While women in Massachusetts will maintain the right to an abortion whether or not the US Supreme Court overturns Roe v. Wade, residents of the Cape and Islands have faced geographic obstacles to pregnancy termination services for years.
“The nearest access to abortion care is over 90 miles away,” state Sen. Julian Cyr, D-Truro, said.
“The closest location with access to surgical abortion is either Boston or Attleboro,” Cyr said.
Over the years there has been a lot of talk about but little action on replacing services once provided by the Women’s Health Center in Hyannis.
The abortion provider on Camp Street closed in 2008 when a client died after a procedure.
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The physician running the practice, Rapin Osathanondh, lost his medical license and was waived to six months in prison after he pleaded guilty to involuntary manslaughter in the death of a woman whose heart stopped while under anesthesia.
Services available in Massachusetts but not close
“There are services in place,” said Penelope Duby of Falmouth, chairperson of the Upper Cape Women’s Coalition. “They’re not everywhere they need to be.”
There is a real geographic limitation on Cape Cod, said Erin Andrews of Centerville, who helped organize an abortion rights rally Saturday at the Airport Rotary.
Traveling off-Cape and off-Island to get a procedural or surgical abortion increases the cost and the difficulty of getting a procedure, Andrews said, especially for low-income women who need to arrange job coverage and child care.
Cyr would like to see abortion services restored on the Cape. But figuring out a way to do that has been difficult, he said.
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The Cape’s community health centers receive federal funding, and that presents a roadblock, he said.
“You’re federally regulated and you can’t provide those services,” Cyr said. “Cape Cod Healthcare runs into similar problems as well.”
Abortion pills provide access, lower costs
Access to abortion services for women on the Cape and Islands expanded at the end of 2021 when the US Food and Drug Administration lifted a restriction on abortion pill prescriptions.
As of Dec. 16, the FDA permanently lifted the requirement for in-person visits with a medical provider in order to get a prescription, meaning patients could receive the medication in the mail.
In Massachusetts, women seeking to terminate their pregnancies now have access to nine providers who can mail them abortion pills following consultation by video, phone or an online form, said Carrie N. Baker, a professor of gender studies at Smith College in Northampton.
Mail ordering the pills can be a cost savings, Baker said.
Going to Planned Parenthood in person for abortion pills can cost $700, she said. But a nonprofit organization in Austria called Aid Access makes them available for $150. It also provides a sliding scale fee for low-income patients.
The abortion pills, consisting of mifepristone, which blocks progesterone and ends the pregnancy, and misoprostol, which causes contractions, are only available for use through 10 weeks of pregnancy.
Abortion services nearest to Cape Cod
The cost of abortion services at Four Women’s Health Services in Attleboro, which terminates pregnancies up to 20.6 weeks of gestational age, can run as high as $2,300, according to the website of Reproductive Equity Now, formerly known as NARAL.
At Women’s Health Services in Brookline, which provides abortions up to 23 weeks and six days of gestational aid, pregnancy termination services can cost $3,300.
The federal Hyde Amendment, passed in 1977, prohibits states from using federal Medicaid dollars to pay for abortions unless the procedure is deemed “medical necessary” or the pregnancy is the result of rape or incest.
More:Abortion access resurfaces as issue in 2016
Massachusetts, however, is one of several states that uses its own funds to cover other abortions, according to the Kaiser Family Foundation. The foundation said those states usually define the abortions as being necessary to protect the physical or mental health of women seeking pregnancy termination.
Cyr said following the May 2 leak, published in Politico, of a draft Supreme Court decision that would overturn Roe v. Wade, the state Senate increased funding proposed by the House for reproductive services including grants for abortion funds, from $500,000 to $2 million.
The proposed funding is “baked” into the proposed budget, Cyr said. “The Senate really expanded it.”
Abortion funds are available in the eastern part of Massachusetts
The fund serving women on the Cape and Islands who can’t afford abortion services is the Eastern Massachusetts Abortion Fund, Baker said.
The Roe Act that passed in Massachusetts in December of 2020 enshrines abortion rights in state law and also expands access to 16-year-olds.
But Baker said she worries that restrictions and bans on abortion in other states will mean longer waits for clinic care for Massachusetts residents.
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“People will be coming here to get abortions,” she said. “It means waiting periods are longer at clinics for inpatient care. I’m very concerned about the impact.”
That could add up to additional obstacles for women on the Cape and Islands seeking pregnancy termination services in Boston, Attleboro and Providence.
“Getting off Cape is not something everyone can readily do,” Cyr said.
“It’s crucial that we not only ensure the right to choose in Massachusetts, but that we make sure that access to reproductive health care including access to abortion is readily available — no matter where you live in the commonwealth,” he said.
Cynthia McCormick can be reached at firstname.lastname@example.org or at @Cmccormickcct