For continuing coverage of how COVID-19 is affecting reproductive health,check out our Special Report.

Four years ago, I needed an abortion in Texas while HB2, Republicans sweeping anti-abortion law, was still in effect. I wondered if Id have to continue a pregnancy for which I wasnt ready.

It took me two weeks to access care that I needed immediately. Im struggling today knowing that as a result of the COVID-pandemic, countless others are facing similar barriers I had faced. Millions have lost their job and are without childcare, and some anti-choice government officials have used the crisis to outright ban abortiondirectly violating our rights under Roe v. Wade.

Weve known that our right to an abortion means nothing if we cant access it. Even though it feels hard right now, you should know advocates have worked for decades to ensure people always have access to abortion care, especially in times like these.

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If youre seeking abortion care during the pandemic, I want to help you learn about the same network that helped me access an abortion whenit felt impossible. Here are some tips that might help you navigate the state of abortion access during COVID-19.

How to get an abortion in a state that has deemed abortion nonessential

If youre seeking an abortion in a state thats attempting to or have already restricted access during the pandemic, youve probably experienced a delay in your appointment at least once. But if you have the capacity, you should call clinicsincluding thosein surrounding areasfrequently for updates because circumstances can change day to day.

Some clinics may be scheduling appointments for the future, and if legal action changes abortion access, scheduling an appointment allows the clinic to contact you to tell you about appointment availability. Providers are working closely with advocates to ensure access to abortion care continues, and theyre one of the first to know when services can resume.

Clinics can also connect people with resources for out-of-state abortion care. Providers are already prepared with this information for people over the legal limit to have an abortion in certain states, and who are forced to travel to one of the statesthat provide later abortions.

If youre considering traveling, youre not alone. Fund Texas Choice, a practical support organization providing Texans with travel assistance, told Rewire.News last month that pregnant people with varying gestational ages have reached out for assistance to go out of state since Texas Gov. Greg Abbott (R) banned abortion under COVID-19. The Brigid Alliance, a practical support organization that helps people traveling to clinics providing second- and third-trimester abortions, told Rewire.Newsthat the organization has recently helped people with pregnancies of earlier gestations, as well as families who are forced to travel together as a result of a lack of childcare.

Because of shelter-in-place orders, some state officials are preventing drivers from crossing state lines and subjecting non-residents to 14-day quarantines, which could increase the logistical costs pregnant people face. Some methods of transportation have been affected too. But the Brigid Alliance says it hasnt encountered drivers being turned away when crossing state lines, and the organization is letting folks flying to New Mexico know that in order to be exempt from the state quarantine, they can only travel between the clinic and hotel where theyre staying.

Brigid Allianceis also seeing the impacts that are surging for those providing and needing practical support.

Bus lines have closed down, airlines have spontaneously canceled flights, hotels have closed down entirely or reduced capacitywe had to move people from hotel to hotel in the middle of a three- to four-day process [to get an abortion], and were hearing from partners that there are some Greyhound lines that are doing temperature checks, Odile Schalit, executive director of the Brigid Alliance, said.

Schalit wants people to know support is available for those seeking care amid the ever-changing landscape of abortion access.

While the obstacles to your health care may appear numerous today, please know that there is a network of good people, volunteers, and resources that exist to support you. Tap into our network and, as much as possible, your own, Schalit said. Take your time, break down your plan and needs, and take stock of your unique physical and emotional safety and comfort. For many, accessing abortion care now means having to travel out of your home town, city, and state. While this may seem impossible, we and many others are here to help you construct safe plans for getting to your care.

If youre thinking about traveling out of state for abortion access, consider going to one of the 23 states that dont have a mandatory waiting period to limit the number of times you have to visita clinic before the procedure.

How to get an abortion if you need help paying for an abortion, traveling to a clinic, or other logistical support

Abortion funds and practical support organizations help alleviate the high costs associated with paying for an abortion and traveling in or out of state. Funds generally help with the cost of an abortion, while practical support organizations cover travel-related costs; some do both. Below are some organizations that may be able to help you access the care you need:

To find other local abortion funds and practical support organizations in your area, visit the National Network of Abortion Funds to search for groups by state.

You can also ask abortion clinics to screen you for financial assistance. Unlike assistance from abortion funds and practical support organizations, in-clinic funding can be income-based, but you arent required to show proof of how much money you earn.

How to get an abortion in a state that allows telemedicine

Eighteen states prohibit the use of telemedicine for abortion care. If you live in one of the states that allow it, medical abortions can be obtained up to ten weeks into pregnancy through video conference with an abortion provider.

While U.S. Food and Drug Administration (FDA) restrictions prevent the medication from being mailed to your home, patients can avoid traveling long distances to an abortion clinic while protecting their health during the pandemic by visiting a nearby health center to receive the medication under guidance of a doctor.

TelAbortion, however, can send the medication to your home if youre eligible. TelAbortion is a study run by reproductive and maternal health research group Gynuity, and the evaluation is offered over the internetso you can access it on your own phone or computer. But the FDA requires people participating in the study to visit a health clinic in order to have an ultrasound or pelvic exam, according to Dr. Elizabeth Raymond, senior medical associate for Gynuity Health Projects.

You will need video conference access in one of the 13 states participating in the study, and have a mailing address in the state where the medication can be sent.

If a person encounters barriers in accessing an ultrasound or pelvic examespecially barriers compounded by the COVID-19 pandemicthey can call a TelAbortion site, as the provider may be able to accommodate their situation.

If youre eligible for a TelAbortion, youll be sent a package containing the necessary medications and an instruction sheet by mail. Afterward, the TelAbortion provider follows up with study participants to ensure the abortion was successful, and to address any side effects and complications. According to their data, the TelAbortion model is just as effective as an in-person abortion.

In the past two months, Gynuity expanded its TelAbortion study to include Maryland and Illinois, and the hope is to continue to expand during the pandemic,as telemedicine abortion care will be critical. In the past few weeks, Gynuity has had a significant increase in traffic to the TelAbortion site.

Weve been doing this study since 2016, [and] now its right there [and] ready, Raymond said. Its gratifying to be able to help in this crisis.

What you need to know about self-managed abortion

Self-managed has proven to be extremely safea 0.3 percent risk of major complications, according to an analysis byAdvancing New Standards in Reproductive Health. Interest in it is also rising.

Self-managed abortion canincludeusing mifepristone and misoprostol, or misoprostol alone, to end a pregnancy. Mifepristone blocks the hormone essential to advancing pregnancy, whereas misoprostol empties the uterus.

Plan C provides a report card on online retailers that offer the medications, resources about how the process works, and the legal risks surrounding it.Some states have laws that could be used against people ending their own pregnanciesat least 21 people have been arrested since 2005, Jill E. Adams, executive director of If/When/How: Lawyering for Reproductive Justice, told Rewire.News.

In states without such laws, Adams said some have faced charges as a result of prosecutors misapplying parts of the criminal codes that were never intended for people ending their own pregnancies. In most cases, the judge determines the law doesnt apply, but at that point, people have already been arrested, lost their job, and face public scrutiny as a result of private records being released.

The risk is highest for populations and communities under surveillance and on the receiving end of disproportionate state violencecommunities of color, especially Black and African American people, immigrants, and trans and gender nonconforming people, are all more at risk of criminalization, and [theyre] also more likely to need self-managed abortion due to barriers to clinic-based care and bans on coverage, Adams said.

Mandatory reporters, like health-care professionals, can also feel obligated to report people should they seek follow-up care from a doctor, even though Adams said the American Congress of Obstetrics and Gynecology and the American Medical Association recommends against it.

No state requires mandatory reporting for suspected or confirmed self-managed abortion, including when the person is a minor, Adams said. If people do report, they are likely violating patient privacy laws.

When seeking follow-up care, people arent legally required to disclose their situation to a doctor. If/When/How: Lawyering for Reproductive Justices legal helpline offers information on a persons rights when talking to law enforcement officialsor doctors involving self-managed abortion. According to the website, no one has been arrested for buying abortion pills online.

The right to abortionself-managed or provider-directedstill exists throughout the United States, Adams said. But laws have been misused and power abused in unjustly criminalizing people for ending their own pregnancies.

The helpline offers free, confidential legal information topeople concerned with being investigated or arrested for self-managing an abortion, as well as legal advice from an attorney when necessary.

But Adams said if there were ever a time to eliminate the sources of criminalization, that time is now. Their legal helpline has received double the number of inquiries they usually get.Local, state, and federal officials should make it clear that no one will be arrested, charged, or detained for ending their pregnancy, or for helping someone else end their pregnancyand not just during the pandemic, but always, Adams said.

If you need an abortion without parental consent

In the 37 states that have forced parental involvement laws for young people seeking abortion care, teenagers are forced to go through the overwhelming process of obtaining a judicial bypass, or permission from a judge to have an abortion. As a result of the pandemic, shelter-in-place orders and school closures prevent teens from discreetly leaving home to go to court, or even obtaining resources that may be able to support them.

Other things to know when seeking abortion care during COVID-19

Be aware that crisis pregnancy centers (CPCs), or anti-choice clinics, are still operating, but they dont provide abortion care. Even if they offer to talk to you about your options, they wont refer you to an abortion clinic or provide the necessary resources to obtain one. Reach out to any of the aforementioned organizations for information about the next steps.

The Online Abortion Resource Squad, a group of volunteers who respond to abortion-related questions on Reddit with compassionate, accurate answers, developed a resource site in response to the confusion and uncertainty around abortion during this health crisis.The site offers up-to-date information on clinic operations in states that have deemed abortion as nonessential health care, as well as connecting with local resources for financial and logistical assistance, and locating clinics in your state and nearby states.

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How to Get an Abortion During the COVID-19 Pandemic - Rewire.News

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