One Move Colleges Can Make to Expand Abortion Access for Students

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One Move Colleges Can Make to Expand Abortion Access for Students

Kelley Dennings

With the future of Roe v. Wade on shaky ground, it's even more critical for campus health centers to make medication abortion available to their students.

It’s no secret that college-age students face increasing uncertainty about their futures due to the climate emergency and extinction crisis, the sky-high cost of college, and political upheaval. Now, with the imminent threat to Roe v. Wade, even access to abortion—a basic human right—is on shaky ground.

According to Advocates for Youth, a national nonprofit that works with young people to fight for sexual health, rights and justice, restrictions on abortion have an outsize impact on young people. That’s because young people’s periods may be irregular, so they may not initially suspect they’re pregnant; they have lower incomes, making abortion cost a barrier; and they’re less able to take time off from work or school and travel long distances to seek abortion care.

Immigrants and people of color are disproportionately affected by these barriers. A person’s age, race, or economic situation shouldn’t limit their reproductive health-care options. Advocates, public health professionals, and the medical community should be working double time to make it easier—not harder—for students to access abortion services.

Using momentum from Texas’ highly restrictive abortion law, SB 8, states across the country are advocating for similarly restrictive laws and working to close abortion clinics. Despite the anti-abortion fervor, a new report by the American College Health Association showed an increase in support for abortion information, referrals, and services at campus health centers. Ninety-one percent of campus health clinics reported they provide “all options” counseling for those with positive pregnancy tests, up from 78 percent in 2015.

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And 87 percent of campus health centers say they will make a referral for abortion, an increase from 72 percent in 2015. While it’s good news that campus health centers are providing students with information about the full range of health-care options, it will become increasingly difficult for them to provide convenient off-campus referrals if states continue to restrict access to abortion—and abortions may become completely out of reach if students are required to travel long distances to get care.

A simple solution is to increase abortion care through college and university campus health centers and make medication abortions available right on campus. A medication abortion is a combination of medications that ends a pregnancy and causes the uterus lining to shed. It requires no surgery nor anesthesia, is very safe, and can be done at home. Unfortunately, only 2.5 percent of campus clinics provide medication abortions.

While campuses should continue to increase access to medication abortions through their clinics, the Food and Drug Administration needs to permanently lift medically unnecessary restrictions for mifepristone—the safe and effective drug used for medication abortion in over a third of abortion procedures nationwide—allowing the procedure to be done safely at home by students.

Currently, mifepristone is regulated by an FDA Risk Evaluation and Mitigation Strategy (REMS), which creates burdensome in-person dispensing requirements. These requirements make it harder for an individual to receive mifepristone from their usual provider because it can’t be dispensed from a pharmacy—the medical office or hospital must be a certified prescriber and have the medication on hand. The strategy is also a barrier to telehealth appointments, though this requirement was lifted during the pandemic. The FDA is expected to announce Thursday whether they’ll permanently waive the in-person requirement.

Permanent removal of the REMS requirements would allow patients to obtain prescriptions for mifepristone from their own primary care provider, local health clinic, or campus health center and allow the medication to be dispensed at pharmacies in the same way that students can access birth control pills, helping to normalize abortion care.

In addition to advocating for easier access to mifepristone, reproductive health advocates must throw our support behind the Women’s Health Protection Act, which protects a person’s right to access abortion care. The act creates a safeguard against bans and medically unnecessary restrictions for surgical and medication abortions, such as physician-only dispensing, mandatory ultrasounds, waiting periods, and prohibitions on telehealth. It was approved by the House of Representatives in September 2021 and is waiting to be heard by the Senate.

When students have access to health care—including medication abortion—they’re able to choose if and when they want to have children, creating a positive domino effect that may be felt for the rest of their lives. When they’re able to stay in school, rather than dropping out to raise a child, students are more likely to start a family later in life and have fewer, healthier children, giving them the opportunity to realize higher wages and build resiliency. A recent report outlines how removing barriers to abortion access would lead to an annual earnings increase of $101.8 billion for working women ages 15 to 44.

College-age students, like everyone else, deserve the fundamental right to make their own decisions about having children. If we don’t provide them access to the full range of vital health services on or off-campus, we fail them at a critical time in their lives and strip them of their ability to make the reproductive decisions that are best for them.