California could become a sanctuary state for abortion access, too

California state Sen. Connie Leyva had a sobering message for her colleagues and the swath of supporters who turned out to support her bill, the College Student Right to Access Act.

“In 1973, the U.S. Supreme Court ruled that the due-process cause to the 14th Amendment of the Constitution provides a fundamental right to privacy that protects a woman’s right to choose,” the Chino Democrat told the Assembly Health Committee on June 11. “Now, almost a half-a-century later, people, groups and institutions have done everything they can think of to restrict access and to shame any woman who chooses to have an abortion.”

In the age of Donald Trump, Leyva’s words aren’t hyperbole.

Since Roe v. Wade, anti-choice legislators have tried to dismantle abortion rights state by state and, since Trump’s election, politicians and activists have ramped up the assault.

In 2019 alone, more than a dozen states passed or attempted to pass legislation restricting abortions. Alabama and Georgia passed two of the nation’s stricter laws. Georgia’s so-called heartbeat bill will make it illegal to perform an abortion upon detection of a fetal heartbeat. Alabama’s law goes one step further into Handmaid’s Tale territory, banning all abortions except in cases where the fetus would be stillborn or die shortly following birth, or when an abortion would “prevent serious health risk” to the mother.

Some of the laws serve a dual purpose. States such as Alabama have passed legislation with a long-term goal in sight: taking the fight all the way to the conservative U.S. Supreme Court in hopes of overturning Roe v Wade.

Leyva’s Senate Bill 24 would require that public universities with on-campus student health centers offer students medication abortion. Otherwise known as the “abortion pill,” this is a two-step, non-surgical process to terminate a pregnancy up to 10 weeks, using doses of mifepristone and misoprostol.

“’Right to choose’ isn’t just a slogan but rather a commitment to improve true access to abortions to Californians across our state,” Leyva said.

With other states chipping away at women’s rights, California is poised to be at the forefront of the reproductive rights justice movement. Its more progressive policies on abortion access, contraceptives and health care have also positioned it as a sanctuary state for women from other states seeking autonomy over their bodies.

But is it doing enough?

California’s previous governor, Jerry Brown, vetoed a similar medication abortion bill in 2018, but reproductive rights activists have found an ally in Gov. Gavin Newsom, who has made it a policy cornerstone.

On May 31, he issued the California Proclamation on Reproductive Freedom, vowing to preserve and expand reproductive health-care access and declaring it vital to “women’s autonomy and liberty and to ensuring women have an equal role in our social and civic life.”

This promise is significant because, while California may be progressive in its policies, the president has also targeted abortion providers at the federal level.

On July 16, Planned Parenthood announced it had stopped using Title X family planning funds after the Trump administration said it would enforce barring fund recipients from advising women on abortion.

California still requires private insurers and Medi-Cal to cover abortion services, meaning that, despite setbacks at the federal level, the state remains a safe haven, said Shannon Hovis, director for NARAL Pro-Choice California.

“We have very good laws in the books and abortion is protected in our Constitution,” she said.

So much so that activists in other, more conservative states often direct women here for care. Some activist groups say they’ve seen a spike in out-of-state calls for help, particularly from Nevada.

The trend will likely continue, says Gabriela Castillo, the hotline program director for the California-based ACCESS: Women’s Health Justice, a nonprofit that connects people to clinics through financial assistance and transportation.

“California goes up to 24 weeks on abortion and our surrounding states don’t go that far,” she said. “I can see that influx increasing.”

California isn’t without its weak spots. Thousands of women struggle to obtain care. While larger cities, including Sacramento, may offer ample options, many in rural areas find it logistically difficult or too costly to obtain affordable birth control or find a clinic. Likewise, those with language barriers or who are afraid to seek prenatal care because of immigration status also face challenges.

“We still have a situation where 43% of [California] counties don’t have abortion clinics,” Hovis said. “The longest distance someone has to drive to get an abortion in California is approximately 180 miles.”

Five percent of California’s women live in those counties, according to the Guttmacher Institute, a research and policy organization that advocates for sexual and reproductive health rights. Telemedicine is one option to bridge such distances. The practice, in which a doctor sees a patient via computer, has become more common.

“Everyone should have unfettered access to the full scope of reproductive health-care services,” Hovis said. “We are looking at the possibility for telehealth as a solution.”

But it’s not an option for everyone. The practice is banned in 18 states, including Texas, Arizona and Alabama.

“We’re seeing an increase in the impulse to punish women,” Hovis said. “Women are looking online to order [the abortion pill] and we’re seeing prosecutors go after this.”

Shireen Whitaker, a Davis-based activist, says California’s progressive policies may also give its residents a false sense of security and optimism. “The challenge is that we don’t necessarily have it as bad as other states,” she said.

Specifically, she said, because California’s reproductive rights activists aren’t used to dealing with restrictions such as Trump’s decision to defund Title X programs, they may not be as prepared to handle future attacks as well as activists in other states.

Certainly, the internet can offer a wealth of resources, regardless of location. Apps such as NURX (nurx.com) connect users to free or low-cost birth control, a boon to those who live in an area where a pharmacist may refuse to dispense it, or an employer denies coverage. It also sells inexpensive HPV-testing kits.

Whitaker co-founded the Abortion Access Hackathon, a nonprofit that provides a platform for tech developers, law students, designers and health-care professionals to brainstorm digital tools and apps, many specifically targeted to prevent harassment.

There are “dark web” options, too, including digital networks connecting those in need to underground providers who induce abortions using herbal remedies—including some here in California.

The dark web and other unconventional approaches may become increasingly necessary.

If Roe is overturned, women won’t stop getting abortions, but it’s likely many will no longer have access to safe, medically supervised procedures. Other scenarios, once seemingly unthinkable, could also emerge.

Take, for example, an Alabama woman indicted by a grand jury for manslaughter. Marshae Jones was five months pregnant when she was shot in the stomach. The bullet killed the fetus and Jones was charged because she’d allegedly started the fight that preceded the shooting. The charges were eventually dropped, but the situation is a chilling reminder of what the future could hold.

The continued need for underground groups and other alternatives is telling. Laura Jimenez, executive director for California Latinas for Reproductive Justice, offers a grim assessment: If she were to grade the state’s progress, she said, it would only receive a “C-plus or B-minus.”

“Just because something is legal doesn’t mean there’s practical access,” she said.

And “practical” isn’t just about transportation or the number of clinics available. Women of color, for example, are more likely to be in lower-paying jobs or jobs with fewer health benefits. Or undocumented immigrants may be fearful about seeking care, while some barriers are inherently intertwined with the social stigmas surrounding abortion, Jimenez said.

“We have small towns in the Central Valley where you are trying to get birth control in the pharmacy but everyone knows your family,” she said.

California won’t truly be a sanctuary state for reproductive health care until it addresses the needs of everyone, she added. If it doesn’t, an influx from other states will only expose what’s not working here.

Now, at least, California appears poised to remedy at least one gap from our past.

The College Student Right to Access Act is now on its way to Gov. Newsom, who is expected to sign the bill, which would go into effect in 2023.

Elena DeNecochea, who will study Gender Sexuality and Women’s Studies at UC Davis in the fall, emphasized the need for SB 24 at its hearing.

“It’s very disheartening to go to the health center [only to] be denied or referred off campus. It’s not affordable or convenient,” DeNecochea said in a later interview.

Politicians must do more, however, she also said.

“Even in progressive states like California, there are barriers,” DeNecochea said. “It’s important legislators destigmatize the abortions that people are already seeking. We need to make it safe and easily accessible so that more people don’t die or face trouble.”