New Legislation Would Give Access to Medication Abortion on California Public College Campuses

As many state and federal legislators work overtime to impose new restrictions on access to abortion across the US, student activists at the University of California, Berkeley, have succeeded in pushing their demand for on-campus access to the abortion pill through the state legislature.

Sponsored by State Sen. Connie M. Leyva (D-Chino) in conjunction with The Women’s Foundation of California — a statewide, publicly supported foundation dedicated to achieving gender, racial and economic justice — the College Student Right to Access Act (SB 320) awaits the governor’s signature.

“Supporting the academic and personal success of California students is good for the students and it’s good for the state,” Surina Khan, CEO of the Women’s Foundation of California, told Truthout.

Khan wants Gov. Jerry Brown, who describes himself as “pro-choice,” to understand the importance of the bill as he considers whether or not to sign it.

“This is not just about the university systems and the students; it’s a model,” she said. “California can be on the leading edge, the forefront of expanding abortion access when the rest of the country is facing regressive policies and attacks on reproductive health and rights. And so, we need to see this as something that’s good for the state as a whole because it is supporting our students to be at their best in terms of academic success.”

Most reproductive health needs like Sexually Transmitted Infection (STI) testing and contraception are already provided on-site at the 34 campuses in the University of California (UC) and California State University systems for their approximately 238,000 students. So, co-founder of Berkeley Students United for Reproductive Justice Adiba Khan was surprised her sophomore year to discover that there was one glaring gap: All abortion care required big co-pays and the burden of going off-campus.

After she founded the Berkeley chapter of Students United for Reproductive Justice, Adiba Khan told Truthout, “One of the things we wanted to do was assess: OK, what are the gaps in access to health care for students?” She added, “Surprisingly, at that time, students did face burdens in the form of logistical and bureaucratic barriers, like going from the student health center to actually being able to [get an abortion]; one had to go through a lot of hoops to be able to obtain it.”

Research from Advancing New Standards in Reproductive Health (ANSIRH) — a collaborative research group at the University of California, San Francisco’s Bixby Center for Global Reproductive Health — confirms what Adiba Khan discovered from talking to fellow students and meeting with campus health center administrators: Out of the 1,038 students in the University of California/California State University system who seek abortion care each month, up to 519 seek medication abortion specifically. According to a 2015 campus-wide survey cited in the study, 21 percent of California State University students are food insecure and 9 percent suffer housing displacement such as homelessness; 25 percent said they had to choose between paying for food or educational and housing expenses. These statistics make it clear that the $604 average out-of-pocket cost of medication abortion (as determined by the same ANSIRH study) at facilities nearest to (but not on) campuses would be a significant burden.

“I always knew about the abortion pill, but I didn’t know so much about it,” Adiba Khan told Truthout. “And then when I did learn what [it] entails and how safe it is and that an actual Ob-Gyn does not have to be there … I really didn’t understand why [on-campus health centers] didn’t provide it.”

The abortion pill protocol’s simplicity is one reason a licensed Ob-Gyn need not be present. The FDA-approved regimen is to take 200 mg of the drug Mifeprex, then follow up with 800 mcg of the drug Misoprostol 24-48 hours later. Patients then experience a miscarriage and return to their providers 7-14 days later for an ultrasound to ensure success. According to the FDA, “Mifeprex may only be dispensed in clinics, medical offices, and hospitals by or under the supervision of a certified healthcare provider.” So, implementation of the College Student Right to Access Act would simply require that the on-campus providers in health services be trained in the protocol and acquire an ultrasound machine — all one-time expenses covered by philanthropic partners of the Women’s Foundation of California.

Armed with the simplicity of the protocol and the clear need of her fellow students, Adiba Khan expected that if they went directly to the all-female health administration at Berkeley, they would be open to fixing what seemed to be, essentially, an oversight. Their response was underwhelming.

“[They said], ‘We are pro-choice; there are options, they’re just off campus,’” Adiba Khan told Truthout. “‘You literally have the power to make this more accessible; do not tell me you’re pro-choice,’ is what I was thinking in my head.”

After it was clear she’d need to seek assistance off campus, Adiba Khan connected with fellows at the Women’s Foundation of California’s Women’s Policy Institute, which trains participants in effective public policy advocacy. It was a Women’s Policy Institute fellow who identified Senator Leyva as a likely sponsor of statewide legislation.

“There were some students at UC Berkeley [who] went to the university and said, ‘We’ve talked amongst ourselves and we’d like to have medication abortion offered on campus at the health care center’ and the school told them no,” Leyva told Truthout. “So, then they came to my office and said, ‘Would you be interested in carrying legislation that would require all [public campuses] to make medication abortion available?’ I said, ‘Oh my god, absolutely! Thank you for thinking of me!’”

Despite rhetoric from anti-choice groups and candidates during election cycles, abortion isn’t the “third rail” issue it’s portrayed as being. A 2016 poll found that even in presidential battleground states, 76 percent of voters (including 66 percent of self-identified Republicans) agreed with the statement, “However we feel about abortion, politicians should not be allowed to deny a woman’s health coverage for it just because she’s poor.” Polling in the largely liberal state of California reflects the national numbers: A January 2018 poll from Change Research found 60 percent of registered voters (and 72 percent of women) support on-campus access to medication abortion.

All of the advocates who spoke to Truthout about SB320 acknowledged the current national political climate as one reason such state-based legislation is so important right now. According to reproductive and sexual health research nonprofit the Guttmacher Institute, as of April this year, 37 states were considering 308 new abortion restrictions, with measures passing at least one legislative chamber in 14 states. Ten new restrictions were enacted in Idaho, Indiana, Mississippi, South Dakota and Utah in just the first quarter of 2018 — a trend Truthout has covered since the 2010 Tea Party wave ushered in the new era of attacks on abortion. A full one-third of the 1,193 state abortion restrictions since Roe v. Wade were enacted between 2011-2017 — 63 last year alone.

“California has been a leader on so many issues and on reproductive rights especially. And there’s still much more to be done — particularly with what’s going on right now in DC,” said Surina Khan. “The Supreme Court nomination could really tip the balance of our current federal laws; it’s really urgent that we do everything we can to protect and expand access to reproductive health and rights and, in particular, access to abortion.”

Leyva echoed this urgency.

“It’s just astonishing to me the times we’re living in,” she told Truthout. “We see judges all across the country restricting access to abortion; we see governors trying to limit how far along you can be before you have an abortion [six weeks]. Women don’t even know they’re pregnant in [six] weeks!”

While there has been sparse good news in reproductive health this year, such as Federal District Court Judge David A. Ezra and the 11th US Circuit Court of Appeals Chief Judge Ed Carnes siding with abortion rights advocates’ lawsuits in Texas and Alabama respectively, both Leyva and Surina Khan are hoping to give abortion supporters around the country a boost with a proactive, access-expanding legislative win.

“I think many people across the country see hope in what’s happening here,” said Surina Khan, who is specifically optimistic about the public-private funding partnership model of SB320. “If it can happen in California, then that means all is not lost and we still have potential in other parts of the country.”

“California needs to do what we do best and that is to lead. And to say that we want to make sure that women always have the right to decide when they incorporate a family into their life,” said Leyva. “Like the old adage says: ‘As California goes, so goes the nation.’ And it’s really true. We have a responsibility to set the tone for the rest of the country. And I have never been so fired up about women’s rights as I am right now at 51 years old because it’s just absolutely shocking to me that we’re still fighting for these rights.”

Leyva sees abortion access as part of the broader need to affirm and cement her constituents’ overall rights and needs.

“State-level work is always critical, always important. But now, state-level work is actually life or death,” she said. “We have the Trump administration not just rolling back women’s reproductive rights, [but] rolling back human rights and civil rights. So, at the state level, when you can lead, you have to lead.”

According to ANSIRH research, up to 519 students at the 34 University of California and California State University campuses seek medication abortion each month out of an estimated 1,038 overall who seek abortion care, so SB320 would have a large and immediate impact. Adiba Khan is hoping that this is clear to the Jerry Brown, the man whose signature is all that remains to make the College Student Right to Access Act into law.

“As governor, you have an obligation to students of public universities,” she said. “Students are asking for this, so you should do the right thing and give them what they want — especially when our administrators [at California State University campuses] are not responding to our needs.”

“The governor has always been pro-choice. He believes in women’s right to access, so that gives me some hope that he’ll sign it into law,” said Leyva. “I understand that it’s a big change; it’s something we haven’t done before and the first step in anything is always difficult. But in five years, this will be our new normal. At some point, women may look back and say, ‘Wow, there was a time when medication abortion wasn’t on campuses?’”

California would be the first to create this new normal — one the state senator never expected she’d have to work on as a public servant 45 years after the Supreme Court decriminalized abortion.

“I was just telling my mom yesterday, ‘I cannot believe, mom, that I may possibly spend the rest of my career fighting for Roe v. Wade.’ Unbelievable. That is settled law. That was handled decades ago. We should not be fighting this fight again,” Leyva said.