Clark Now | Navigating a post-Roe Massachusetts

Reproductive health experts explain barriers to care

By Melissa Hanson
Story Originally Appeared in Clark Now

Massachusetts was among the first states in the nation to protect health care providers after the Supreme Judicial Court reversal of Roe v. Wade last year, but there continue to be serious questions and concerns about access to reproductive health care locally and nationally, according to a panel of experts who spoke at Clark on March 2. The panelists considered a number of issues, including national access to emergency contraception and gender-affirming care, and taking actionable steps to improve maternal health in Massachusetts, with particular attention to racial and financial inequities.

They flagged legislation pending before the Massachusetts legislature as a national model for the provision of reproductive care services, and clarification for patients of the differences between abortion clinics and crisis pregnancy centers.

“We have to recognize that Roe was never a full guarantee of access to the full spectrum of reproductive health care,” said Claire Teylouni, the director of government affairs for New England-based Reproductive Equity Now. “As we respond to the overturning of Roe, we have to do so in a holistic way, recognizing that while we have made significant strides in abortion access and rights here in Massachusetts, some states are looking to further restrict and criminalize access to abortion care beyond their borders. We have to continually monitor this and look for ways that Massachusetts might need to step in and respond.”

In addition to Teylouni, the “Reproductive Justice in a Post-Roe Massachusetts” panelists were Carrie Baker, a professor of women and gender studies at Smith College; Nikki Fonsh, a grassroots reproductive justice advocate who serves as a volunteer intake case manager for The Abortion Rights Fund of Western Massachusetts and co-chair of the Reproductive Rights subcommittee at the Jewish Community of Amherst; Jenifer McKenna, a reproductive and gender equity consultant and co-founder of the California Women’s Law Center; and Jenny Pacillo, a volunteer and activist with The Jane Fund, which works to fund and support access to abortion in Central Massachusetts.

The event was moderated by Abbie Goldberg, professor of psychology, and Danielle Hanley, professor of political science. The panel was organized to inform the Clark community about the status of reproductive rights and abortion care in Massachusetts and beyond, highlighting key issues impacting bodily autonomy and offering avenues to get involved in advocacy efforts.

“At a time when reproductive rights are under threat across the country, it seemed important to pull together scholars, advocates, and people with lived experience to discuss the challenges of a post-Role America and Massachusetts, but also the opportunities for advocacy and activism,” Goldberg said. “Clark students, faculty, and staff were able to listen to and participate in dialogue with an incredibly engaging group of dynamic leaders, and left feeling more fully informed about the current landscape of issues surrounding reproductive rights and empowered to contribute to a push for change.”

Reproductive Equity Now’s goal for the state legislative session that started in January is to push for policy solutions that benefit maternal health. This includes centering patient care and eliminating financial barriers that were exacerbated by the COVID-19 pandemic. The organization hopes Massachusetts can re-envision health care spending by eliminating all cost-sharing for pregnancy-related care, and is pushing forward a bill that would offer Medicaid coverage for doula care services.

“We know doula care can improve birthing experiences, birthing outcomes, and improves breastfeeding rates,” Teylouni said. “We’re also supportive of another bill that aims to expand access to midwifery care, which we know improves maternal health outcomes. Midwife-attended births often have lower cesarean rates.

“Reproductive equity isn’t just the ability to choose if and when you want to become a parent, but also that when you do, you’re able to parent with dignity and with financial security,” Teylouni added.

McKenna said patients should learn about the difference between abortion clinics and crisis pregnancy centers, which are typically anti-abortion and do not offer abortion services or contraception. The centers also lack the privacy protections patients receive at hospitals and clinics, she added.

“They’re not health care clinics, they’re not doctor’s offices, and that means they’re not protected by any medical privacy law, like HIPAA,” McKenna said.

The group also noted that states banning abortion are often also banning gender-affirming care.

“I think it’s terrifying for people around the world that this is happening here in the United States, the supposed beacon of democracy,” Baker said.

Immediately after Roe was overturned last June, former Gov. Charlie Baker signed an executive order that protects Massachusetts health care providers from extradition to states that seek criminal charges in connection with reproductive health services offered legally here, among other measures. This legislation allows doctors to keep their licenses while offering potentially life-saving care to patients who live in states that don’t allow abortion. The care can be offered via telehealth.

“A doctor here in Massachusetts can now provide [telemedicine] services to somebody in Texas and their license is protected,” Carrie Baker said “It’s still risky. They don’t want to travel to Texas if they do that.”

The Baker administration in December awarded $4.1 million in grants to 11 community-based organizations and health care providers to improve access to reproductive health, including abortion care. The Jane Fund and The Abortion Rights Fund of Western Massachusetts were among the organizations to receive funding.

Fonsh said The Abortion Rights Fund of Western Massachusetts provides funds for an abortion procedure but wants to remove other barriers.

“Are there ways for us to help people with transportation,” Fonsh said. “Are there ways to help with lodging, especially when people need to travel out of state for abortions that are farther along? It will be amazing to see what this funding can do.”

Thirty years ago, these community-based organizations might have asked patients to cover a portion of their services, even if it meant taking out a loan. Today, The Jane Fund and similar organizations receive enough financial support to cover the entire cost, Pacillo said.

“We can just say, ‘We’ve got you.’”