Will California Transform the Abortion Access Conversation?

In January, the California state Senate passed a bill that would require all state public colleges with campus health centers to offer medication abortion. Medication abortion refers to the intake of mifepristone followed by misoprostol to terminate a pregnancy at or before ten weeks. The bill first moved through the Senate Health, Education and Appropriations committees, and after passing the Senate has moved to the State Assembly. Now, it awaits a hearing in the state House Committee on Rules to determine SB 320’s future in the weeks to come, according to House Speaker Anthony Rendon’s office. Should the bill pass the requisite committees in the Assembly, it will move to the floor for a crucial vote that could decide whether female college students in the state have access to a crucial health service as early as January 2022.

In other words, the bill has come a long way. And its progress was made possible by a surprising source: Student activism, which both led to the bill’s conception, and helped push it to where it is, today.

While the bill was introduced by state Sen. Connie Levya last February, Levya told NPR that she learned about the need for it from UC Berkeley’s Students United for Reproductive Justice. The group worked with Berkeley students who had attempted to access abortion at the health center and been denied, as well as university administration, but despite a 2016 student government resolution demanding abortion access on campus, the university took no action.

“When they were denied, they brought the issue to us, and I thought that this was something that young women should have access to, because it is their constitutional right,” Leyva said.

From there, despite receiving minimal national coverage until recently, things progressed quickly. The Women’s Foundation of California Women’s Policy Institute helped draft the legislation, while student activists across the state have been raising awareness about SB 320 on campuses, and applying pressure to state lawmakers.

At the present, the reproductive health care that campus health centers provide is limited to STI testing and contraception. Last year, University of California-Davis made national headlines for installing Plan B vending machines on campus, after student government representatives worked directly with the campus health center. Now, SB 320 is just a few steps away from changing the lives of female college students throughout California—and setting a critically important precedent as lawmakers in other states chip further and further away at abortion access.

Abortion access on campus: a Title IX issue?

When we hear about Title IX, we tend to think of issues like campus sexual assault, or providing equal resources to men and women’s athletic teams. For all the decades that have passed since the implementation of Title IX, a federal law prohibiting institutions receiving federal funding from discriminating on the basis of gender, the issue of abortion access on college campuses has yet to be discussed from the standpoint of gender equality.

This, in itself, is unsurprising; despite the fact that abortion is a legal, objectively safe and common medical procedure (almost three in ten women will have an abortion before turning 45), it remains mired in stigma. But the need for abortion care on campus is so inextricably bound with the issue of gender parity in education that nonetheless, it’s astounding that even with SB 320 getting closer and closer to becoming a reality in California, connections have yet to be drawn between the bill and Title IX.

Last month, the Huffington Post told the story of a Berkeley student who traveled off-campus for an ultrasound and abortion, and had no choice but to miss class and her internship, and lose about $100 in wages from missing work. Despite some state insurance coverage, she also spent $200 out-of-pocket, a burdensome cost for a student putting herself through college.

The reality is that abortion access affects female students’ ability to participate in their education and extracurricular pursuits on the basis of gender. Even in California—where no major restrictions such as mandated waiting periods or limits on insurance coverage exist—for young women juggling classes, work and internships, the time commitment and anxiety of having the procedure places a potential burden on them that their male peers will never face. For female college students with strained budgets, or those attending school in rural areas where the nearest abortion clinic is a day trip away, restrictions or no restrictions, abortion comes with far too many challenges and barriers. And these barriers start almost immediately, with the time women will be forced to spend researching the procedure, discerning between credible information and anti-abortion propaganda on the internet, finding the nearest clinic, and preparing for their trip.

Additionally, on top of the fees associated with the procedure and travel to a clinic, not to mention the academic and professional costs of putting commitments on hold to leave campus for the day, the anxiety that can come with an unwanted pregnancy and facing barriers to abortion access take a toll on female students’ mental health, as studies by University of North Carolina and University of California, San Francisco researchers have revealed. According to the University of California, San Francisco study, women who are unable to access abortion “reported significantly more anxiety symptoms and lower self-esteem and life satisfaction” than women who are able to access the procedure.

Just as the need for abortion is inherently gendered, so, too, are the consequences of that need not being met.

A national issue, magnified

Despite the demonstrated need of female students and the inequality that comes with lack of abortion access on campus, even in a state like California, opposition to SB 320 persists.

Predictably enough, critics of the bill claim funding for its implementation will be too expensive and detract from other university amenities like “housing and scholarships,” according to Wynette Sills, director of Californians for Life. (Notably, the group supports public funding for crisis pregnancy centers that offer propaganda and misinformation over medical services.) But while medication abortion on campus is certainly deserving of state funding, SB 320’s implementation would be privately funded by the Women’s Foundation of California, Tara Health Foundation and another private donor, who will together cover the estimated $14 million cost.

Of course, costs aren’t the only concern that SB 320’s opponents claim to have with the bill—they also argue it could jeopardize women’s health. According to Sills, university systems “are poorly equipped.”

“These student health centers are basically first-aid centers with oftentimes just the basic medical infrastructure,” she said.

And yet, not only is medication abortion FDA-approved with a major complication rate of under 0.31 percent, but in some states it’s also administered via telemedicine and sent to women’s doorsteps. The issue of abortion on campus may only affect a specific demographic, but in many ways, it’s the same as the issue of abortion access on the national level. Opposition to female bodily autonomy is packaged as paternalistic concern for women’s safety, codified into laws that restrict abortion access — and, in doing so, put women in actual risk.

The five years between 2011 and 2016 have seen the passage of more than a quarter of all of the roughly 1,050 restrictions on abortion across the country passed since Roe v. Wade. In recent years, the United States’ maternal mortality rate has become the highest in the industrialized world, with states with more restrictions on abortion boasting the highest rates. Surgical and medication abortion are provably safe health services; it’s the “concerns” of abortion opponents that are costing women their economic security, bodily autonomy and at times, even their lives.

Medication abortion is as safe — and as legal — as any other authorized service provided by campus health centers. What threatens SB 320’s passage is the typical doctrine of understanding abortion as legal, but treating it different in the law, nonetheless.

Consider the Hyde Amendment, a federal law that prohibits federal funds from paying for abortion in order to not offend those same, very “pro-life” individuals who support funding for foreign wars that often claim the lives of born, living people. Abortion may be legal, as we understand that banning it (or even restricting it, for that matter) has never stopped it from happening, and never will so long as unintended pregnancy continues to happen. But the mere fact that people—namely those more inclined to see the humanity in fetuses than in women—are offended by the procedure has always been enough to strip women of access to their rights.

On college campuses, the dialogue is even more complicated by abortion opponents’ stereotyping of women seeking the health care service as young, promiscuous and irresponsible. The popular narrative ignores how the majority of women who seek abortions used contraception when they conceived, many barriers obstruct access to birth control, and not everyone has the privilege of receiving accurate sexual health education. From this perspective, it’s easier to see opposition to abortion and bills like SB 320 for what they are, made even more evident in the context of college campuses—the punishment of female sexuality.