while. So, I'm very excited to do this long-term look at abortion later in pregnancy and why we need to care about it in many different aspects of it. And I couldn't think of a better place to start than with Garin Marschall and Erika Christensen at Patient Forward. They were wonderful guests and I had so much fun talking to them. And I talk a little bit about the way they have impacted my work, and I am just so grateful for all of the work that they are doing. It is so important and I am so excited to be able to highlight it and just feel lucky to have them on. They were wonderful guests. Okay, so with that, let's go to my interview with Erika and Garin. Hi Garin. Hi Erika. Thank you so much for being here today!
Erika: Oh my gosh, hi! Thank you for having us. We appreciate it.
Jennie: I'm so excited to have you here. And before I let you introduce yourselves, I'm going to probably embarrass you for a second. I have definitely followed you on social media for a very long time, and I have been just so grateful for all of the advocacy that you have done around abortion later in pregnancy. As you know, we've done our 50 state report card for, I don't know, I think this year's was our 13th year. And because of your tireless advocacy—not aimed at me or anything, but just like watching the amazing work that y'all do—when we switched the report card from Population Institute to rePROs we got rid of, we used to only ding states for 20-week abortion bans or lower. And because of all of your work and advocacy, we switched it to any gestational ban.
Erika: Yes. Clapping. Oh, that's incredible. That's wonderful to hear. Thank you for sharing that. That is amazing. I'm gonna ride that.
Jennie: Yay!
Erika: I'll be riding this high all day. That's amazing.
Jennie: Okay, so let's go ahead and have you introduce yourself. Erika, do you wanna go first?
Erika: Yes, thank you. My name is Erika Christensen. My pronouns are she/her. And I am co-founder of Patient Forward, and I will let Garrin introduce himself before we share too much more maybe.
Garrin: Hi, I'm Garrin Marshall. I use he/him pronouns and I'm also the co-founder of Patient Forward. We're married—sometimes you know, it's important to like put that out there so people understand maybe our relationship or why we're familiar or
Erika: Yeah, it would be confusing listening to this and thinking we're coworkers. People might think, wow, they are very, they have a real problem over there. [laughs] No, we started this work married, we remain married. And that is, you know, that's just something we try to let people know from the beginning.
Jennie: Well, I am really excited to have the two of you on. That's just because you've played a big role in influencing how I think about this. But it's a good start of a new series we're gonna do in coordination with Patient Forward for the next six months. We're gonna have one episode a month talking about some aspect or some issue relating to abortion later in pregnancy. And honestly, I couldn't think of a better place to start than with the two of you. Do you maybe want to talk about how you got involved in this work?
Erika: Yes, thank you. And also, we're so excited about this series. Thank you so much for being such a wonderful partner as we put all of this together along with our Patient Forward's Chief External Affairs Officer Bonyen Lee-Gilmore—she's also been incredibly instrumental in putting this series together and we're so excited for it. So, thank you. Maybe we'll plug it a few more times over the course of this conversation as well, because we're so excited. So, I guess I'll start. Garrin and I started doing this work almost nine years ago, which is so wild. It's so amazing how fast the time goes, but it was very much a case of an issue sort of choosing you. We were newly married, we were wanting to grow our family, and we thought quite naively in retrospect, that we were going to experience pregnancy and having children, hopefully without too much friction. And what we found is it was much harder, I think, than we had anticipated. My first pregnancy ended in a miscarriage at 10 weeks, and then I was pregnant again soon after. And that pregnancy proved to be very complicated, and the complication sort of grew as the pregnancy progressed. It got so that every appointment, you know, every two weeks we would learn some new piece of critical complicated information about our pregnancy that eventually culminated in learning at 30 weeks that in fact, our doctors no longer thought that my pregnancy was viable. Their treatment or one, you know, one option available to us, one treatment was to end the pregnancy was to have an abortion. We were living in Brooklyn at the time. Our doctor was on the Upper West Side. You know, we had access to the best medical care in America. We were really lucky. And in the same conversation where my doctor suggested that we might consider ending this pregnancy, he also shared that if that is the course we chose we would not be able to do it in New York, in New York State and that it would require flying across the country to one of the last stop all trimester abortion clinics. The one he recommended was in Colorado. And so, at the same time that we're learning all of this new information about my pregnancy and we're processing, you know, this terrible news, the grief, the trauma, we're also learning in real time about New York State abortion law, which I, you know, I think for many people it's not until you face a ban that you might have even thought to look into it. You know, it's not something that people anticipate having to experience. So in very real time, we're learning about New York State abortion law. We're learning that there's a limit at 24 weeks, which I had sailed past weeks before without anyone having mentioned that it existed, even as my pregnancy was already quite complicated. I also had, you know, health complications of my own. I had had a brain surgery the year before which could be its own podcast. So, you know, there was a lot of complicating factors, but in the end, we sort of focused on getting every, all the pieces together that needed to be together for me to be able to travel at that point in my pregnancy and reach care. A lot of doctors had to get on the same page. My maternal fetal medicine specialist, Dr. Hern in Colorado, my brain surgeon, they're all having, you know, these conversations about how best to care for me despite the law in New York. And that was clarifying for us. They thought, how can we best help this person given this law in New York? And so we were able to put travel on credit cards, you know, last minute flights, car, rental hotels. My mom gave us $10,000 out of her 401k so we could pay for the care itself. And we realized really immediately how lucky we were to be able to do that. And at every point, Garrin and I would look at each other and say, oh my God, what if we didn't have IDs? What if we couldn't fly? What if we didn't have a driver's license and couldn't rent- what if we couldn't rent the car? What if we were under 25? What if we didn't have my mom who had access to this money who could take it out of her account and give it to us? You know, it was the whole time we were just understanding how if any piece had not been in place, I would be forced to carry that doom pregnancy to term, and then we would be grappling with what that would look like, you know? So, I think that was pretty immediately radicalizing for us. And I think we sort of became really overnight obsessed with abortion laws, I think that's safe to say, and remain maybe more obsessed than ever. So Garrin did I leave anything out? Any important pieces that I'm missing?
Garrin: Well, I think, I think to that point, like when we were sort of going through this, we were like, oh my God, does anyone know about this? And nobody that we knew did. And, and I think, I think there was this impulse that we had to fix it, right? And, like, the way mine showed up is I was like, I kind of went down a rabbit hole on insurance or whatever, but Erika, to her credit was like, I want to, I wanna talk to someone about this. And, you know, she reached out to Jia Tolentino and did an anonymous interview with Jia Tolentino for Jezebel about her experience needing this care. And, and, you know, then later through advocacy, you know, we got, because of that article, we got hooked up with folks with the New York Civil Liberties Union and, and learned about efforts in, in New York state to sort of fix the law and decriminalize abortion. And this process of like, feeling the need to tell people, feeling the need to try to help fix it so that someone else didn't have to go through it. You know, I think those were very early impulses of ours. And I think that then those drove like really what was like a learning process, frankly, about how the law works, about how insurance works, about how these, these complications exist, about the sort of barriers and obstacles that existed in New York at the time that weren't allowing that law to move forward, you know? So, we sort of threw ourselves into that and we're able to work with other folks in the state, other advocates that have been working on it for some time to get the New York Reproductive Health Act passed in 2019. And I think early on we realized that, like, you know, we realized that that was, like, it was very important to decriminalize abortion in New York. And then we also learned that we wish we had gone farther, and we wish that that law had gone farther and had not in a way like reified a line still in the state. And I think that, you know, that learning process really drove what became Patient Forward of realizing that, you know, we wanted folks who were, who were sharing their stories in an effort to change laws, to have more tools, to have more education, to have more resources. We wanted advocates in the field to understand the sort of breadth of experiences way beyond ours that drove people to need this care. And I think that's the other thing is we realized that stories like ours were way overrepresented with regard to later abortion—stories of a fetal diagnosis or, or something like that. And realizing that there were all these stories and all these people and all these experiences missing from this narrative around abortion later in pregnancy. And so, Patient Forward is really like, you know, it began as our efforts to try to figure out some of those problems and, and see if we could like work with others and, and kind of start to shift things in the country. But, you know, both federally and at the state level.
Jennie: Yeah, I think I first started following y'all around during the Raya fight and remember following all of that and, and then really just thinking back of like, my early days working in this field and how, how much abortion later in pregnancy wasn't really talked about other than like, like you said, like those specific cases with the fetal diagnosis or the parent’s life being at risk. And, but even then you weren't hearing it very often. And it's become such a bigger part of the conversation now. And I think you, you all are a huge part of why that conversation has been really pushed forward over the last years. And I think it goes back to something I've tried to talk about on the podcast a lot of how: all of these things are interconnected, right? Like, you can't just talk about gestational bans without talking about waiting periods or insurance coverage, or how these things impact people with low incomes or having to travel to get access. And these are all interconnected and just, like, this messy web that people have to try and navigate to access care. And so many people are unprepared for that when they encounter it. And it makes it so hard to find the care they need and in a timely way and to be able to afford that care. And I think all of that just kind of gets amplified when it's later in pregnancy.
Erika: Yeah, a hundred percent, I mean, further into pregnancy, the cost of care goes up, the number of providers goes down, and more and more restrictions go into effect, right? And so what you, what people experience is that later in pregnancy first maybe I should back up a little bit for anyone listening who is maybe new to this topic or might, you know, have the question that we get most often, which is: why does someone even need a later abortion? You know, and that's asked on the, you know, that's asked on the maybe less kind end of the spectrum in like a: why did she wait so long to...you know, couldn't we put things in place that would essentially eradicate the need for this care? Like if we make early care so accessible and possible and easy, then theoretically, perhaps we wouldn't, you know, need this care. You know, there's like, there's sort of this wide spectrum of misunderstanding when it, that is really rooted in a lack of awareness about why most people need this care. The truth is that people need abortion later in pregnancy for the same initial considerations that they do early in pregnancy. However, there's a lot of people who just cannot access care as soon as they would like.
Erika: And there are sort of two pathways, two main pathways that people find themselves on when they're seeking care later in pregnancy. And this framework comes to us from a wonderful researcher named Dr. Katrina Kimport out of UCSF. So, Dr. Kimport identified these two paths. The first path is new information that the person just could not have known until they knew it. And that is after the first trimester that they learned this information. This information like me could be a new fetal diagnosis or issue that they weren't aware of. It could be an issue with their own health that came up later in pregnancy. As pregnancy itself grows more complicated and more things can come up later, it could be a new life circumstance that they didn't anticipate a loss of a partner, a loss of income, a, a hurricane. I mean, the list, the list goes on, or the new information that they might learn is that they're pregnant. Later recognition of pregnancy is far more common than people think. And it's actually the most common scenario that faces folks who need care later. You know, not to be too obvious, but you can't seek an abortion that you don't know you need yet. And again, later recognition of pregnancy—far more common than people think, particularly for young people, who maybe haven't had their periods for very long, for people with complicated medical histories, et cetera. The other path is knowing that you want and need care earlier, but being delayed by circumstances outside of your control. That could be TRAP laws, that could be abortion ban, certainly. It could be the $400 that you might need for an abortion earlier. And as you are working yourself to the bone to try to get that money together, your pregnancy is continuing to inch up and with it the price. And so, you're just constantly chasing a price that you can never meet until it's, until you find yourself over these lines. And then for most people, they like, they experience a combination of the two. They find out new information later in their pregnancy that they couldn't have known any earlier, and then they were delayed even further by these circumstances outside of their control. Now the reason we'll always need access to later abortion care is because that path one, new information—that's life stuff, that's body stuff. We are never gonna be able to legislate or regulate away bad pregnancy outcomes later recognition of pregnancy. This is just the experience of being a human being with a pregnancy-capable body. We will always need access to this care because those things will always happen. Now, column B, path B—barriers to accessing care as early as we would want—those are man-made problems. And we could eradicate all of those tomorrow. And we should, and we should be working to eradicate every single one unequivocally and without qualifiers. All abortion bans gotta go. They're not rooted in health, they're not rooted in safety, they're rooted in control. We can absolutely decide there is no such thing as a benevolent abortion ban, and therefore we're gonna do our best to get rid of every single one. Uwe could make abortion care free
Jennie: So, you've been doing this work for six years with Patient Forward. What have you seen change over that time? Or what challenges have you really run up against?
Garrin: I feel like hope is not something that people talk a lot about these days, understandably. And I think there's a lot to be terrified about in a way, like outside of this very specific topic. But I think with regard to abortion later in pregnancy, we have some hope with regard to how things have evolved and changed over, over the, the last five, six years or so. I mean, first of all, we've seen major shifts in public opinion. So like you said, it's something that people are talking about more and more and more. It really is getting simplified to the fact that people just actually don't want the government involved in this interfering in people's, you know, decisions to get care, ability to get care, et cetera. And it used to be that people understood they didn't want the government involved prior to viability or something, right? And now we're realizing that like, no, it is actually just that people don't want the government involved. They actually just don't, they don't want it, they don't trust the government to be someone in that space. Right? And that makes a lot of sense. And we're, and we're seeing a big movement with regard to public opinion post-Roe on this. And that, I think, is giving us a lot of hope. The other things that we're seeing are advances in policy that reflect this, so not everywhere, but you know, like California passed Prop. 1 in 2022. Vermont amended their constitution. Both of those didn't have limits at all involved. California still has a viability ban, which we would love to see repealed. But, you know, the ballot measure itself didn't have a limit. Minnesota got rid of its, Michigan following their ballot measure. We saw them repeal their viability line. And, and like for instance, right now we see Massachusetts actually there are active efforts in the state to repeal their viability line. These are all things that are actually quite new. Like, in the time that we started patient forward, or like around 2019, there were all these efforts to yes, protect abortion, but only up until viability. And we're still seeing that, you know, we saw all these ballot measures last year that had viability lines, but at the same time we are seeing this other sort of cross-cutting momentum with regard to just, just getting the government out of that part of it in a way. Like, identifying a more supportive role for the government. The government can provide funding so people can get care, they can support clinics. There's a really great bill in Maryland that just passed that's, you know, gonna, they found a really novel way to get some money to help support abortion care and clinics and stuff like that. And I think that those, those two things, this movement in public opinion, some of this movement in policy suggests, like, a big sea change with regard to how we are understanding where people are in the public and where advocates and politicians should be. This is one of these cases where the public may be a little bit in front of a lot of the advocates in the field and the politicians. People are scared of abortion later in pregnancy when they're talking about it in these political spaces. But they needn't be, it turns out. And that's not to say that people don't have complicated feelings about this, but they have actually very uncomplicated feelings about whether the government should be stopping people from getting care.
Jennie: Yeah. I feel like that shows up very clear in any polling around most health things, right? Like the government should not be getting involved.
Garrin: Yeah. Or the way that we want the government involved is to, you know, make sure instruments are clean, make sure people can get to the care, make sure that, you know, providers have training. There are all these really great places. 'Cause I feel like there's this big attack right now on even the idea of government so I just wanna clarify: there is a role for the government.
Jennie: No, very good point.
Garrin: The government, a collective project is something, you know, we can make sure to take care of each other. That's what the government could be. And so we can take care of people that end up for all the reasons that Erika listed in terms of like why people need abortion care later in pregnancy. Like, for instance, like, I've been thinking a lot about recently how many people are having to travel just for this care, just for abortion care later in pregnancy, people are traveling all the time for this care like we did. And you know, on, what is it? May 7th, they're gonna start requiring real IDs to fly domestically. So, suddenly there's gonna be a lot of people that have, like, heightened ID requirements who are gonna find that out maybe at the airport. And they are, you know, they have an appointment in two days or whatever, they're gonna have a problem. And so I think this is just one of these things where like every news article I read, I understand how that's gonna affect, you know, people who need abortions later in pregnancy who are already, the people who are the most marginalized in our society are already overrepresented in that population. And so I think there are all these things where, you know, we tend to silo these issues. We tend to silo abortion, we tend to silo it away from these other things. But if you think about immigration, if you, if you're someone who has, whose immigration status makes it difficult for you to travel suddenly, if you need abortion care later in pregnancy, that's a problem. If you're someone who, because of criminalization for something else, you're not allowed to leave your state without, like, approval from your parole officer or just not at all. Suddenly you can't get care that you need. And so I think, I think that's the other big trend that we're seeing is people are starting to connect dots between things better. So we're starting to understand why criminalization is happening, why these other things are affecting people and stop being so siloed. And I, and I think that's an encouraging trend as well.
Jennie: Yeah, that also just makes me think of young people and not how, like, how that's gonna impact their ability to access care later in pregnancy if they have to travel out of state. You mentioned it earlier, you know, maybe not be able to rent a car. Like, if you have to fly, like that's a whole new level of money that many young people aren't gonna be able to meet.
Garrin: A thousand percent. We think about young people all the time, and you know, in response to the research, we sort of think of young people as young people and very young people because there are the teenagers, of course, that find themselves overrepresented among the later abortion population. But this also, this population includes children. And if you talk to any all-trimester abortion provider, they will tell you that they have all cared for children at their practices. And, you know, I am a parent, like, it's crushing to think of these cases and so many kids who are unprotected and who have the least amount of bodily autonomy in our country, they have tremendous barriers. And we know that this is yet another reason to fight so hard to protect access to these incredible all trimester clinics that are culturally competent. They're, you know, trained in trauma and trauma response. Like that's, if, if someone finds themselves in these terrible situations, where do we want them to end up? Do we want them to end up trying to figure out what to do on their own? We do not. We're starting to see some of those cases and it's terrifying. We want them to find their way to one of these excellent clinics that are trained and very able to care for them so that their health and wellbeing is intact. You know, and I think like this is also related to, to the public's evolution on this. Ultimately, people care most about health and safety. And this is a health and safety issue, and certainly we should care because the population includes low-income people, people who are already most likely to be criminalized, young people, children, et cetera. But also everyone understands that if they're in a hard circumstance, they want access to health and safety too.
Jennie: So, that makes me think of like the next part of the conversation of: how do we bring people in on this, right? We've talked about, we've seen discussions of it happening more, and it does seem like the public is moving on this, but, but how can we continue to bring people in to get them to understand why abortion later in pregnancy is such an important issue?
Erika: Well, one, I think, you know, we, we continue to invest in education and communications resources. We have a website called Who Not When, who not when.com, which is sort of the go-to resource for information about abortion later in pregnancy. We have fact sheets on there. We have a media guide for a better reporting on abortion later in pregnancy. We have a ton of resources if people want to educate themselves and hopefully then educate their circles and communities, share good organization information, have better language for talking about this. So, that's there for people to learn, always. And then another big piece of this is helping people understand the ramifications of gestational bans, including viability bans, beyond abortion. Because these lines, these bans harm us in myriad ways that- I think I kind of wanna pass to Garrin this one because he's been working very hard on some resources to, to help people do just that. So, I'm passing you the baton.
Garrin: Yeah, I mean, I think that we've...you know, for years in Patient Forward, we were very focused on abortion later in pregnancy and, and, and sort of making the case to people that it was worth protecting this care, making sure people could get this care for all of the reasons that have to do with abortion and all of those are still true. People deserve to get care as soon as possible and as late as necessary, period. And these lines that people keep drawing in our protective abortion laws, like lines at a specific gestational age or lines at potential fetal viability have other ramifications beyond abortion. So, what those lines are doing is saying that this is the point that we, you know, in this ballot measure or in this, in this law, we are recognizing that the state has an interest in a pregnancy that becomes controlling, right? So, and that's, that's really the crux of what Roe v. Wade was. And so where they were trying to balance the interest between the pregnant person and the state, and they weren't trying to, like, give people bodily autonomy. They were trying to give, they were trying to balance the interests between the state and the individual. And we have not really escaped that. That's one of the biggest challenges here is that even folks within our field have not escaped that general idea that there should be some sort of line. And so, again, beyond abortion, the problem with those lines is that when you give the state that place, when you give the state control over pregnancy, at some point, when you draw that line, that line has to be policed. And that the way that line is policed is by investigating pregnancy outcomes. If there is a stillbirth, why is there a stillbirth? Did someone do something wrong? We need to go find out, we need to arrest that person, investigate them. There will be local news stories sharing their name publicly. We're gonna go do all that, and then we may decide that we're not gonna charge them with anything, right? Like, just happened in Georgia, but that person's name is out there that they went through that whole experience. That's awful. But obviously there are also other people who are in prison because of pregnancy outcomes. There are people in, in prison because of behavior or conduct during their pregnancy ranging from substance use, which is in itself not a crime. It is not illegal to have ingested drugs in America, but it is often illegal to have ingested drugs if you're pregnant. So, there are all these things that become illegal because you're pregnant. That line that we're drawing at viability is saying after this point, we're okay with the state doing all this stuff. We're okay with the state investigating pregnancy outcomes, you know, controlling pregnancy behavior. There have been situations where people are, they have forced medical interventions like C-sections or blood transfusions. Often people are rejecting these things based on religious grounds or just because they don't want them. And again, that is a pervasive, right, in this country, you're not allowed to have things done to your body that you don't want to do unless you're pregnant.
Erika: Can I interject one important piece of this, which is that quote unquote "viability" is not a hard line. It's a, it's like a general gray area, and like everything that involves the carceral state, it tends to creep. So, really whenever there is a developed pregnancy that is the concern here, the state is going to take their place where they feel that it's appropriate, which is how you have people investigated at 20 weeks, at 19 weeks. We know from a report by F1 that 87% of cases of criminalization affect pregnancies in the second and third trimester. So, while from an abortion context, this care is uncommon, when we're talking about criminalization, it represents the vast majority of cases where someone is criminalized and they're being criminalized based on ideas and legal concepts that we are writing into the law ourselves.
Jennie: Yeah, I was just thinking this, like, while you were talking about that, of how we got in, in this place where we lost Roe anyway, right? Like you had like this slow chipping away. So all of a sudden we have these viability bans. Okay, so then 24 weeks. Okay, 20 weeks. And it just, you see it start creeping back and back and that it would start impacting more and more people because again, it's not going to stay at just viability.
Erika: Well, it also speaks to the inherent difference of goals. I think if we're singularly focused on abortion, if that's the goal is to get people abortions and to ask state daddy for permission to get as many abortions as possible, then you would write policies and act the way we kind of have, for the past 50 plus years. If your goal is to have bodily autonomy, to wrestle control from the state, to be left alone, to be unharmed by the state, then a gestational ban would be unthinkable. But we have different goals. And that is something that, it's another challenge that we have found is that that is a conversation that starts to make folks really uncomfortable. But until we have that conversation about what our goals are, what it is we are trying to win, what is a win? Until we can really have that conversation openly and without blaming or hurting each other, I fear that we are just going to norms our way to, like, a total personhood protections at the fed level because we're not, we're fighting different fights sometimes at cross purposes.
Jennie: Oh man, this is just making me so excited for the rest of this series, y'all. I am so excited for all the conversations we're gonna be having. Let's wrap up this one. I always love to end with: what can our audience do? How can the audience get involved around these issues?
Garrin: I think one thing that we would love to invite folks to do is that when you're asked to support something—a bill, some legislation or a ballot measure or whatever, is to read it—and see if there are, are there lines in it? Are there limits to the protections in it? Ask yourself whether it allows government interference and criminalization 'cause all pregnancy criminalization is based on the idea of fetal personhood, which is a very dangerous idea. And so, it's important for people to kind of, like, have their spidey senses up about this when they're reading things that they're asked to support. So, that's one. And I think to be clear, it's okay to push back to say, hey advocate, hey, elected person asking me to do something, I'm concerned about this thing in this law. Why is that there? Could we maybe not do it? 'cause I don't support that. Let them know. I think that's really important.
Erika: You know, I think we all, well, anyone with, with, you know, who's even remotely covering what is happening in our country knows that this is a time that we must be working together, pulling our resources, having a singular focus to fight fascism, to fight all of these attacks on our bodily autonomy in all of these different ways. We can't do that if there are a lot of us throwing the most under-resourced and over-policed members of our communities under the bus. We just cannot. And so we're, we want to work together. We want everyone to work together under and towards the same goal. But that is going to require simply stopping the protections of criminalization in our own laws. And again, we could all decide to do that. And I know that there are so many conflicting sort of interests out there. You know, you can take these ballot measures for one. The ballot measures are a tactic. They're not a strategy. What are they a strategy for? I don't know. People have different interests in, in, you know, what these ballot measures can, can or cannot do. What I know is from a perspective of a full-time, you know, worker working towards the protection of bodily autonomy and access to abortion, I know that there's harmful things in there. And I know that we can do more together and we can be more united if we simply come together to decriminalize abortion in America. We should just be decriminalizing abortion. That will require repealing a bunch of bad laws that are on the books and that have been on the books for, like, a hundred years. It means going back and getting them all out of there. Like, everyone now knows about Comstock and how it was very bad to let that thing sit there for so long and now it's gonna come back, you know, as this zombie law and do terrible things to us. Well, you know, unfortunately, there are a lot of such laws on the books. People are being charged under them today and they all need to go. And so instead of writing, you know, new things with limits in it that can also be used to hurt people we could just be enshrining fundamental bodily autonomy and protections into our state constitutions. And then repeal, repeal, repeal, repeal. In Arizona, our proactive reproductive justice coalition wrote a bill that aimed to repeal the 50 plus restrictions in Arizona: repeal, repeal, repeal. [chuckles] So, that's, that's I guess the, the policy hope that we have. There's other things people can do. People can always give money to funds and PSOs funds and PSOs are doing the goddesses work when it comes to getting people access to safe, dignified quality later abortion care, care throughout pregnancy. Few people have access to the amount of money that it takes to access timely later abortion care, which is where the funds and PSOs come in. If you wanna support people finding their way to good care, give your money to the funds, to the PSOs. That's where I give my dollars.
Garrin: And I would say that it's, it's important to understand that this is not just like a Red State problem. So a lot of the funds and practical support organizations that are based in places where people are going for care are the ones helping people pay for care in that area. So it's important really to just like, I mean, I think a good rule of thumb is to support your local fund and give there and just recognize that those people, you know, one thing that I don't think a lot of people know is that when we're talking about abortion care later in pregnancy, because the cost is so high, it's often that not even one fund can help pay for it. And so therefore, there's what's called solidarity funding, where a number of abortion funds will help fund a single abortion. And that has to be coordinated. That is people across the country coordinating to help one person access care. And they do it every week, all the time. It's an ongoing project. There's never enough money, any amount of money helps.
Jennie: And I'll just point out it is Fund-a-thon time, so now is the time when most of them are getting all of their money for the year. So yep, donating now, making sure you are following a bunch of abortion funds on social. If you're on social, because you talked about every week you see funds coming together for, like, a big ask. You will see emergency appeals of, like, we have a patient who needs care, we need $10,000. And so, you'll see those calls on social. So, if you have the money or time, it's a great opportunity to take in. And my always appeal when I talk about funding abortion funds is their money is so they never know what they're gonna have each month. So if you can be a monthly donor, and again, that doesn't mean you're giving a hundred dollars a month, you can give $2 a month. They know they are getting that $2 every month and they can budget for the year, and they can make plans because they know they can count on it. So I have funds that I give to, I have funds that I am a monthly donor of. It really makes a huge difference to them to know that they can count on X amount every month as they're making their plan for how they're divvying up their funds throughout, throughout their month.
Erika: And I thank you. Thank you for that. Yeah. I, what, what is it? The, it's somewhere in the ballpark of like $300 million have gone towards these ballot measures. And you've got funds, you know, basically stringing together $7 and a tube of chapstick to take care of all the people who are left out of those frameworks. So again, please, yes, give to those funds. Another thing folks can do is press your elected officials for what you really want, right? Call, tell these supposedly pro-choice elected officials that you would like them to decriminalize abortion. And by the way, 41 states ban abortion at some point in pregnancy. So, there is a lot of work to be done here with elected officials in certainly Massachusetts. Please call Massachusetts and tell your elected officials there that you support the repeal of the viability ban there, but also in New York, in California, in Illinois. Yes. Please call your elected officials and say, why aren't you decriminalizing abortion here? That's what we should be doing and if you do, I will knock doors for you. I will send you some money. I will, you know, I'm team you, you know, let them know they need that, they need that reinforcement because they're getting plenty of messages from consultants telling them that people don't want this. So, it's our job to tell them what we actually do want. And we should be telling them often. And then lastly, this is-
Jennie: And then thank them. Thank them when they do the good thing.
Erika: Yes. And when they do the right thing.
Jennie: Don't just hear from you and you're mad.
Erika: Yes, yes. That's such good advice. Let them know when they do a good thing. And then maybe the lowest lift is to spend a little time on whonotwhen.com if you've learned anything or if you're surprised by anything or if any myths have been busted for you, share it. If you see these myths being perpetuated even if it's from an organization that is otherwise pro-choice, you know, let them know what the truth is. If somebody tells you 22 states ban abortion at some point in pregnancy, for instance, you can always comment and say: well, in fact, 41 states ban abortion at some point in pregnancy. Don't let them erase all of the people who are experiencing bans in these 41 states. That's something we can all do. And that's free.
Garrin: And you can see that you know, Who Not When and other, our other projects on our website, patientforward.org. We do a number of different things, and we continue to add new stuff there— various projects that we're working on, all of which are exciting and awesome.
Erika: Yeah. So check those out. Yeah, I mean, if you can't tell, we are, we are a thousand percent obsessed with this, [chuckles] you know, and it's, and it actually is affirming for us. Like, we love to do this. We love to make new resources. If one person says they read one thing or used one thing, I will ride that high all week. So, please check those out. And if anyone listening ever requires assistance or collaboration around this topic, you know, we have done later abortion one-on-ones now for many, many years. We've done them for nonprofit boards, we've done them for Planned Parenthoods, we've done them for advocacy organizations, progressive clubs. If you are, if you have a few friends who you can get together on a Zoom to learn about abortion later in pregnancy, please reach out. And we're happy to share what we've learned and continue to learn every day.
Jennie: There's nothing like the community that you're trying to support using your resources because they say they're good. I rememberI did an episode on intimate partner violence and talked about my experience with, with somebody else and, and Domestic Violence Wisconsin shared that episode as a great resource. And like, as an intimate partner, violence survivor from Wisconsin, like that just like hit like, ugh. Like, it...really? Like, okay, I'm glad. Like, it just meant everything that they thought it was helpful.
Erika: Oh, I love that. Yes. Like, please, it is, it truly is the best, the best feeling for sure. So thank you. Thank you for all of the good information you've shared on this episode too. We appreciate it. We always learn from your podcast as well, so it's very...
Jennie: Aww, thank you. Yeah. Thank you so much for being here. I am so excited about this series and cannot wait for the next episodes and learn more about abortion later in pregnancy. So Garrin, Erika, thank you so much for being here today.
Erika: Oh, thank you. Thank you so much for having us.
Jennie: Okay, y'all, I hope you enjoy my interview with Erika and Garrin. I am so looking forward to this series, talking about abortion later in pregnancy. We'll have one episode a month for the next six months, talking about abortion later in pregnancy. And with that, I will see y'all next week. [music outro] If you have any questions, comments, or topics you would like us to cover, always feel free to shoot me an email. You can reach me at jennie@reprosfightback.com or you can find us on social media. We're at @RePROsFightBack on Facebook and Twitter or @reprosfb on Instagram. If you love our podcast and wanna make sure more people find it, take the time to rate and review us on your favorite podcast platform. Or if you wanna make sure to support the podcast, you can also donate on our website at reprosfightback.com. Thanks all!
Learn more about Patient Forward and their work here. You can also spend some time on whonotwhen.com, a people-centered resource for understanding abortions later in pregnancy.
Read bills or legislation that you are asked to support. Does it allow government interference or criminalization? If there is, push back. Press your officials for what you really want, and thank them if they deliver on it.
If you can, give money to abortion funds. And if you can, make that donation a re-occurring monthly donation. Remember, this isn’t just a red-state problem—support funds in states where abortion is limited but also support your local abortion fund. It is now Fund-a-Thon time, so keep up-to-date. You can also follow funds on social media, where emergency appeals are often announced.