Have you ever considered what it’s like to need an abortion in the middle of a natural disaster?

Many of the parts of the country that experience some of the worst conditions during hurricanes, tornadoes, flooding, and other storms are also the parts of the country where access to affordable health care does not exist. Three weeks ago, Hurricane Dorian forced me to reckon with that reality.

I was working on the helpline at Carolina Abortion Fund (CAF) to support folks who were seeking financial assistance for their abortions across North and South Carolina. In the Carolinas, heavy rains flooded homes in coastal areas. High winds caused power outages. Hazardous road conditions made several modes of travel inaccessible. Still, Hurricane Dorian was projected to be much more catastrophic for the Carolinas than it actually was. The Bahamas, however, experienced some of the worst devastation in recorded history.

Even though the storm didn’t have the impact that people thought it would in the Carolinas, it still wreaked havoc on access to abortion care. During storms like Dorian, when abortion clinics close, clients have to push their appointment dates further back, which can lead to increased costs. It can even mean not being able to access an abortion at all, especially considering state-required waiting periods and other anti-choice restrictions. Folks who already experience financial barriers to accessing abortion then face additional logistical and geographic barriers. This is particularly bad when there aren’t many clinics that offer abortion care in the first place. Some CAF clients travel anywhere from 30 minutes to six hours for their abortions when there is no storm; imagine what it’s like when there is a hurricane.

During the storm, the CAF helpline was flooded with calls from folks who had their appointment dates changed by clinics. Many of them had already taken time off from work, scrambled to secure child care, secured a ride and/or support person, and used every dime to fund the abortion itself. Having to reschedule your abortion and use even more limited resources, time, and energy can be another disaster in the midst of a disastrous storm. CAF was able to support these people with funding assistance and help finding rides to their appointments.

Some see hurricanes as natural disasters, but with the reality of climate change, others increasingly see them as man-made disasters. If a hurricane can be understood and framed as a man-made disaster, then, certainly, so can the gutting of abortion rights, alongside the denial of affordable health care and the fight against higher wages. This is a multipronged man-made storm that is spinning viciously and growing in size, and it is causing catastrophic and unimaginable harm to millions of people.

The reproductive justice framework establishes that we all have a right to have a baby, to not have a baby, and to determine the conditions under which we make these decisions. It also establishes that given those rights, we all deserve to live free from harm from individuals, institutions, the government, and the environment. This means that we have to take seriously the effect that natural and man-made disasters have on access to abortion care, especially in the places where folks have already been living “post-Roe realities.” When I say “post-Roe realities,” I’m talking about the people who have always had very limited or nonexistent access to health care, and those who have always had to seek it outside of the medical industrial complex.

For example, North Carolina has one of the longest state-mandated wait times for an abortion in the country—a restriction that constrains access even as abortions are legal. South Carolina has fewer than five outpatient clinics where people can access abortion, forcing many people to drive long distances for their care in addition to finding money for their procedure; North Carolina has about 15 outpatient clinics, in addition to many anti-choice crisis pregnancy centers falsely posing as clinics. In my experience working at an abortion fund, we’ve often supported folks traveling from rural places in South Carolina to clinics in the Raleigh/Durham/Chapel Hill area, Asheville, and Charlotte. During Hurricane Florence, folks who had appointments on the coast had to travel to Fayetteville, Greensboro, and Raleigh for their new appointments. Many folks who live on the coast already travel far for their appointments because access to abortion clinics in that part of the state is particularly scarce. The Carolinas restrict abortion coverage in both public health insurance and private plans offered through the health exchange, with few exceptions. This is in addition to the discriminatory Hyde Amendment, which bans federal funds from being used for abortion.

Hurricane Dorian, and storms like it, often mean an increase in police presence in already overpoliced communities. But this is not limited to hurricane season. For some of us, the state violence we experience is a kind of natural disaster all its own. The clinic at which I had two abortions in Charlotte, North Carolina, saw more than 10,000 anti-choice protesters in 2018. Because the clinic serves so many people in the Southeast, it is a prime target for right-wing, anti-choice, puritanical religious people and organizations. Harassment of this kind will only ramp up during Love Life’s upcoming 40 Days for Life, which includes events aimed—in the name of Jesus—at shaming and targeting people seeking abortion. These protesters bring a police presence with them that especially threatens people who have experienced state violence and surveillance, and those with documentation statuses criminalized by the state.

Abortion is health care. All people deserve access to health care. All people deserve to live free from harm, wherever they choose to live. If experiencing hurricane season in North Carolina for the past 24 years has taught me anything, it has taught me that natural disasters do not affect all of us in the same ways. Those of us who are whiter, richer, and more able-bodied, who have documentation status and access to education, housing, and job security, will always be better able to prepare for and defend against the threat of environmental destruction. Furthermore, people who do not care for children or other family members will always be able to flee more quickly from a storm.

Financial assistance for people surviving a disaster and seeking abortion care is critical. The reproductive justice framework urges us to understand the intersections of climate change and abortion access. It also has provided us with a road map to support people on the ground, in our communities, in a direct way. Giving to local abortion funds is one way to do that. For example, Carolina Abortion Fund is countering 40 Days for Life with a campaign called 40 Days for CAF, which is aimed at ending clinic harassment and funding abortion. Supporting someone with a ride to their appointment is another way. Becoming a volunteer abortion doula who provides consensual emotional, physical, and information support to people seeking financial assistance for their procedure is yet another.

With the 2020 election around the corner, it is time for all of us to take these racial, gendered, geographic, financial, logistical, and reproductive implications much more seriously. We are continuing to see more restrictions in the very places that are affected most negatively by climate change, poverty, sociopolitical conservatism, and natural disasters. What I know is that these things are inextricably connected to each other.