On June 24, the day that Roe v. Wade was overturned, a pregnant person in Wisconsin had an appointment for an induced abortion due to an ectopic pregnancy. But as the Roe decision came out, the hospital decided not to move forward with the procedure. That afternoon, Women’s Medical Fund (WMF), an abortion fund in the state, provided funding for the person to travel to Illinois so they could get the care they needed. 

“One thing that we’re seeing is that because it’s so unprecedented, this legal landscape, and because places like hospitals are extremely risk-avoidant, even if a pregnant person’s life is in danger in Wisconsin, many, if not all, of those folks are still needing to travel to [out of state],”  Lucy Marshall, WMF’s board president, said. “Even within an extremely narrow scope of the exception of the law, people are not able to access the abortions that they need.”

In the 13 U.S. states where abortion is now banned post-Roe, abortion funds and advocacy organizations have held the line and dealt with uncertainty, confusion, and distress as pregnant people struggle to find reproductive care. Many abortion funds have had to shift their operations to comply with new laws. Despite the ongoing challenges, they continue to support pregnant people in their states. We caught up with abortion fund leaders and advocates in six of the ban states—Arkansas, Louisiana, South Dakota, Tennessee, Texas, and Wisconsin—to talk about what their states are experiencing and how they’re holding up. 

Patients are frustrated and desperate

Patients in ban states like South Dakota and Louisiana not only have to figure out the nearest state they can travel to, but they also have to go through several hoops to arrange care. “We need to figure out if they need gas money, or if they’re going to fly, or how many nights in a hotel they’re going to need,” Kim Floren, co-founder of the Justice Empowerment Network (JEN) in South Dakota, told PGN. “There are a lot of restrictions even in states where it’s still legal.” 

For instance, if a patient is traveling from South Dakota to Minnesota, some abortion clinics require the pregnant person to take the abortion pill at the clinic. “So what that means is they’re going to start bleeding, and if they have a really long drive ahead of them, we don’t want them on the road when that starts to happen,” Floren said. “So now, they also are going to need a hotel room for that night.” If a person gets an appointment in Sioux City, Iowa, the closest option from South Dakota, there is a 24-hour informed consent law, so they need two appointments. Floren added: “So you have to go one day, and then you have to go back the next day just for a pill.” All of this is especially challenging for parents—about 59 precent of people who get abortions—who need to arrange child care. 

In Louisiana, patients face a time crunch due to a Florida law that only allows abortions up to 15 weeks. “It takes a minute to realize that you are pregnant. And from the time that you realize that you are pregnant, to get a pregnancy test and [to go through] all the hoops you gotta jump through to get access to abortion,” Lakeesha Harris, co-executive director of Lift Louisiana, an advocacy organization, said. “So by the time a person jumps through all those hoops, they may have already passed that 15-week mark to get an abortion in Florida, which means they have to travel up to Illinois to get abortion services.” 

Though abortion funds try their best to help patients get the resources they need to travel out of state, sometimes money isn’t enough. There’s also the problem of judicial bypass, a process by which judges allow minors to get an abortion without involving their parents or legal guardians. That’s no longer an option for teens in ban states post-Roe.

In Arkansas, Ali Taylor, executive director of the Arkansas Abortion Support Network, says that some people are simply not able to leave the state, even if provided funding. “Sometimes money is not the issue, or it might be the issue, but it can’t fix everything,” Taylor told PGN. “And we have heard of at least two folks who have taken extreme measures like trying to use household chemicals to end their pregnancies. As far as I know, both of those people were able to get better help. And they are okay, but that anybody would think that they needed to resort to that is horrifying.” 

Bans are exacerbating the maternal mortality crisis and care deserts 

Accessing reproductive care was already hard pre-ban in states like South Dakota, Louisiana, and Arkansas, which are considered maternity care deserts or ranked high in maternal mortality. “In rural areas here, it’s really difficult to find an OB-GYN and just prenatal care in general,” Floren of JEN in South Dakota added. “So if you have something go wrong, you might be three hours away from your nearest hospital. So already, people are at a higher risk for complications and not being able to get the emergency care that they need when they need it.” 

In Louisiana, a state experiencing a maternal mortality crisis that disproportionately affects Black women, legislators have averaged $1 million a year in funding to anti-abortion centers that don’t offer actual prenatal care. Often called crisis pregnancy centers, these organizations are hotbeds of reproductive misinformation. Lift, in Louisiana, has been fighting against these centers that are, according to Harris, “pandering to a way of thinking that is not constructed or based in scientific evidence and in fact could really lead to harmful outcomes to our people, Black people in particular, who are really having a crisis in pregnancy.” 

An isolating experience: Afraid to ask for help

In response to full bans and punitive legislation in places like Texas, abortion funds like the Lilith Fund have had to shift their approach. Though it is not directly providing funding for patients to get an abortion, the Lilith Fund is still funding other reproductive care like birth control, IUD insertion or removal, ultrasounds, and more. There are also hotlines that provide useful referrals and resources to pregnant people seeking abortions

In Texas, people are scared to seek help thanks to the bounty law known as S.B. 8, which financially incentivizes citizens to sue someone who helped or encouraged a pregnant person to get an abortion. “These laws are meant to scare people and coerce them from getting support from the community and their trusted loved ones, and so people feel more isolated throughout this process,” Shae Ward, hotline program director at the Lilith Fund in Texas, said. “Luckily, we can tell them what they actually can do, where some safe places to go [are], or where to look for information on what their options are.” 

Others are also increasingly concerned about “being policed” and “surveilled” in Tennessee, according to Cherisse Scott, founder and CEO of SisterReach. Her organization has been trying to spread the message that “abortion is still legal in other areas of the country, and we’re here for you.” 

This shouldn’t be the norm 

All abortion advocates emphasize that having to travel across state lines to get reproductive care shouldn’t be the norm. “It’s an extremely dire situation,” Marshall of Wisconsin’s WMF said. And even if there’s funding available for people to travel, Floren added, “nothing is going to replace having local care in your community, with your own providers from your community. This is not sustainable at all in any way.”