Student activists in California are determined to achieve reproductive justice on college campuses — and thanks to a new bill, they may just succeed. What started as a local effort by a student reproductive health group at UC Berkeley has become a statewide effort to make medication abortion accessible on public college campuses across California, and students' push to do this has culminated in California state Senate Bill 24. As part of their efforts to fight for reproductive justice, activists across the state of California launched justCARE (Campus Action for Reproductive Equity), a movement that aims to bring abortion access to college campuses.
UPDATE: On Oct. 11, California Gov. Gavin Newsom signed SB24 into law, making the state the first to require public college students' access to medication abortion on campus. In a statement shared with Elite Daily, state Sen. Connie Leyva, the bill's author, praised the decision. "Abortion is a protected right, and it is important that everyone — including college students — have access to that right, if they so choose," she said. JustCARE activist Phoebe Abramowitz tells Elite Daily that she is “ecstatic” that students will be able to access abortion care on their campuses and credited the student movement. “This is a major step towards gender equity and reproductive justice in California, and it's incredible to see a major legislative victory come from our grassroots student movement,” Abramowitz says. The legislation will go into effect in 2023.
EARLIER: In April 2019, the California state Senate approved SB24, a bill that would give college students the right to access medication abortions directly at student health centers on the University of California (UC) and California State University (CSU) campuses. As of Aug. 7, 2019, SB24 is currently on its way to the California State Assembly, where reproductive justice advocates hope it will pass before ultimately landing on Gov. Gavin Newsom's desk. The Assembly has until mid-September to pass the bill, and Newsom will then have until mid-October to sign it.
Seeing abortion alongside all the other 'noncontroversial health services' makes it clear that abortion is part of normal health services.
The bill has been shepherded along by student activists, including members of groups like Students United for Reproductive Justice (SURJ), who tell Elite Daily that they are determined to bring medication abortion access to California's college campuses.
"Seeing abortion alongside all the other 'noncontroversial health services' makes it clear that abortion is part of normal health services," Adiba Khan, a UC Berkeley alumna and co-founder of SURJ, tells Elite Daily. "Abortion is normal and it should be very visible."
A medication abortion is induced using two types of pills — mifepristone and misoprostol — and according to Planned Parenthood, it is most effective within the first 10 weeks of pregnancy, with an overall success rate of 95 to 99%, according to the Guttmacher Institute. Ushma Upadhyay, an associate professor of public health at UC San Francisco (UCSF), tells Elite Daily that "being able to get an abortion on campus should be similar to any kind of primary health care" that students can get.
"Medication abortion is not complex at all and they should be able to get that care to avoid the disruption of having to travel to a clinic," Upadhyay says, adding that administering medication abortions on campus is certainly feasible.
In recent months, medication abortions have come under scrutiny after the FDA issued cease and desist letters to Aid Access and other companies that ship abortion pills to pregnant people in the United States. The FDA claimed that these pills are "misbranded and unapproved," and that they pose "an inherent risk to consumers." According to Upadhyay, these letters are misguided.
"Medication abortion is extremely safe, it’s safer than Viagra, it’s safer than aspirin," Upadhyay tells Elite Daily. "Our research on over 11,000 medication abortions found that less than one-third of 1% resulted in a major complication; that means they had to get a blood transfusion or be hospitalized." The Guttmacher Institute has indicated that serious complications requiring hospitalization or blood transfusions occur in less than 0.5% of medication abortion cases.
Currently, students in need of an abortion are referred to off-campus clinics — which may be an average of five miles away, according to Upadhyay — to take a two-dose medication that induces an abortion. This medication can typically only be taken within the first 10 weeks of pregnancy. Upadhyay's research on the subject indicates that these limitations impose numerous barriers to access for pregnant students, especially for low-income students, students of color, first-generation students, and students experiencing homelessness.
"If students are already low-income, they’re going to have a harder time finding the cost to take an Uber or drive," Upadhyay says. "They’re less likely to have a car to get to a clinic so that means that they do have to take public transportation."
Students spend an average of two hours on public transit to get to and from off-campus clinics, according to Upadhyay. However, at some of the more rural campuses, Upadhyay says it can take students up to 1.5 hours on public transportation each way to get to a clinic. A pregnant student seeking a medication abortion needs to go to an off-campus clinic twice — one visit each to take mifepristone and misoprostol — so that can add up to as many as six hours on public transit. That's time that students often do not have, especially if they are juggling both classes and work, and many clinics are closed on weekends.
While legislators are always asking for data and statistics to support the need for this bill, to me, experiences are also fact.
Upadhyay adds that in addition to limited mobility, roughly 10% of CSU students do not have health insurance, and Latinx and black students are more likely to be uninsured than white or Asian American students. While California requires Medi-Cal — the state version of Medicaid — to cover abortion, it only requires "most" private insurance programs to cover abortions. According to Planned Parenthood, a medication abortion can cost up to $1,000 without health insurance.
For San Jose State University sophomore Grace Pang, the fight to pass SB24 has a lot to do with trusting students to know what's best for them. Pang is the incoming vice president of legislative affairs for the California State Student Association, and she describes herself as a low-income, first-generation student. Back in June, Pang testified before the California Assembly Health Committee to advocate for SB24. She tells Elite Daily that lawmakers ultimately need to "trust students" to know what they need, which has become something of a guiding principle of the justCARE movement.
"While legislators are always asking for data and statistics to support the need for this bill, to me, experiences are also fact," Pang says. "It's been really empowering for the bill to center around student experience."
The bill currently moving through the state legislature has its roots in student activism, too. After speaking with students and hearing about all of these hurdles that they must go through to obtain a medication abortion, SURJ proposed a student resolution in 2016 that would make medication abortions accessible on campus. This resolution successfully passed UC Berkeley's student Senate on March 18, 2016 but was largely symbolic, Khan tells Elite Daily. According to Khan, university administrators subsequently refused to provide medication abortions at the UC Berkeley Tang Center, which is the school's on-campus health center. In a statement to Elite Daily, UC Berkeley said that officials at the Tang Center "fully support a woman's right to choose," and that officials at the time had discussed access to medication abortion with student activists, but had not taken a position.
Then, in early 2017, reproductive justice advocates through the San Francisco-based nonprofit Women's Foundation of California approached SURJ to ask if they were interested in expanding their proposal to a statewide bill — and that's how SB320 was born. Introduced by Democratic State Sen. Connie Leyva, SB320 would have required all 32 UC and CSU campuses to provide medication abortion access in their campus clinics. Khan says that she and two other student activists from SURJ helped co-write SB320.
The Women's Foundation connection came at the "best timing ever," Khan says, "because at that time our Berkeley campaign was unfortunately coming to a halt because we had exhausted all of our options and our administration was pretty firm on saying no."
Ultimately, though, the bill failed when former Gov. Jerry Brown vetoed SB320, saying that it was "not necessary" because medication abortion services were "widely available" off-campus. But advocates refused to give up, and in December 2018, Leyva introduced SB24, a similar piece of legislation designed to guarantee "comprehensive sexual and reproductive health care" for students.
Although SB24 has received widespread support from student activists, not everyone on campus supports the bill. Kristi Hamrick, a media strategist for the anti-choice student group Students for Life of America, tells Elite Daily in an email that "the legislation does not protect student conscience rights for those who don't want their student fees to fund this and student fees do subsidize the health centers." Hamrick also argues that "sending students to their dorms to suffer the intense bleeding and loss of life is a trauma and a risk that should not be forced into campus bathrooms," although SB24 would require university health clinics to provide "24-hour, backup medical support" to any students that have obtained medication abortions.
Asked about the backup medical support requirement, Hamrick counters the idea that abortion is safer than childbirth, and adds that UC clinics were "not set up" to care for students undergoing a medication abortion. However, a December 2017 study from a collaborative research group at UCSF — Advancing New Standards in Reproductive Health (ANSIRH) — found that while additional investment, including 24-hour staff, would be needed at student health centers, providing medication abortion on campus would be "feasible."
This fight for medication abortion access may have started at UC Berkeley, but it isn't just Berkeley students that are involved anymore. On July 17, student activists testified before the UC Board of Regents in support of SB24 and asked the regents to publicly support the bill as well in order to persuade lawmakers to pass it.
The need is more important than, or bigger than, my fear.
"The UC Regents have the chance to support students and live up to their pro-choice, pro-student values by supporting SB24 and supporting abortion on campus ... It's well past time for them to stand up and support students," says Phoebe Abramowitz, a justCARE activist and recent graduate of UC Berkeley who testified at the July 17 hearing. "I testified that it was extremely disappointing for students when the UC Berkeley administration let us down in 2017 by rejecting our efforts to implement medication abortions in the UC Berkeley Tang Center for explicitly political reasons, not because it was unfeasible."
After the Board of Regents meeting, Abramowitz and other justCARE activists continued to rally in support of medication abortion at UCSF, where the meeting took place. Anne Shaw, the Secretary and Chief of Staff to the UC Regents, tells Elite Daily in an email that "the Regents rarely take a formal position on legislation." Sarah McBride, a media and communications strategies for UCOP, tells Elite Daily that "the University of California has not taken a position on SB24."
"We believe students should have access to affordable and convenient reproductive health care of their choosing," McBride says. "UC student health centers currently provide students with access to comprehensive reproductive health services, including referrals to nearby facilities for abortion services when requested."
That hasn't stopped student activists from pushing the UC and CSU systems on this issue, however, especially because many off-campus facilities providing abortion are not actually nearby via public transit. Pang describes the need for medication abortion access on college campuses as not only a student health issue, but also an issue of equity and academic retention.
"I think it’s an academic retention issue because if a student needs to go off campus to access care, they need to take time off work, they need to take time off school and it adds another unnecessary stress on students," Pang says.
That's why Pang supports SB24 — and why she brought the bill before her fellow CSU students, who then endorsed it.
"I think I put myself in a vulnerable position but it turns out to be worth it because it really resonated with a lot of students," Pang adds. "The need is more important than, or bigger than, my fear."
Students who are in college right now do have agency and power in making a difference.
Khan, who graduated in December 2018, is no longer involved in student advocacy around the bill, but she thinks that if Newsom signs SB24, it could set a national precedent for abortion access on college campuses.
"What's so special about this bill is that it's not defending [abortion access]," Khan says. "It's trying to very much outwardly mandate it, make it a reality."
Already in Massachusetts, lawmakers are trying to pass a similar bill that would require public universities to make medication abortions accessible on their campuses. So at a time when states like Alabama are passing increasingly restrictive abortion laws, SB24 is trying to do something different, Khan says.
"This is a huge campaign with a lot of money behind it and oftentimes many people think that when a campaign like this exists, it may not be grassroots," Khan says. "But I like to just bring back how this is all very much student-led, grassroots, started by people who the bill actually affects."
"Students who are in college right now do have agency and power in making a difference," Khan says, "not just on their own campus but on campuses everywhere in the state or even further away."
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