Win and Deliver Toolkit

A toolkit for Massachusetts municipal action to expand
access to reproductive health care

With the decision in Dobbs v. Jackson Women’s Health Organization, the U.S. Supreme Court overturned nearly 50 years of federal constitutional abortion protections. In response to this unprecedented rollback of reproductive rights across the nation, we need a whole-of-government response to fight back against attempts to restrict reproductive freedom. Defending our rights at the federal level is not enough; states and municipalities must take action to expand reproductive equity. That is why Reproductive Equity Now created the Win & Deliver Toolkit, a portfolio of resources to support Reproductive Equity Now City Champions and other municipal officials in taking action to advance reproductive equity in their communities. 

This toolkit, which includes policy proposals and supporting materials, will serve as a starting point for municipal leaders looking to move the needle forward in their community.

Each and every city has a role to play in this fight. Join us!

  1. Support medication abortion access in your community

Medication abortion accounts for more than half of abortions across the country, and nearly 50% of abortions in Massachusetts. It is a safe and effective medication that offers non-invasive access to care in the privacy of one’s own home. Medication abortion can be obtained through telehealth or an in-person consultation with a provider. However, traveling to an in-person appointment to access medication abortion can be difficult, especially for public college students, 600-1,380 of whom obtain medication abortion care each year. This year, the state legislature passed a law requiring our public colleges and universities in Massachusetts to work with the Department of Public Health on readiness plans to implement medication abortion access on campus, either directly or by providing referrals to offsite care. This marks a significant step in improving access to care for young people.

As politicians in hostile states across the country are taking action to restrict access to abortion, now is the time to make sure residents in every corner of our Commonwealth know the facts about medication abortion. Municipal leaders can organize a public awareness campaign about how to access medication abortion. By speaking accurately and honestly about abortion and medication abortion, such a campaign will not only educate residents more broadly about how to navigate medication abortion care and telehealth services, but also contribute to the destigmatization of abortion care in the process. Municipal leaders can also play a role in supporting public higher education institutions working on implementation of the state law as well as encouraging private higher education institutions to expand access to medication abortion for their students.

Resources

  • This Q&A document offers information on what medication abortion is, the prevalence of abortion pills, and the barriers that prevent people from accessing this essential care. Read the Spanish and Portuguese versions.

  • Use this model resolution as a template when looking to expand access to medication abortion in your town or city.

  • Use this model resolution as a template when working with private colleges to expand access to medication abortion for students.

2. Appropriate municipal funding to the nearest abortion fund

This year, the state legislature took significant steps to make abortion care more affordable, including passing a mandate for private insurers to cover abortion with no cost sharing, in addition to an investment of nearly $20 million in reproductive health care access, security, and infrastructure. $2 million of that funding was allocated in grants to support abortion funds in Massachusetts. These were major steps to make care more affordable, however, for people traveling to Massachusetts for care, or those on an insurance plan not subject to the coverage mandate, cost can still be a major barrier to abortion access. This is where abortion funds come in: the grassroots, community-based organizations with decades of experience filling systemic gaps in health care coverage and helping put affordable abortion care within reach.

Municipalities can allocate funds to the nearest abortion fund to not only make an immediate investment in abortion access, but also make a bold statement as state legislatures across the country take action to strip away our right to bodily autonomy.

Resources

  • Abortion funds are grassroots organizations that help people (both in and out of state) obtain an abortion when they may not be able to afford it otherwise. In Massachusetts, we have four abortion funds that do this heroic work to help people finance their care. Learn more about our Commonwealth’s abortion funds. Read the Spanish and Portuguese versions.

  • Use this sample resolution as a template when looking to allocate municipal funding to your local abortion fund.

    See Portland, Oregon’s resolution to use city dollars to support reproductive health care.

  • Use this sample ordinance when looking to use city dollars to support reproductive health care.

  • Use this model bylaw/warrant article language as a template when looking to appropriate city dollars to reproductive health care.

  • See FY2023 state budget language that appropriated state dollars to reproductive health care access and abortion funds. (PDF version HERE)

Massachusetts Abortion Funds

3. Prohibit municipal involvement in hostile out-of-state litigation

As state legislatures across the country look to criminalize and chill access to abortion care beyond their borders, Massachusetts must do all it can to protect our providers, patients, and anyone aiding in access to abortion and gender-affirming care from hostile out-of-state litigation. An Act expanding protections for reproductive and gender-affirming care establishes best-in-the-nation protections at the state level for any individual engaged in the provision of reproductive health care that is lawful in Massachusetts. Salem, Massachusetts took action to codify many of these same provisions at the municipal level, by prohibiting city employees, contractors, and any recipient of municipal funds from providing information or assisting in any investigation related to what constitutes legally protected health care in our Commonwealth. Easthampton, Massachusetts City Councilor Owen Zaret has also filed ordinance language that similarly restricts municipal participation in any hostile investigation and requires municipal employees to follow all state regulations pertaining to reproductive health care and gender-affirming care. Other municipalities can follow Salem and Easthampton’s lead by introducing a similar ordinance.

Resources

  • This summer, the state passed best-in-the-nation state-level protections for patients and providers of abortion and gender-affirming care. Read the law to help protect patients and providers from hostile out-of-state litigation.

  • Salem has taken steps to codify protections for those accessing reproductive health care and gender-affirming care by prohibiting the City from assisting any person or jurisdiction in litigation, prosecution, or extradition targeting anyone who has received such services.

    Read Salem’s Safe Access Ordinance. Read Salem’s Safe Access Ordinance Fact Sheet.

  • Easthampton has introduced an ordinance to restrict municipal participation in any hostile investigation and require municipal employees to follow all state regulations pertaining to reproductive health care and gender-affirming care.

4. Take steps to support the statewide emergency contraceptive standing order

Decisions around emergency contraception are time-sensitive, and people often pay out-of-pocket for over-the-counter emergency contraception instead of jumping through hoops to get a prescription. The state legislature recently took steps to rectify this situation: a key provision of An Act expanding protections for reproductive and gender-affirming care directs the Massachusetts Department of Public Health to issue a statewide standing order for emergency contraception. Issued on August 4, 2022, this standing order offers a significant step forward to improve timely and affordable access to emergency contraception, and municipalities can play a key role both in proper implementation and in raising awareness. Municipal action could include launching public awareness campaigns, hosting public awareness events to ensure residents understand what the emergency contraception standing order is and how it affects them, as well as an audit of pharmacies within municipal borders to ensure compliance.

Resources

“Reproductive Equity Now has released a toolkit to help people access the right emergency contraception for them—and is providing a roadmap for other states to follow.”

Boston Business Journal

Read Our Toolkit to Expand Access to Emergency Contraception

5. Implement municipal vending machines for emergency contraception

Another key provision of An Act expanding protections for reproductive and gender-affirming care ensures that emergency contraception approved by the FDA for over-the-counter sale, such as Plan B One Step, can be sold in vending machines. This idea is growing in popularity on college campuses and in cities across the state, often spearheaded by college student organizers eager to make emergency contraception more affordable and accessible to young people where they spend their time—in student centers, public buildings, and appropriate centralized locations downtown. Municipalities can take action by allocating money for emergency contraception vending machines in appropriate public venues.

Resources

6. Raise awareness and educate residents about the dangers of crisis pregnancy centers (CPCs)

Crisis pregnancy centers outnumber actual abortion clinics 3:1 in Massachusetts, and pose a major threat to people seeking unbiased reproductive health care. These often unlicensed facilities purport to offer the full spectrum of pregnancy care, but actually aim to manipulate and dissuade people from obtaining abortion. Providers in Massachusetts report that some of their patients first go to a crisis pregnancy center before finding their way to a legitimate clinic, often because of a Google search for clinics that leads them astray.

Municipalities can and should play a role in educating their constituents about their nearest legitimate abortion clinic and helping them learn to identify the signs of these dangerous facilities. Cities like Easthampton, Massachusetts, led by City Councilor Owen Zaret, are also taking initiative to call out the deceptive practices of crisis pregnancy centers and, by employing the City’s interest in the public health of its residents to facilitate reporting to the state, educating residents on how to report negative experiences to the Massachusetts Attorney General’s Office.

Resources

7. Launch a multilingual public awareness campaign on the state of abortion access in Massachusetts

Despite the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, abortion remains legal in Massachusetts. The legislature has taken important steps to expand abortion access in Massachusetts, but barriers to care—including exorbitant costs, complicated insurance coverage, and stretched providers—still exist. These barriers disproportionately impact low-income communities, communities of color, and immigrant communities. These same communities may not know about the recent wins of the ROE Act and An Act expanding protections for reproductive and gender-affirming care, and even more may be confused about what happens to abortion access in a post-Roe landscape.

Municipal leaders know their communities and constituencies best. Allocating municipal funds to develop a targeted, community-specific public awareness campaign will help constituents understand the status of abortion access in Massachusetts post-Roe and learn how to navigate care.

Resources in English, Spanish, & Portuguese

  • Read Reproductive Equity Now’s FAQ on the overturn of Roe v. Wade and what comes next for abortion access in our Commonwealth.

  • Use Reproductive Equity Now’s New England Abortion Care Guide to find an abortion provider in your area. Search by zip code to see clinics and hospitals that offer legitimate abortion care, in addition to fake abortion clinics that do NOT offer abortion care, near you.

  • If you are on a fully insured health benefit plan issued in Massachusetts, you may be eligible for several benefits, including 12 months of contraception with no copay.

    Learn about contraception access in Massachusetts in this one-pager. Read it in Spanish and Portuguese.

  • Decisions about emergency contraception are time-sensitive and sometimes overwhelming. Faced with what can be a stressful situation, it is crucial that people in Massachusetts can access the emergency contraception that is right for them without having to jump through any hoops. Read more about emergency contraception access in Massachusetts. See the Spanish and Portuguese versions.

  • Abortion is a legally protected right in Massachusetts. Learn more about the Commonwealth’s abortion laws. Read the Spanish and Portuguese versions.

  • If you are on a fully-insured health benefit plan issued in Massachusetts, you are eligible to have abortion and abortion-related health care covered by insurance with no cost-sharing, such as co-payment, deductible, or coinsurance. Learn more about insurance coverage for abortion in Massachusetts. Read the Spanish and Portuguese versions.

  • Crisis pregnancy centers are fake abortion clinics that work to deceive and manipulate people facing unintended pregnancy away from receiving abortion care. Often, they are located near legitimate abortion clinics and appear to offer the full spectrum of pregnancy care when in reality they do not. Learn more about how to recognize these deceptive and dangerous facilities. See the Spanish and Portuguese versions.

8. Host a public forum on maternal health in your community

Maternal health — and, specifically, Black maternal health — is a crisis in our country and our Commonwealth. In Massachusetts, Black mothers are twice as likely to die or have a “near miss” than white mothers. Every community must be having conversations to bring residents, experts, and advocates together to break down the systemic barriers and medical racism in our health care systems and combat the maternal mortality crisis. Municipal leaders can host a public forum to discuss the status of maternal health in their community and invite local doulas, midwives, abortion providers, physicians, experts, and residents to provide insight, share their experiences, and discuss ideas for improving access.

Resources

  • The Special Commission on Racial Inequities in Maternal Health was created by a legislative act signed by Governor Charlie Baker in January 2021. The 28-member body’s charge was to investigate and study methods to reduce racial inequities in maternal health.

    Read the final report of the Special Commission on Racial Inequities in Maternal Health.

  • Because high-deductible plans are common, many people face steep deductibles when trying to access the full spectrum of pregnancy care. We are trying to change that by passing a law that would require health insurance plans to cover all pregnancy care–including abortion care, miscarriage management, prenatal care, childbirth, and postpartum care–without any kind of cost-sharing. See the legislation and read a one-pager.

  • Doula care improves birthing experiences, breastfeeding, and maternal health outcomes, but the cost of doula care without insurance coverage can put this critical care out of reach for low-income pregnant, birthing, and postpartum people, many of whom are Black, Indigenous, and people of color. This bill is an essential tool for the Commonwealth to combat the maternal mortality crisis and address racial inequities for birthing people.

  • Learn more about disparities in pregnancy outcomes and the Black maternal health crisis.

  • MOTHER Lab at the Tufts University Center for Black Maternal Health and Reproductive Justice is doing critical work to address and eradicate inequities Black women face, through research, advocacy, and mentorship by confronting and dismantling the system that enables and perpetuates racism for Black women who give birth. Learn more.

“This unprecedented health care crisis demands an unwavering, whole-of-government response, from state houses to city halls across the country.”

Rebecca Hart Holder
Reproductive Equity Now President

9. Expand municipal paid leave

Everyone deserves time off to care for their children or family members without the fear of financial instability or job loss. Municipalities can invest in healthy families by supporting municipal workers—our teachers, fire fighters, public health workers, and more—with paid leave, whether by opting into the Massachusetts Paid Family and Medical Leave Program or adopting an expanded paid leave that covers leave for pregnancy loss.

Resources

  • Municipalities, districts, political subdivisions or authorities are excluded from Paid Family Medical Leave law unless their governing body, like a city council or town meeting, votes to opt-in. Learn more about how to opt-in to Massachusetts PFML.

  • Read about Boston’s expanded paid leave policy.

  • Use this model ordinance as a template when looking to implement paid parental leave policy in your city.

  • Use this model bylaw as you look to implement paid parental leave in your city.

  • Learn more about the benefits of paid parental leave.

10. Amend municipality charter or bylaws to use gender inclusive language

The language we use matters, especially in reproductive health care. Women are not the only people who access abortion care. Trans, nonbinary and gender nonconforming people need access to care, and often face tremendous barriers to obtaining that care. Municipal leaders can promote inclusivity and welcome every resident by removing gendered language from municipal bylaws, charters, and other official municipal documents.

Resources

  • The Massachusetts Commission on LGBTQ Youth has several helpful gender inclusive language resources.

  • The City of Attleboro recently passed a home rule petition, with the help of its state delegation, to update its city charter. Read the legislation HERE.

  • Read the City of Boston’s ordinance for gender inclusivity on city forms.

  • Use this model ordinance as a template when looking to use gender inclusive language in your municipal documents.

  • Municipal leaders can support their constituents getting involved and proposing local ballot questions in support of gender neutral language. Here is a model local ballot question to amend the town or city code to be gender inclusive.

11. Support affordable and equitable access to child care

Reproductive equity is not only the ability to decide if and when to start or grow a family. It’s also about ensuring that when you do decide to become a parent, you can raise a family in a safe and healthy environment without breaking the bank on child care. Robust child care access means healthy futures for all children but right now, Massachusetts families are paying exorbitant prices for child care (the second highest in the country!). This is a reproductive equity issue and an economic justice issue. Cities across Massachusetts can take action by organizing to support state legislation like the Common Start bill, and can follow the lead of cities like Somerville by investing directly in child care assistance.

Resources

  • The Common Start Coalition is a statewide partnership of organizations, providers, parents, early educators and advocates working together to make high-quality early education and child care affordable and accessible to all Massachusetts families.

  • Use this model resolution as a template for showing your city’s support for Common Start.

  • Learn more about the benefits of quality, affordable child care.

  • Use this model ordinance and this model resolution as a template when looking to establish a child care access and affordability program in your city.

12. Fund free menstrual products in schools, libraries, and other public buildings

As job insecurity, homelessness, and food insecurity rise, especially for families and individuals facing instability during the pandemic, so does period poverty. According to a 2019 survey conducted by MassNOW, more than half of school nurses say they have assisted with students who miss class to obtain menstrual products, and 17% said they pay for tampons and pads for students with their own money. Municipal leaders can step in to provide these products free of charge—in schools, libraries, and other public buildings—making them a public good and eliminating stigma around menstruation.

Resources

  • The Massachusetts Menstrual Equity Coalition is a group of activists and organizations coming together to end period poverty statewide. Learn more.

  • Learn more about period poverty in Massachusetts and the benefits of free menstrual products in public restrooms.

  • (H.2354/S.2730) Read the I AM bill, legislation to provide access to free menstrual products to all menstruating individuals in schools, shelters & prisons.

  • Read Brookline’s bylaw in support of free menstrual products in public Brookline restrooms.

    Use this model ordinance as a template for your own city to support free menstrual products.

  • Use this model ordinance as a template to allocate municipal funds for menstrual products.

  • Use this model resolution as a template to allocate municipal funds for menstrual products.

Get in Touch With the Reproductive Equity Now Team

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