Analysis Abortion

California Students and State Senator Press Colleges for On-Campus Medication Abortion

Dr. Diane Tober

A Berkeley student went through multiple health-care visits and insurance re-enrollment to get an abortion. By that time, it was too late for a medication abortion.

In the summer of 2016, University of California at Berkeley student Tanya discovered she was pregnant. She had an IUD and was also using condoms with her partner. But the condom broke, and a few weeks later, she was faced with a pink plus sign on a home pregnancy test.

“I kept taking pregnancy tests over and over again because I couldn’t believe I got pregnant through two forms of usually reliable birth control,” said Tanya, who asked to use a pseudonym.

She went to the Tang Center, the campus’ student health center, to confirm the pregnancy and to find out what she needed to do next. She knew right away she wanted to terminate the pregnancy.

“After the health center confirmed my pregnancy, then they sent me to the emergency room for a blood test and ultrasound. Then I had to come back to the health center to see the social services representative so I could get approved to seek care off campus. I wanted to go to the El Cerrito Planned Parenthood, so I could get the pill for a medication abortion, but by the time my pregnancy was confirmed and I went through all the steps, it was past 10 weeks and too late for the medication. I ended up having to go to Walnut Creek Planned Parenthood for a surgical abortion. And then, my student health insurance wouldn’t cover it because I was ‘out of network.’ But luckily, at Planned Parenthood they were able to sign me up for Medi-Cal to cover the cost.”

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If SB 320, also known as the College Student Right to Access Act, passes through the California legislature and is signed by Gov. Jerry Brown (D), women like Tanya will be able to get the medical care they need on campus, rather than having to go through the obstacles she and other students have faced. The bill would require that university and college insurance plans include abortion coverage and that such coverage make medication abortion available in campus-based health centers. It does not cover surgical abortions.

SB 320 was authored and introduced in February by state Sen. Connie Leyva (D-Chino). It is co-sponsored by the Women’s Foundation of California, ACCESS Women’s Health Justice, and ACT for Women and Girls. The bill emerged after students expressed the need for abortion care on campus.

In 2016, UC Berkeley students founded Students United for Reproductive Justice (SURJ). SURJ co-founder Adiba Khan said, “I saw there was a Students for Life club on campus and I wanted to join a ‘Students for Choice’ club, but there wasn’t one. So a group of us got together and started SURJ.”

SURJ’s first mission was to appeal to the Berkeley administration to provide medication abortion at the campus’ student health center. They faced numerous challenges trying to get the administration on board and were ultimately denied due to concerns about the possible need for increased security in case of protesters and other costs of implementation.

“It made no sense to us that something as simple as medication abortion wouldn’t be provided on campus when other reproductive and sexual health services are available,” Khan said. “Our medical insurance covers abortion, and there are trained providers already there at the Tang Center, so there’s no reason not to make the medication available—other than to avoid controversy on campus.”

By the time Tanya was finally able to get the treatment she needed, she had gone through weeks of bureaucratic delays and unnecessary diagnostic appointments and had missed several days worth of work and class. In total, she spent more than $300 out of pocket for emergency room charges, transportation costs, and other expenses. This was in addition to another $300 in lost wages—quite an expense for a college student.

Tanya added: “It seems ridiculous I had to go through all these steps and pay all this money—when I’m already paying $2,000 for my student health insurance—rather than just go to the health center and take a couple of pills. But I’m lucky. At least I live in Berkeley and there are clinics nearby. I can’t imagine what some of my friends at UC Riverside have to go through when the closest clinic is over 60 miles away.”

If Tanya had had access to medication abortion, she would have taken mifepristone and misoprostol under a doctor’s care over the course of two days, and avoided the delays. It’s safe and effective, with a success rate between 95 and 98 percent, and minimal side effects such as cramping and sometimes nausea or chills.

As director of Advancing New Standards in Reproductive Health at UC San Francisco, Dr. Daniel Grossman has called for an end to overregulation of mifepristone and medication abortion. His research resonates with Tanya’s experience.

“When women have to travel long distances to access care, they may be delayed in the process of obtaining an abortion. Research has shown that improving access to medication abortion helps women obtain care early in pregnancy and may reduce second-trimester abortion,” said Grossman.

Elizabeth Wells, another Berkeley student and SURJ member, addressed why access to medication abortion on campus would make such a difference to women in her community.

“I’m from the Central Valley, and I went to a community college, and I have a lot of friends who needed to get an abortion and had a really difficult time. It’s a conservative area—so it’s even difficult to talk about abortion and sexual health because there’s a cloud of stigma. Everything is super spread out, and getting access is really difficult because clinics that provide abortion are few and far between. It’s expensive, and you have to make your way through throngs of anti-abortion protestors just to get to a clinic. One of my friends had to drop out of college because she couldn’t get access to an abortion.”

For Tanya, getting an abortion in her hometown wouldn’t have happened. “If I had gotten pregnant in my hometown, I would have been out of luck. SB 320 is a huge deal for all students, but especially students in more rural areas.”

According to Sara Spriggs, operations manager and spokesperson at ACCESS Women’s Health Justice in Oakland, student access to abortion medication is imperative whether it’s in California’s Central Valley or the Bay Area. ACCESS maintains a hotline that gives callers reproductive health information and directs them to public insurance programs.

“We receive calls from students all the time,” said Spriggs. “It’s really hard for students. Many of them are still trying to navigate being an adult. And they don’t know where to go to get health care that isn’t provided on campus. So we help them through that process and help them get Medi-Cal coverage. But if medication abortion were available on campus that would be a huge relief, both logistically and in terms of the mental health aspect. And this is why SB 320 is so important. It would make an enormous difference in students’ lives.”

When asked why she authored the bill, Sen. Leyva responded: “I firmly believe that college students should have access to safe and reliable comprehensive reproductive health care on campus. It is always safest for a woman—if she chooses to do so—to end her pregnancy during the first few weeks, so it is vitally important that this health care service be available at college student health centers. A woman during her first 10 weeks of pregnancy should not have to travel several hours away from campus, possibly pay out of pocket, secure transportation and even miss school or work so that she can access her constitutionally protected right to end her pregnancy.”

The bill passed through the Senate Health Committee with a 6-2 vote and heads next to the Senate Education Committee. University of California and California State University officials expressed some concerns about how to implement medication abortion availability across their educational systems during testimony at an April 19 hearing, but are generally supportive of the bill’s intent.

In the meantime, California students are busy organizing. SURJ has an on-campus rally planned for later this week in Berkeley, and they’re building student coalitions across California campuses to join their efforts.

“I’m so excited that Sen. Leyva is championing this bill! It makes us feel like students actually can make a difference. And hopefully this legislation in California will set an example for other states to follow,” said SURJ member Marandah Field-Elliot. “I hope this bill helps normalize or de-stigmatize abortion on a larger scale, because it’s just a normal part of women’s health.”

Abortion is a normal part of women’s health, and regardless of whether one is a student or not, the College Student Right to Access Act is important for women everywhere. Students, along with reproductive health researchers, providers, and advocates, are looking to California to raise the bar on comprehensive reproductive health care.

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