For continuing coverage of how COVID-19 is affecting reproductive health, check out our Special Report.

Four years ago, I needed an abortion in Texas while HB2, Republicans’ sweeping anti-abortion law, was still in effect. I wondered if I’d have to continue a pregnancy for which I wasn’t ready.

It took me two weeks to access care that I needed immediately. I’m struggling today knowing that as a result of the COVID-pandemic, countless others are facing similar barriers I had faced. Millions have lost their job and are without childcare, and some anti-choice government officials have used the crisis to outright ban abortion—directly violating our rights under Roe v. Wade. 

We’ve known that our right to an abortion means nothing if we can’t access it. Even though it feels hard right now, you should know advocates have worked for decades to ensure people always have access to abortion care, especially in times like these.

If you’re seeking abortion care during the pandemic, I want to help you learn about the same network that helped me access an abortion when it felt impossible. Here are some tips that might help you navigate the state of abortion access during COVID-19.

How to get an abortion in a state that has deemed abortion “nonessential” 

If you’re seeking an abortion in a state that’s attempting to or have already restricted access during the pandemic, you’ve probably experienced a delay in your appointment at least once. But if you have the capacity, you should call clinics—including those in surrounding areas—frequently for updates because circumstances can change day to day. 

Some clinics may be scheduling appointments for the future, and if legal action changes abortion access, scheduling an appointment allows the clinic to contact you to tell you about appointment availability. Providers are working closely with advocates to ensure access to abortion care continues, and they’re one of the first to know when services can resume. 

Clinics can also connect people with resources for out-of-state abortion care. Providers are already prepared with this information for people over the legal limit to have an abortion in certain states, and who are forced to travel to one of the states that provide later abortions.

If you’re considering traveling, you’re not alone. Fund Texas Choice, a practical support organization providing Texans with travel assistance, told Rewire.News last month that pregnant people with varying gestational ages have reached out for assistance to go out of state since Texas Gov. Greg Abbott (R) banned abortion under COVID-19. The Brigid Alliance, a practical support organization that helps people traveling to clinics providing second- and third-trimester abortions, told Rewire.News that the organization has recently helped people with pregnancies of earlier gestations, as well as families who are forced to travel together as a result of a lack of childcare. 

Because of shelter-in-place orders, some state officials are preventing drivers from crossing state lines and subjecting non-residents to 14-day quarantines, which could increase the logistical costs pregnant people face. Some methods of transportation have been affected too. But the Brigid Alliance says it hasn’t encountered drivers being turned away when crossing state lines, and the organization is letting folks flying to New Mexico know that in order to be exempt from the state quarantine, they can only travel between the clinic and hotel where they’re staying.

Brigid Alliance is also seeing the impacts that are surging for those providing and needing practical support.  

“Bus lines have closed down, airlines have spontaneously canceled flights, hotels have closed down entirely or reduced capacity—we had to move people from hotel to hotel in the middle of a three- to four-day process [to get an abortion], and we’re hearing from partners that there are some Greyhound lines that are doing temperature checks,” Odile Schalit, executive director of the Brigid Alliance, said.

Schalit wants people to know support is available for those seeking care amid the ever-changing landscape of abortion access.

“While the obstacles to your health care may appear numerous today, please know that there is a network of good people, volunteers, and resources that exist to support you. Tap into our network and, as much as possible, your own,” Schalit said. “Take your time, break down your plan and needs, and take stock of your unique physical and emotional safety and comfort. For many, accessing abortion care now means having to travel out of your home town, city, and state. While this may seem impossible, we and many others are here to help you construct safe plans for getting to your care.”

If you’re thinking about traveling out of state for abortion access, consider going to one of the 23 states that don’t have a mandatory waiting period to limit the number of times you have to visit a clinic before the procedure.

How to get an abortion if you need help paying for an abortion, traveling to a clinic, or other logistical support 

Abortion funds and practical support organizations help alleviate the high costs associated with paying for an abortion and traveling in or out of state. Funds generally help with the cost of an abortion, while practical support organizations cover travel-related costs; some do both. Below are some organizations that may be able to help you access the care you need:

• Northwest Abortion Access Fund provides financial and logistical assistance to people seeking abortions (and those needing to travel out of state for a later abortion) in Alaska, Idaho, Oregon, and Washington. 
• Yellowhammer Fund provides financial assistance to people seeking an abortion in Alabama, including those needing to travel out of state. The organization recently increased its budget and implemented a Visa gift card program to help alleviate some of the additional burdens people may face.
• New Orleans Abortion Fund provides financial assistance to people who live in or are traveling to southern Louisiana for abortion care. People who need to travel outside of Louisiana for care can call the organization for more information.
• ARC-Southeast provides financial assistance and travel support to people seeking abortions in Alabama, Florida, Georgia, Mississippi, South Carolina, and Tennessee—including people needing to travel out of state.
• The Brigid Alliance provides logistical support through referrals from clinics and funds by providing plane, bus, and train tickets, hotel stays, rideshares, meal stipends, parking, gas, and toll costs, as well as “reimbursement for childcare and travel-related expenses, like flat tires or oil changes,” Schalit said.
• The Lilith Fund for Reproductive Equity provides financial assistance to central and southern Texans seeking abortion care, including those needing to travel out of state. According to the organization, its hotline will remain open on an extended schedule from Monday to Friday, 7 a.m. to 10 a.m. Central time. “At Lilith Fund, we will continue to fight for our callers and ensure that folks have access to care during this pandemic,” Shae Ward, hotline coordinator for the Lilith Fund, told Rewire.News. “Every day on our hotline we hear how these [abortion] bans are hurting people. In the past two weeks, our clients have had to travel an average of 700-plus miles to get to a clinic in a neighboring state; one recently traveled as far as 1,600 miles—even though she lived only three miles away from her local clinic that was forced to stop providing care due to the ban. Our clients are forced to make appointments with clinics in surrounding states and are facing long wait times. This pushes them further into their pregnancy, which makes their procedures more expensive. The restrictions on clinic services are cruel and put people’s lives in danger.”
• Texas Equal Access (TEA) Fund provides financial assistance for abortion costs to people in north Texas, including those needing to travel out of state.
• Fund Texas Choice provides travel support, like plane tickets, hotel stays, and gas costs, for Texans needing to travel to abortion clinics. People can call the organization for more information, or fill out an online application every Thursday starting at 8 a.m. local time. 

To find other local abortion funds and practical support organizations in your area, visit the National Network of Abortion Funds to search for groups by state. 

You can also ask abortion clinics to screen you for financial assistance. Unlike assistance from abortion funds and practical support organizations, in-clinic funding can be income-based, but you aren’t required to show proof of how much money you earn.

How to get an abortion in a state that allows telemedicine 

Eighteen states prohibit the use of telemedicine for abortion care. If you live in one of the states that allow it, medical abortions can be obtained up to ten weeks into pregnancy through video conference with an abortion provider.

While U.S. Food and Drug Administration (FDA) restrictions prevent the medication from being mailed to your home, patients can avoid traveling long distances to an abortion clinic while protecting their health during the pandemic by visiting a nearby health center to receive the medication under guidance of a doctor.

TelAbortion, however, can send the medication to your home if you’re eligible. TelAbortion is a study run by reproductive and maternal health research group Gynuity, and the evaluation is offered over the internet—so you can access it on your own phone or computer. But the FDA requires people participating in the study to visit a health clinic in order to have an ultrasound or pelvic exam, according to Dr. Elizabeth Raymond, senior medical associate for Gynuity Health Projects.

You will need video conference access in one of the 13 states participating in the study, and have a mailing address in the state where the medication can be sent. 

If a person encounters barriers in accessing an ultrasound or pelvic exam—especially barriers compounded by the COVID-19 pandemic—they can call a TelAbortion site, as the provider may be able to accommodate their situation. 

If you’re eligible for a TelAbortion, you’ll be sent “a package containing the necessary medications and an instruction sheet by mail.” Afterward, the TelAbortion provider follows up with study participants to ensure the abortion was successful, “and to address any side effects and complications.” According to their data, the TelAbortion model is just as effective as an in-person abortion.

In the past two months, Gynuity expanded its TelAbortion study to include Maryland and Illinois, and the hope is to continue to expand during the pandemic, as telemedicine abortion care will be critical. In the past few weeks, Gynuity has had a significant increase in traffic to the TelAbortion site.

“We’ve been doing this study since 2016, [and] now it’s right there [and] ready,” Raymond said. “It’s gratifying to be able to help in this crisis.”

What you need to know about self-managed abortion 

Self-managed has proven to be extremely safe—a 0.3 percent risk of major complications, according to an analysis by Advancing New Standards in Reproductive Health. Interest in it is also rising.

Self-managed abortion can include using mifepristone and misoprostol, or misoprostol alone, to end a pregnancy. Mifepristone blocks the hormone essential to advancing pregnancy, whereas misoprostol empties the uterus.

Plan C provides a “report card” on online retailers that offer the medications, resources about how the process works, and the legal risks surrounding it. Some states have laws that could be used against people ending their own pregnancies—at least 21 people have been arrested since 2005, Jill E. Adams, executive director of If/When/How: Lawyering for Reproductive Justice, told Rewire.News.

In states without such laws, Adams said some have faced charges as a result of prosecutors “misapplying parts of the criminal codes that were never intended for people ending their own pregnancies.” In most cases, the judge determines the law doesn’t apply, but at that point, people have already been arrested, lost their job, and face public scrutiny as a result of private records being released.

“The risk is highest for populations and communities under surveillance and on the receiving end of disproportionate state violence—communities of color, especially Black and African American people, immigrants, and trans and gender nonconforming people, are all more at risk of criminalization, and [they’re] also more likely to need self-managed abortion due to barriers to clinic-based care and bans on coverage,” Adams said. 

Mandatory reporters, like health-care professionals, can also feel obligated to report people should they seek follow-up care from a doctor, even though Adams said the American Congress of Obstetrics and Gynecology and the American Medical Association recommends against it.

“No state requires mandatory reporting for suspected or confirmed self-managed abortion, including when the person is a minor,” Adams said. “If people do report, they are likely violating patient privacy laws.”

When seeking follow-up care, people aren’t legally required to disclose their situation to a doctor. If/When/How: Lawyering for Reproductive Justice’s legal helpline offers information on a person’s rights when talking to law enforcement officials or doctors involving self-managed abortion. According to the website, no one has been arrested for buying abortion pills online.

“The right to abortion—self-managed or provider-directed—still exists throughout the United States,” Adams said. “But laws have been misused and power abused in unjustly criminalizing people for ending their own pregnancies.”

The helpline offers free, confidential legal information to people concerned with being “investigated or arrested” for self-managing an abortion, as well as legal advice from an attorney when necessary. 

But Adams said if there were ever a time to “eliminate the sources of criminalization,” that time is now. Their legal helpline has received double the number of inquiries they usually get. “Local, state, and federal officials should make it clear that no one will be arrested, charged, or detained for ending their pregnancy, or for helping someone else end their pregnancy—and not just during the pandemic, but always,” Adams said.

If you need an abortion without parental consent 

In the 37 states that have forced parental involvement laws for young people seeking abortion care, teenagers are forced to go through the overwhelming process of obtaining a judicial bypass, or permission from a judge to have an abortion. As a result of the pandemic, shelter-in-place orders and school closures prevent teens from discreetly leaving home to go to court, or even obtaining resources that may be able to support them.

• If you’re under 18, live in Texas, and want an abortion without telling your parents, contact the Jane’s Due Process hotline 24/7 at 866-999-5263 to be matched with a free attorney. You’ll also receive direct support from Irma Garcia, Jane’s client services manager, and the abortion costs will be covered by the National Abortion Federation. Those living outside of Texas can text the hotline from 8 a.m. to 11 p.m. Central time to learn about the process in their own state.
• Teens in North Carolina and South Carolina can reach the Carolina Abortion Fund for help getting a judicial bypass by texting “ABBY” at 844-997-2229 from 9 a.m. to noon Eastern time every day.
• Teens in Illinois can contact the Illinois Judicial Bypass Coordination Project, a project of the ACLU of Illinois, by calling 877-442-9727 or texting 312-560-6607 weekdays from 5 p.m. to 10 p.m. Central time and from noon to 5 p.m. on weekends.
• Those living in Alabama, Florida, Georgia, Mississippi, South Carolina, or Tennessee can contact ARC-Southeast for assistance with the process. Some Planned Parenthoods and independent abortion clinics might be able to help you learn about the process, including which courthouse you need to go to. 

Other things to know when seeking abortion care during COVID-19 

Be aware that crisis pregnancy centers (CPCs), or anti-choice clinics, are still operating, but they don’t provide abortion care. Even if they offer to talk to you about your options, they won’t refer you to an abortion clinic or provide the necessary resources to obtain one. Reach out to any of the aforementioned organizations for information about the next steps. 

The Online Abortion Resource Squad, a group of volunteers who respond to abortion-related questions on Reddit with compassionate, accurate answers, developed a resource site in response to the confusion and uncertainty around abortion during this health crisis. The site offers up-to-date information on clinic operations in states that have deemed abortion as nonessential health care, as well as connecting with local resources for financial and logistical assistance, and locating clinics in your state and nearby states.