At Some Colleges, the Fall of Roe Will Weaken Student Health Care

On June 24, an independent women’s health center in Tuscaloosa, Alabama, received cease-and-desist orders from the state’s attorney general for its abortion services. The order came immediately after the US Supreme Court’s Dobbs decision, overturning Roe v. Wade .

The clinic’s operations manager told local news that his team spent that day canceling more than 100 appointments . The clinic sits right across the road from the University of Alabama and was one of only three providers in the state. As a new school year begins on college campuses across the country, many students will move to states that promise them fewer rights now than when they applied to school last winter, or when they accepted enrollment offers this spring.

On some of those campuses, health centers—fearing legal consequences for their staffers—will likely roll back what they can offer students, both in terms of care and information about how to access abortion services or pills elsewhere. Some health advocates worry that the chilling effect may even spread to conveying general information about birth control and sexual health. “It’s going to have devastating effects,” says Gillian Sealy, chief of staff with the nonprofit Power to Decide, which advocates for reproductive rights.

“In many instances, this is the place that a young person might go to get their health needs met. ” Unplanned pregnancies diminish the likelihood that a student will continue their education. So having the power to choose is paramount, she says.

But the Dobbs decision may leave students without that power. Ten states currently ban abortion. Another four ban procedures after the six-week mark, before many people realize they’re pregnant.

In some of these states, including Texas and Alabama, students who depend on their college for health care already had to journey off campus to access abortion care. Now, students may face the even heavier burden of traveling out of state, forcing them to miss class, work, assignments, and exams. Health advocates are especially worried about how state bans might affect young survivors of assault.

“We know that the first month of college, rates of sexual assault are really high. And pregnancies do result from that,” says Carrie Baker, a professor of gender studies at Smith College in Massachusetts who studies social justice movements and the law. “So I think about that first-year student who’s 18, goes to college, experiences assault, and ends up pregnant.

She’s in a state that bans abortion. That’s kind of a worst-case scenario. ” And there are other awful scenarios: Young people who are away from family and trusted health care providers may be vulnerable to misinformation .

Those who try to find help online may be tracked and criminalized based on personal information they’ve entered on the wrong website or app. Activists and aid organizations are scrambling to get useful information out—and discovering the limits of how they can help. “Everybody’s very afraid,” says Baker.

“And that, of course, is by design, because they want to try to kill any sort of help that people might be wanting or willing to give. ” There’s loads of evidence that unwanted pregnancies hinder a young person’s life. A project called the Turnaway Study followed the lives of 1,000 women in the United States for 10 years: Some had recently had abortions when the study began; others had been denied them.

The study found that those who were “turned away” faced economic hardship that lasted for years. They were statistically more likely to stay with violent partners, and the developmental wellbeing of their children was negatively affected. Among the participants, 71 percent of college students who received abortions earned degrees, but only 27 percent of those denied abortions were able to graduate.

By this logic, abortion access serves colleges themselves, Sealy argues. Restricting access “can, and will, impact their graduation rate,” she says. “It’s in their best interest to make sure that their students are well cared for.

” But it’s not clear how campuses will react in a post- Roe world; WIRED contacted administrators at 14 campuses in 10 states with six-week restrictions or total bans, and only a handful responded. Representatives from the universities of Missouri, Mississippi, and Kentucky note that, because their states already had preexisting restrictions, Dobbs would not affect services offered at their health centers. A spokesperson from the University of Missouri says that prior to Dobbs , they “were able to provide neutral information about reproductive health services.

That is still the case. ” The University of Kentucky rep notes that prior state laws stop the university from offering abortion services “except in cases where the life or health of the mother is threatened” and that their student health insurance does not cover elective abortion, but campus providers will share information about medication abortion upon request. An official from Washington University in St.

Louis, a private college in Missouri, pointed to a June post on Instagram affirming that the campus would continue to provide contraceptive counseling and IUDs. The post says that students will still have access to abortion services in neighboring Illinois, with “two clinics within a 30-minute drive. ” And Emory University, a private college in Georgia, where abortion is banned after six weeks, will continue support out-of-state abortion care under its student health insurance plans , according to a link shared by a university representative.

On at least one campus, abortion information already seems to be a hot topic: In July, the Texas Tribune reported that the University of Texas at Austin’s health center had scrubbed any mention of abortion as an option from its website and that students had petitioned for expanded sex education and resources. (In an email to WIRED, a representative for the university wrote: “University Health Services offers a variety of reproductive health care services for students such as annual wellness exams and education, pregnancy testing, and information on contraceptives and pregnancy prevention. UHS does not dispense abortive medications, provide abortion services or obstetrical/prenatal services.

”) Representatives from the University of Alabama, Auburn University, Louisiana State, Tulane University, the University of Wisconsin, Georgia State, the University of Arkansas, and the University of Tennessee did not respond to email requests for comment. In at least two states where abortion remains legal, one form of access will actually be expanded: At the start of 2023, California will require all its public universities to offer access to medication abortion. The law, originally passed in 2019 , is the first of its kind in the US.

“Young people not only fought to get the bill passed, but they’re asking for even more,” like trans-inclusive services and extended clinic hours, says Kimberly Inez McGuire, executive director of URGE (Unite for Reproductive & Gender Equity), a nonprofit that helped support the legislation. A new law now ensures medication abortion access for students of public colleges in Massachusetts as well. In ban states, advocates like Sealy are worried that clinics will cease offering other reproductive health services too.

“We know that there’s a possibility that this won’t just stop with Roe v. Wade ,” Sealy says. “It really is an access issue, not just about abortion, but also about contraception.

” “A lot of the states that are hostile to abortion are also hostile to contraception,” agrees Baker. “For a lot of women, the first time they go to a health care provider to talk about birth control is when they’re in college. So what if you live in a state where they’re not giving you complete candid information?” For years, many students have sought information and care from off-campus groups like Planned Parenthood or the Yellowhammer Fund, a nonprofit based in Alabama that provides financial and logistical support for abortion services.

But some states with bans now criminalize “aiding and abetting” an abortion. Texas, Oklahoma, and Idaho have passed “bounty hunter” laws that enable private citizens to sue anyone who facilitates an abortion. Those laws mean that some aid organizations can’t directly refer people to help—or even provide funds—because they must abide by these rules.

“Truly, all of the services that we used to provide to abortion seekers we had to cease,” says Kelsea McLain, Yellowhammer’s deputy director—and that includes in the organization’s home state. Yellowhammer has continued to fund a family justice program —which supports pregnant and parenting people—and to provide emergency contraception in ban states. They can’t refer callers to abortion providers, but they can provide moral support and indirect guidance, like sharing news articles, which they view as being protected by the First Amendment.

But McLain points out a danger in how students search for help in the first place: the internet. “A lot of the referrals we got before Dobbs were people calling us saying, ‘My friend got help from y’all,’” she says. “The scary thing, though, is that they’re also going to Google.

And Google can just be filled with great information or terrible information. ” Internet searches can lead even cautious abortion seekers to “ crisis pregnancy centers ,” which pose as clinics willing to guide people through unplanned pregnancies but actually dissuade them through pressure and misinformation. Experts are also concerned about web surveillance and data from period-tracker apps being used to criminalize people seeking abortions.

(They recommend using a VPN when researching options or ordering pills from sites such as Plan C. ) What then, is the best recourse for activists and aid organizations? In both access-friendly states and those with bans, campus activists are pressuring university administrators to support students: to ensure flexible attendance policies in the event that students require care; to set up emergency or travel funds; to establish confidentiality policies that protect students seeking information; and to provide medication abortion. “Now’s the time to talk to the powers that be at their university—to understand the university’s position,” says Sealy.

Tamara Marzouk, director of abortion access at the nonprofit Advocates for Youth, points out that this matters even in very blue states : When campuses in places where abortion is legal provide care to students, it lightens the burden on local independent clinics—clinics that feel the pressure from out-of-state patients. It’s still to early to know how these on-campus campaigns will go, but “I’m ready to be surprised by some administrations that we assume to be anti-abortion,” Marzouk says. “We’re still mostly in summer.

So we’re going to see student activism ramp up in the fall. And I think that that’s when we’ll really see how administrations respond. ” Students can also vote with their feet.

For some universities, a sizable chunk of the student population comes from out of state: more than 40 percent at the University of Oklahoma and nearly 60 percent at the University of Alabama. Early data shows that teens applying to college are avoiding schools in states with bans, and a July survey done by an education magazine showed that a quarter of high school students heading to four-year colleges would attend only where abortion is legal. URGE’s McGuire says that students can also help turn up the pressure on legislators who are crafting still-evolving state laws on abortion and contraception.

Some radical bans are passing, others aren’t . “We have majorities in every state in this country of people who want abortion to be safe, legal, protected, accessible,” she says. She’s optimistic, suspecting that people underestimate youth political engagement and the history of social justice movements in the South and Midwest: “These are regions of the country that have birthed liberation movements.

” Marzouk says that there’s been increased interest among student activists in learning about self-managed abortion, which involves pills approved by the Food and Drug Administration that can be accessed via telehealth appointments and sent through the mail—although the legal limits on both are still rapidly evolving . “We’ve seen information sharing about self-managed abortion increase tremendously over the past few years, and even more since June,” says Marzouk, who works alongside hundreds of activists around the country. In states with bans, campus activists must follow the same rules for counseling as Yellowhammer.

Advocates for Youth has had dozens of young people teach their peers how to share the World Health Organization’s guidance on self-managed abortion in a way that is “not providing any type of advice that could be construed as medical or legal advice,” she says. For example, like “saying ‘a person would do XYZ’ and not using ‘you’ language. ” And most of all, advocates say, it’s important to encourage students not to fear seeking information or help.

“No matter what, there are so many people in this country that are committed and dedicated to helping you get that abortion care you need,” says Yellowhammer’s McLain. “Without stigma, without shame, and without it ruining your life. ” Marzouk says she still finds space for optimism, despite draconian restrictions on abortion.

“Working alongside young people has given me so much hope,” she says. “I’ve seen young people stay incredibly creative through what is an incredibly dark time. ”.