A day at the Philadelphia Women’s Center: How staff navigate state restrictions to provide compassionate abortion care

By Julie Zaebst, Senior Policy Advocate, ACLU of Pennsylvania

On a recent day in March, a group of our staff was glued to our phones in anticipation of the Georgia state House vote on a draconian anti-abortion bill. The bill would ban abortion at six weeks gestation — a stage before most people even know they are pregnant. But as this circus was unfolding in Georgia, we were also preparing to spend the day at the Philadelphia Women’s Center, getting an inside look at what it actually means to provide abortion care under the current regime of restrictions and red tape in Pennsylvania.

The Philadelphia Women’s Center is an independent abortion provider that has been providing first- and second-trimester care for more than 45 years. Every day, their staff arrives at work prepared to navigate byzantine laws and regulations that were designed to make their jobs of providing safe, compassionate, and timely abortion care difficult. But despite the politically motivated restrictions, they’ve developed systems to make the experience as seamless as possible for patients.

By the time patients arrive for their appointment, they have already cleared countless hurdles. First, they must locate a provider and get themselves to the office. With more than 85% of counties in Pennsylvania lacking an abortion provider, this is no small feat. The number and locations of abortion providers is not a reflection of the need for care; rather, it is a reflection of the challenges of opening and operating a clinic, a task made more difficult by restrictions the state imposes only on abortion providers and not on other similar healthcare providers.

Of course, patients must arrange time off from school or work for their appointment. For low-income folks, this may mean a day without pay that their family counts on for survival. The majority of patients are already parents, so securing affordable childcare is often another obstacle that they face.

State law imposes a mandatory delay on patients: at least 24 hours before their procedure, they must receive state-directed counseling from a provider. The Philadelphia Women’s Center offers a couple of options to make this process as least burdensome as possible to patients. But if a patient misses their counseling session and they can’t reschedule quickly enough to satisfy the waiting period, they have to cancel their procedure and restart the scheduling process.

Perhaps the biggest barrier of all is the ban on insurance coverage of abortion care. During our visit, we had the chance to read patients’ entries in journals that the center provides in their waiting room. Many of them shared that their decision to get an abortion was driven by financial circumstances — they simply couldn’t afford to raise a child (or, in many cases, another child). According to a study by Guttmacher Institute, 75 percent of the people who received abortion care in 2014 were low-income.

Still, PWC staff must break the news to most of their patients that their insurance will not cover their procedure because state and federal law prohibit Medicaid from covering abortion care in most circumstances.*

Because most patients who are insured through Medicaid must pay out of pocket, some may wind up “chasing the fee,” as one staff member explained to us. A patient may take a few weeks to scrape together the money needed, only to find out that the cost of care has increased because they are now further along in their pregnancy — so they have to go back to the drawing board.

A patient must navigate all these barriers before they even arrive at the center for their procedure. And for some patients, the hurdles are even higher: for incarcerated folks, for instance, or for young people, who must obtain consent from a parent or get a judicial bypass.

When they arrive, patients will likely be greeted by anti-abortion protesters outside the clinic — but also by escorts, who help them make their way inside safely. There, staff will welcome them and prepare them for their procedure.

What we observed during our visit were dedicated, compassionate medical providers doing what they were trained and committed to doing: providing healthcare. The only difference we saw between the Philadelphia Women’s Center and any other healthcare facility? Doctors and patients — those who know best — face politically motivated restrictions and interference.

Thank You, Abortion Providers!

By Marah Lange, MSW, former Duvall Project intern

This slideshow requires JavaScript.

Last Wednesday was an important day in the fight to protect abortion access.

As the justices gathered to hear arguments in Whole Woman’s Health v. Hellerstedt, thousands came together outside the U.S. Supreme Court to have our voices heard: stop the sham. While Texas’s HB2 and similar laws are engineered to appear to be focused on protecting women’s health, they do just the opposite. In fact, they restrict access to safe abortion by placing medically unnecessary restrictions on providers and causing clinics to close. For patients, this creates an obstacle course of barriers to having an abortion. If I have to travel hundreds of miles for my procedure, who can watch my children? Will my employer allow me the time off I need to travel for my appointment? How will I afford the cost of travel in addition to the cost of my procedure?

This is something we need to be shouting about. And on March 2nd, we shouted! I was one of 60 people who took a 5 a.m. bus from Philadelphia to Washington, DC, to join the Rally to Protect Abortion Access that day. Once on board the bus, I sensed excitement, adventure and, with some bus mates who had been in the fight since Roe, camaraderie. I also felt some trepidation. This was my first large-scale abortion rally, and I did not know what to expect from the opposition. After some coffee, chanting, and eventually a sunrise, we arrived and joined over a thousand other advocates who came together to defend access to abortion (and to show off some fantastic posters).

The Rally to Protect Abortion Access was also a platform for celebration. Women gathered to share their abortion stories, leaders of the fight spoke of their mission to protect access, and abortion providers were met with cheers of gratitude for their dedication to caring for patients with respect and dignity. It was electric.

While advocates await the court’s decision in June, today marks the National Day of Appreciation for Abortion Providers. We observe this day each year on the anniversary of the death of Dr. David Gunn, one of several abortion providers and clinic workers murdered by an anti-choice extremists. It is a day to show our gratitude for the courageous medical professionals who provide abortion care despite political interference and often threats of violence. Each day, providers stand in solidarity with patients who have chosen abortion for themselves and their families. Today we stand with those same providers and say “thank you.”

Thank you, Providers!

THANK YOU to the providers who work hard every day to make sure that people across Pennsylvania have access to the abortion care they need! We appreciate all you do to make reproductive rights a reality. #AppreciateProviders #NDAAPPlanned Parenthood Southeastern Pennsylvania, Planned Parenthood Keystone, PPWP–Planned Parenthood of Western PA, Philadelphia Women's Center, Allentown Women's Center, Delaware County Women's Center, Allegheny Reproductive Health Center Physicians for Reproductive Health

Posted by ACLU of Pennsylvania on Thursday, March 10, 2016

Abortion: Breaking the Silence

By Lisa Wildman, Clara Bell Duvall Reproductive Freedom Project Intern

Clara Bell Duvall

Clara Bell Duvall

Why are we re-fighting abortion forty years after Roe v. Wade? State legislators across the country are putting forth regulations that target abortion at an increasing rate. Alarmingly, many of these have become law. Why have these laws succeeded in eroding abortion rights?

A big part of the answer lies in the stigma surrounding abortion, which has helped keep abortion hidden. The movement working against abortion has shamed and intimidated people who seek abortions and those who provide abortion care. Look and listen to the condemning, demonizing language they use outside of clinics. When I volunteered as a clinic escort, why did protesters call me a whore? And who can forget Rush Limbaugh’s vicious slander of Sandra Fluke just for seeking birth control? American society is uncomfortable with abortion in part because it is uncomfortable with female sexuality. The war over abortion is a war over who controls women’s bodies. If we use our reproductive rights, we frighten those who would control our bodies for us.

A woman considering abortion care likely feels very alone and frightened. I know I did. Many Americans may think that they do not know anyone who has chosen to have an abortion. But one woman in three has an abortion by age 45. We all know someone who has had had an abortion. She is our coworker, our friend, our neighbor, our sister, our mother. In fact, most women who choose abortion are already mothers.

Silence perpetuates the stigma surrounding abortion. We can help remove the stigma surrounding abortion by breaking the silence. Empower yourself by beginning to talk about abortion. If a family member of yours died from an abortion in pre-Roe days, tell that story. (Mitt Romney did.) If you are pro-choice, say so. If you had an abortion, say so. Tell anyone who will listen.

Studies have found that how we talk about abortion does make a difference. Talk about how abortion is a personal and private decision. Talk about how abortion is a right under the U.S. Constitution, not something that should vary state by state. Talk about how politicians should not be allowed to interfere in what is a decision a woman makes with her own doctor and her own family.

But most importantly, keep on talking.

Learn more about the Clara Bell Duvall Reproductive Freedom Project.

Lisa WildmanLisa Wildman interned at the ACLU-PA’s Duvall Project while completing a master’s degree in social work at Temple University.