Many colleges pride themselves on providing a range of sexual and reproductive health services to their students, including birth control, STD screenings, and even insurance coverage for termination of pregnancy.
What they are reluctant to provide is abortion, whether via pill or procedure. For this purpose, they refer students to other clinics or doctors’ offices.
For some students, that standard of care is no longer good enough, not with the Supreme Court’s decision to overturn Roe v. Wade. They want colleges to expand access to abortion, reduce stress and barriers, and give women more autonomy and control over the process.
The top item on many of their wish lists: drugs to end unwanted pregnancies.
Niharika Rao, a senior at Barnard College in New York, who uses the pronouns they, said the students demanded that medical abortion be made available on campus: “Student access to abortion is stigmatized and politicized,” they said.
Medical abortion involves taking two types of pills federally approved for use during the first 10 weeks of pregnancy. It differs from the morning-after pill, which is more widely available at student health centers and can be taken to block pregnancy before it begins.
Several colleges, including the University of Illinois at Chicago, already provide abortion pills. The University of Massachusetts Amherst plans to begin offering it in the fall. In California, a new law requires all public universities to provide medical abortion on campus by January; some campuses, such as at Berkeley, have already begun to do so.
But because of the changing landscape of abortion law and complicated politics, it will be difficult to convince more colleges to provide medical abortion.
Colleges in states with restrictive abortion laws, such as Missouri, may not be able to legally offer it. Other universities, especially publicly funded ones in states where the laws are changing, don’t want to find themselves on the wrong side of the legislation.
Even in states that protect abortion rights, colleges are treading cautiously. Providing the abortion pill on campus instead of referring students elsewhere embroils colleges in a personal, sometimes emotionally and physically taxing medical decision, according to administrators at several colleges who spoke on condition of anonymity because of the sensitivity of the issue.
Administrators say colleges need to be prepared for students who will feel stressed as well as those who will feel relieved by the procedure. They must have the ability to provide emergency medical care. And they should keep in mind that protesters may show up at the door of a college health center, ready to offer security and privacy to the women walking inside.
“There are some legitimate security concerns,” said Dr. Guy W. Nicolet, vice chancellor for university health services at the University of California, Berkeley. Also, he said, “not every provider feels competent or comfortable doing this.”
But Dr. Nicolet said that overall, Berkeley Health Services believes that offering medical abortion on campus, with counseling, is the delicate approach. “Because of our connection to campus, we try to be a trusted source for health care for students, recognizing that often this is their first time away from home, their first time accessing health care away from home,” he said.
Cost is also an issue. In California, the new law does not pay for the abortion pill, and students must pay through insurance or cash. Community colleges are exempt from the requirement to provide medical abortion, although a 2021 study estimated that those students sought 865 to 1,109 medical abortions per month. Women who have a child while in college are less likely to graduate than those who don’t, according to data from the U.S. Department of Education.
Read more about the end of Roe v. Wade
Women in their 20s account for more than half of abortions, or about 57 percent, according to 2019 data from the Centers for Disease Control and Prevention.
About 300 to 500 Cal State University students sought medication abortions each month, according to a 2018 study by UCLA researchers published in The Journal of Adolescent Health. A full 62 percent of students in the system were more than half an hour away by public transportation from the nearest abortion provider. The average cost of a medical abortion is $604, and the average wait time for the first appointment is one week, which can tip the pregnancy past the approved 10-week period in which the drug can be prescribed.
“This happens a lot — people are forced into another trimester waiting for a referral from the student health center,” said Cindy Cruz, Western States program director for Unite for Reproductive and Gender Equity, an advocacy group.
Students who must travel to a distant abortion clinic may also miss classes and work, said Z Zenobia, a student at California State Polytechnic University, Humboldt, a rural campus where access to abortion services is limited.
“Having to travel an hour there and an hour back by bus, an entire lab could be missing,” said Mx. Zenobia, who also lobbied for abortion services to be more sensitive to transgender students.
At Barnard College and Columbia University, where abortion rights are not threatened, student activists who sought medical abortion through the university’s health department were unhappy with the institutions’ response.
Columbia provided them with standard university material that said, “Private doctors’ offices tend to be less crowded, have shorter wait times, afford more privacy, and feel more private. Clinics or nonprofits like Planned Parenthood may allow more anonymity.
Mx. Rao, the Barnard student, said students seeking abortions often go to Planned Parenthood clinics in Lower Manhattan or the Bronx, which have been targeted by anti-abortion protesters, including some fellow students.
“I would say it’s more anonymous to go to your clinic on campus,” Mx. Rao said.
Mx. Rao said a meeting with Barnard’s health administrator last week made them feel a little more optimistic.
Barnard said through a spokesman that he was committed to working with students and grassroots organizations to “strengthen” reproductive health care, including termination of pregnancy, and “to define what that looks like in a post-Roe environment.”
Universities are also pushing back against abortion opponents.
Carol Tobias, president of the National Right to Life Committee, an anti-abortion organization, said offering medical abortion on campus creates the potential for complications, such as in the case of an undiagnosed ectopic pregnancy. “I just don’t think this should be handed out like aspirin in college to young girls who may not know what’s going on,” she said.
Grace Lake, a senior and nurse practitioner at East Carolina University in Greenville, N.C., said Roe’s rejection has empowered anti-abortion activists on campus. She is the secretary of a recently formed group, Students for Life, which lobbies the university chancellor for daycare services for students who have children.
“From my perspective, there’s no reason why there should be any access for students to be able to end their child’s life, especially if it’s through the school,” she said.
In states where abortion laws may become stricter, students are scrambling to find alternatives. At Michigan State University, some students worry that their access to abortion in the state is scarce because of a 1931 law currently tied up in court that criminalizes almost any type of abortion.
They were not reassured when Samuel L. Stanley Jr., the university’s president, said in a statement that reproductive health care is a “basic human right,” while acknowledging the “diversity of opinion” on the issue.
“I thought, this is just not enough,” said Lana Heaney, a rising junior who organized a rally.
For now, Ms. Heaney said, the women are working on a “backup plan” — a push to distribute contraceptives and a Plan B on campus in case the law goes into effect.
Activists also hope that abortion doulas can support women taking abortion drugs. This year, Advocates for Youth, a reproductive health group, helped train 100 people — three-quarters of them current or recent college students — to be abortion doulas. These doulas will provide information and emotional support to those going through an abortion.
“The practical support is really stepping up — the transportation, the shelter, the funds and all the different logistical pieces that are needed to make access to abortion care possible,” said Tamara Marzuk, director of abortion access at Advocates for Youth.
Caitlin Bull, who will be a senior at Oberlin College in the fall, has been part of the Oberlin Doula Collective, which is not officially affiliated with the school, since her freshman year. “It was very cool to see the campus community come together around this work,” she said.
The college, she said, has sent messages in support of reproductive rights, “but we really live in a hostile state.”
In the more volatile post-Roe landscape, abortion rights advocates must also be careful—just as careful as universities. They are being trained to “share” information about self-monitoring abortion – not to teach people how to do it – because “sharing” is legal, Ms Marzouk said.
“When we move toward potentially giving medical advice or saying, ‘You should do this or that,’ that can be interpreted as medical or legal advice,” she said, “and that veers into a risky zone.”
Kitty Bennett contributed research.
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