A recent report by the Guttmacher Institute, published in the American Journal of Public Health, showed that one in four women in the United States will have an abortion by the age of forty-five. Though the rate for annual abortions declined by 25% between 2008 and 2014, this figure reveals that abortion remains a common procedure in the US.
At the same time, abortion is perhaps the most stigmatized medical procedure in contemporary society. Large crowds of anti-choicers gather outside abortion clinics throughout the year to harass and intimidate abortion-seeking patients, which is not common to other medical procedures or facilities. Abortion clinics are often vandalized, sometimes even violently attacked, by “pro-life” terrorists. Even media portrayals about abortion tend to be negative.
Moreover, anti-choice legislatures are constantly working to undermine access to abortion by passing far-reaching legislation that often does not hold up against the law. Though many of these anti-abortion laws are eventually overturned by the courts, the constant attack on reproductive rights by legislatures often leads to a mess of confusion about what is legal and what is not legal regarding one’s reproductive health.
Not only is abortion stigmatized, but those who seek abortion care are often portrayed as being irresponsible, immoral, or otherwise not a good person. It’s no wonder then, that people seeking an abortion often feel alone, confused, and scared, struggling to find who or where to turn to for support.
In the RGV, organizations like South Texans for Reproductive Justice and La Frontera Fund, along with Whole Woman’s Health Clinic of McAllen, are working to build a network of support for people seeking abortion care in our community.
Only a few years ago, Whole Woman’s Health of McAllen was among the clinics forced to shut down after the Texas legislature passed an anti-abortion bill during the 2013 legislative session. House Bill 2, which was famously filibustered by Wendy Davis, placed outrageous and medically unnecessary restrictions on abortion providers, forcing many to close their clinics. The Supreme Court ruled the law unconstitutional last year, and Whole Woman’s Health of McAllen remains the only abortion provider in the RGV.
Neta interviewed Kristeena Banda-Pecina, clinic administrator for Whole Woman’s Health of McAllen, to learn more about their services and the process of getting an abortion.
The first step, she explained, is for patients to call the clinic. Clinic staff will ask a few questions, like how far along a pregnancy the patient may be, as well as share information about services and fees, before setting an appointment for the first consultation.The initial consultation may include an ultrasound to measure gestational age, lab work, and counseling. After reviewing options with patients, clinic staff walk patients through the process of the abortion, including reviewing the costs for the procedure. She told me that many patients cannot afford to pay for their procedures.
“Even if patients are insured,” she explained, “most insurers only cover the consultation visit, and not the abortion procedure itself. In the past, there were a few insurance providers who covered elective abortions, but very few.”
This year, the Texas legislature passed a law making it even more difficult for those with health insurance to access abortion care through their providers. House Bill 214 bans providers from covering abortion care, and mandates consumers who want abortion coverage must instead purchase a separate policy specifically to cover abortions. This measure adds an undue financial burden for those seeking an abortion and is already being challenged in the courts.
The majority of the clinic’s patients, however, are not insured. Texas leads the country for the highest rate of people without health insurance, with more than 4-million people in Texas having no health care coverage, and the RGV is among the highest uninsured regions in the state.
“Most of our patients need some assistance to afford the procedure,” said Banda-Pecina. “It’s not easy to come up with the funds to cover an abortion, and even if someone can, it usually means they have to give up groceries, or rent, or gas, and nobody should have to make that decision.”
She went on to express frustration about common misconceptions people have about abortion, health care, and federal funding.
“It’s alarming how many people think that taxpayers fund abortion,” she said, “there is no government funding for abortion due to the Hyde Amendment.”
In 1976, anti-choice congressman, Henry J. Hyde, introduced an amendment to the House Appropriations Bill to prohibit federal funds granted to states through the Medicaid program from being used to cover abortion care. The Hyde Amendment, as it would come to be known, took effect the following year, and has been renewed each year since, as part of the annual congressional appropriations bill. The original amendment included an exemption for covering abortions in cases where carrying a pregnancy to term would threaten the life of a patient. During the Clinton administration, exemptions were extended to include covering abortions for cases where the pregnancy was the result of incest or rape.
Today, only seventeen states offer abortion coverage beyond the exemptions for the Hyde Amendment (through state and not federal funds), by extending exemptions to include “medically necessary” abortions. Still, even in these states, the definition for “medically necessary” can vary wildly, and patients are often forced to endure long and complex processes to meet their respective state’s qualifications. Texas does not provide funding for abortion through any state funds, nor does it extend exemptions for abortion coverage beyond the Hyde amendment.
Introduced just three years after the Supreme Court’s ruling in the landmark Roe v Wade case, which established abortion as a constitutional right, the Hyde amendment was an early example of legislative attempts to undermine access to abortion in lieu of being able to ban the procedure outright. In that regard, the Hyde amendment has been highly successful. Since 1976, abortion care has been banned from coverage under Medicaid, making the procedure inaccessible to millions for more than forty years.
Laws like the Hyde Amendment and House Bill 214 hurt communities like the RGV the most because we already have such low access to healthcare. Besides being among the most uninsured regions in the most uninsured state in the country, the RGV also has among the highest rates of poverty in the nation, making access to health care of any kind unlikely for many residents.
Fortunately, there are organizations called abortion funds working to provide financial and practical support for people seeking abortions, in direct response to laws like the Hyde amendment.
“There are multiple private funding organizations nationwide that help cover the costs of the procedure if somebody needs financial assistance,” said Banda-Pecina
The clinic works with a network of national, regional, and local abortion funds. If patients reveal they cannot afford to pay the fees when clinic staff review the process during their initial conversation, the clinic will refer patients to the abortion funds and screen them to see if they qualify to receive support, based on household income, household size, and a few other factors. If they qualify, the clinic will help patients connect with the funds to receive assistance.
“At Whole Woman’s Health of McAllen, about 95% of our patients are supported somehow by these private funds,” Banda informed.
The Frontera Fund is among the abortion funds that works with Whole Woman’s Health of McAllen. Established only a year ago, the Frontera Fund is the only abortion fund based out of the RGV.
“There’s never a shortage of anti-abortion legislation in Texas,” said Sofia Rivera Pena, who helped establish the fund, “so we knew when we decided to start the Frontera Fund, that we were coming into a network of funds and organizations dedicated to abortion access.”
While Rivera Pena and others who established the fund worried they might undermine the work of other abortion funds by forcing already scarce resources to be stretched more thinly, they also knew they could help bring more resources to support abortion access in the underserved RGV community.
“We live in an area where, even if the clinic is open, a lot of people cannot get there because they don’t have a car, they don’t have support, they don’t have money,” she said, “our concern was that there needed to be more of a concentration of money in the Rio Grande Valley.”
According to their website, “the Frontera Fund provides relief from economic barriers to obtaining safe abortion care and birth control to people residing in or seeking abortion care in the Rio Grande Valley, as well as emergency contraception and pregnancy testing for those who cannot otherwise safely access these services.”
As a practical support fund, the Frontera Fund works with clinics like Whole Woman’s Health of McAllen, along with other abortion funds, to provide a broad range of assistance and support for people seeking abortions. The Frontera Fund focuses mostly on funding lodging costs, which may include booking hotels or purchasing airline tickets for a patient, though they also help cover costs for the procedure if necessary.
Most people who call the Frontera Fund hotline are referred by Whole Woman’s Health of McAllen, though a few are referred by out of state clinics if the patient they are seeing will be traveling from Texas.
“When people call our hotline,” Rivera Pena explains, “they will automatically get a voicemail asking them a few questions, like what city they live in, and the name of the clinic where they will receive their procedure.”
In order to ensure a patient’s safety and privacy, the Frontera Fund does not ask for a person’s immigration status, she explained, “but we do ask if it is alright to leave a message or send them a text.”
A hotline respondent will return the patient’s call within twenty-four hours to review the information the patient shared in the voicemail and assess their needs.
“People will tell us they live in Edinburg, but don’t have a ride to the clinic. They’ll tell us they need a hotel room or a gas card,” Rivera Pena said.
“We stay in contact with a caller as long as needed,” she told me, before explaining the broad range of support they offer abortion-seeking patients throughout the process. Some who call the fund have never flown on an airplane before, for example, so volunteers at the fund must walk them through the entire process, as well as offer reassurance and advice when necessary.
“Some callers will express fear or isolation because they don’t feel it’s something they can talk to their families about. Some people have support, someone to watch their kids, or to drive them, but that’s usually not the case,” she said.
She explained how callers will often tell hotline respondents that they have no one to confide in or receive support from. “I’ve disclosed my own story because sometimes people need to know that the person they are talking to understands. It usually helps them feel better, even if my story isn’t exactly like theirs.”
In these instances, the Frontera Fund is about much more than providing direct financial assistance to people seeking abortion care in the RGV. Those answering and returning phone calls for the fund must often also serve as the only source of support for a stranger in a vulnerable situation. More than provide financial relief, the Frontera Fund is challenging the stigma, shaming, and violence so prominent in our anti-abortion society, by cultivating a network of compassionate support in the RGV.
They are not alone in this effort. Besides the private donors who make contributions to support the Frontera Fund’s work, there is a network of local activists and advocates that also want to challenge the stigma about abortion and build a community of support for people who are seeking or have had abortions.
The South Texans for Reproductive Justice (ST4RJ), for example, are an organization that formed to advocate for reproductive justice in the RGV, and to push back against the harassment patients and staff at Whole Woman’s Health in McAllen often endure. Besides organizing rallies to counter marches and protests organized by anti-choice activists and the Archdiocese of Brownsville, the ST4RJ also coordinate volunteer clinic escorting to help ensure patients can safely access the clinic for their appointments.
Other groups, like Unite for Reproductive and Gender Equity and Planned Parenthood Texas Votes, are organizing to challenge anti-abortion legislation and mobilize young voters to transform the Texas political landscape.
Meanwhile, the National Latina Institute for Reproductive Health has worked tirelessly to uplift the voices and efforts of colonia residents in the fight for reproductive rights and justice in Texas and beyond. Some of their community leaders even spoke in front of the UN Human Rights Committee about the crisis people in communities like the RGV face due to a broken healthcare system.
Together, these organizations are working not only to support access to abortion for people in the RGV but to transform the way our community talks about and approaches abortion altogether. They want people in the RGV to know that they are not alone, that they don’t have to be ashamed or afraid because there is a community ready to accept and support them.
And while they are committed to continuing their work to support access to abortion, to push back against anti-abortion stigma, to challenge anti-abortion laws at the capitol and in the courts, to advocate, and educate, and speak out, most of these activists would much rather live in a world where their efforts are not necessary.
“It’s terrible that we have to exist,” said Rivera Pena, “people should have accessible health care, and federal funds should cover abortions.”
If you or someone you know is considering an abortion, contact Whole Woman’s Health of McAllen by calling: 956-686-2137
For the Frontera Fund Hotline, call: 956-307-9330
The National Network of Abortion Funds maintains an online database of national and local funds, at fundabortionnow.org. You can also call the National Abortion Federation hotline at 800-722-9100.