When Gov. Jerry Brown vetoed the bill last year that would have provided California's public university students access to medication abortion - widely known as the "abortion pill" - at their on-campus student health centers, he justified it by saying most students lived within five to seven miles of an off-campus abortion provider. He saw the distance as not "unreasonable."
But this reasoning is an oversimplification of the barriers students face in trying to secure abortion services.
I'm one of those students who had to travel to an abortion provider off campus, but I attended a private California university. About 500 students a month at the state's public universities are forced to seek medication abortions off campus.
My experience was unreasonable. I had to travel almost 47 miles, one way, to secure an earlier appointment at an abortion clinic that would allow my sister to stay with me in the room. Yet distance was not the only barrier I faced. To obtain the care I needed, I had to miss multiple classes and a midterm to make weekday appointments and I fell behind in my studies. I was forced to deal with careless referrals from the student health center that directed me to antiabortion doctors covered by my student insurance plan. Stigma was attached to every step. This is not "reasonable."
After the College Student Right to Access Act was revived in December as Senate Bill 24, I initiated a study to measure the barriers to undergraduate access to abortion services - and the resources devoted to them - by interviewing students who had sought out such services at California State University and University of California campuses.
Preliminary findings from the interviews revealed students believe medication abortion should be available on campus. Some students reported that an unintended pregnancy and traveling off campus for an abortion negatively impacted their academic performance. Overall, UCs and CSUs should do more to support students seeking abortion services, the students said.
SB 24 passed the State Assembly on Friday and only needs Gov. Gavin Newsom's signature to become law. While campaigning for governor last fall, Newsom signaled he would sign such a bill.
The majority of students use public transit to travel more than 30 minutes, one way, to the nearest abortion provider and pay an average of $604 for a medication abortion. More than half of UC and CSU students are low-income, and experience food and housing insecurity on campus.
None of the 34 UC or CSU campuses offer the abortion pill or other abortion procedures. The health centers only give students a list of off-campus abortion clinics. After that, they are on their own to navigate another health care system - a time-consuming task.
Students must register as a new patient, schedule an often hard-to-get appointment at an abortion clinic, undergo repeated lab tests to confirm they're pregnant, receive an ultrasound to determine how far along the pregnancy is, screen for sexually transmitted infections and HIV, and set up billing and payments options. All of this can be required before health care is administered.
As a consequence, abortion care is often delayed. For medication abortions, even a delay of days can have a huge impact, given that the FDA has approved its use for only up to 10 weeks of pregnancy. It's a simple, nonsurgical process that involves taking two sets of pills.
One UC student spoke of her experience on campus as "cold" and "helpless." Like many students, she did not receive the health care she expected from her campus student health center. She eventually had an abortion, but only after three appointments at two different clinics. The clinic she used was more than two hours away on public transit.
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Getting to these appointments off campus often required sacrifices, study participants said. Traveling to an off-campus abortion clinic often meant missing classes, work or both. A full-time CSU student who worked two jobs to support herself had to miss two work shifts. The time she took away from work to travel to a clinic "was the first time my bank account had hit zero," she said. "I had to borrow some money from my partner to be able to make my tuition payment."
If they had had the option to stay on campus, these students say they would have gone to their student health center and quickly received the needed services. On-campus abortion care would also allow students to stay close to their community for any support they desire.
An undergraduate who attends a UC in the Central Valley said having to go off campus to an unfamiliar clinic was an isolating experience. If something went wrong, she would have no help. On campus, "if I need a hand," she said, "I could definitely call a friend."
Opponents of the College Student Right to Access Act often argue that on-campus student health centers already offer "comprehensive reproductive health services," which includes gynecological exams and contraception. But inconsistent use, failure, and nonuse or availability of contraceptives contributes to high unintended pregnancy rates among college-age women.
Any comprehensive reproductive health care should include abortion. Many students I spoke to were on birth control when they became pregnant.
Newsom should not repeat Brown's mistake. The initial idea for the bill came from a group of UC Berkeley students who unsuccessfully tried to get their campus to provide medication abortions.
Students - who are also informed and consenting adults - should be trusted to know what's best for their reproductive well-being.
ABOUT THE WRITER
Jackie Castellanos is a third-year medical student at the UC Berkeley-UCSF Joint Medical Program and a research intern at Advancing New Standards in Reproductive Health at UCSF.
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