‘This Is Life Or Death For Some Patients.’ How I Help People Access Abortion Care

Angela Huntington’s phone has been ringing nonstop lately. The Missourian works at Planned Parenthood, and, this past September, stepped into a newly created role within the organization called a “patient navigator.” This means she takes calls from patients across the country who need an abortion, but who can’t get one in their state — usually due to laws limiting access where they live. Such laws have become more and more common over the last decade, but, in the past year, a number of bills restricting access to reproductive healthcare have passed and made a dire situation even worse, advocates say. In fact, 2021 was “the worst year for abortion rights” in nearly half a century, according to The Guttmacher Institute.

Huntington’s position was created after the passing of the Texas law known as Senate Bill 8, or S.B. 8, which made it impossible to have an abortion there approximately six weeks after a person’s last menstrual period, a point at which many people don’t know they’re expecting. The law deputizes citizens to sue anyone who helps someone obtain an abortion after a fetal heartbeat is detected. This leaves people searching for a way to get an abortion out of state, which many can't afford or access. That’s where Huntington and others like her step in, helping them find care and figure out how to pay for it. Huntington mostly serves folks in one of the states she oversees in her role — Oklahoma, Arkansas, Kansas, and Missouri.

And going north to neighboring Oklahoma is one of the closest options for pregnant people in Texas. From the time S.B. 8 went into effect at the end of 2021, Planned Parenthood health centers in Oklahoma reported a nearly 2,500% increase in patients with Texas zip codes year over year.  But that reality — and, thus, Hungtington’s role — are changing fast, as restrictive abortion bills continue to pass around the U.S.

In the past month, Oklahoma lawmakers approved a near-total ban on abortion, disallowing it “except to save the life of a pregnant woman in a medical emergency.” Anyone who performs an abortion outside of this circumstance can get up to 10 years in prison and be fined $100,000. Abortion advocates hope that the Oklahoma Supreme Court will block this ban from going into effect, but the future of access in the Sooner State and others hangs in the balance. Providers also expect a Texas copycat bill, House Bill 4327, to be passed imminently in Oklahoma.

Meanwhile, this summer, it’s expected that abortion access will be even further curtailed when the Supreme Court hands down a decision on the imminent case Dobbs v. Jackson Women’s Health Organization. Experts assume that they’ll either gut or overturn Roe v. Wade, the 1973 ruling enshrining the right to abortion, which would put bring “trigger laws” into effect in various states that would make abortion illegal overnight — including Oklahoma. In fact, the Guttmacher Institute estimates that in a post-Roe world, 26 states would be certain or likely to ban abortion. 

This means, the need for people like Huntington to help folks get out-of-state abortions is increasing constantly and their work may be even more essential and difficult by this summer, when access will likely be limited even further. Here, we ask her about how she does her job, what to expect if you need an abortion out of state, and what’s causing fear and hope in her right now. 

Angela Huntington: "The more I’ve gotten into this position, the more I’ve realized how vital this work — and everyone who does it — is. We are approaching the possibility of a post-Roe era, and S.B. 8 in Texas is a trial run. It’s imperative that there are positions and people and systems in place to catch these patients when access to this vital heathcare is either limited more or completely removed."

"Since I started, a lot of my work has been helping people traveling from Texas to Oklahoma City. For them, it can be 250 miles to 900 miles to get to a clinic. You can imagine how hard that journey would be for a single working mom. How do you find childcare? How do you find time off work? And what if you don’t have a car? Our job is to help make that trip as easy as possible, whether that’s answering questions or, more often, helping with financials. This is a big expense that often comes out of nowhere for people. Finding money to pay for an abortion is virtually impossible for some, but we try to help remove those barriers."

"We help reduce the cost of actual abortions and connect them with abortion funds. We have an internal fund at Planned Parenthood called the Justice Fund that we access first, and we also connect people to partners in Texas such as the Tea Fund, The Lilith Fund, and Indigenous Women Rising. Afterward, we help connect them with Texas patient navigators, who can help them if they need gas cards to pay for the trip to Oklahoma City. Or if they need gift cards for food, or a night at a hotel because it’s a two-day procedure. Sometimes there is no car in the picture so we’ve been known to help out with that… We might have patients who’ve never flown before and they’re terrified to do so, so we need to get them on a Greyhound bus. It really depends on the patient and there is no cookie-cutter ‘abortion package.’ It’s whatever helps the patient feel like they’re in control of their situation and that they have the support to get the procedure, so they don’t feel like they’re flailing. It’s making the process easier, because it’s already hard, even in the best circumstances."

"Once we heard about this new, horrible legislation in Oklahoma, our team had to start looking into how we’re going to get these patents from Oklahoma to wherever they need to go for abortions. We’ll help get patients anywhere that can get them in, it doesn’t have to be a Planned Parenthood or a clinic in our specific states. 

"It weighs heavily on us to think about all the Texas patients who were coming to Oklahoma for their care because they couldn’t get it in their home state, though there’s not a lot we can do about it. Where are they going to go now? We’ll still be working with them, but it might be that they have to travel extra to get to Kansas instead of Oklahoma. And, we will have to switch more of our work from helping people in Texas come here, to helping patients in our states get to other states. 

"I will say, there’s nothing good about Texas’s S.B. 8, but it has allowed us to see how the patient navigators doing this job based in Texas did things. We’ve learned from them and are preparing for how we’d handle such restrictions in our states. 

"I think in Oklahoma, one of the biggest challenges to getting people out of state will be finding the funding. Texas already had all these resources in place, and we do have some help, but I’m not exactly sure if it’s as robust as it is in Texas. But my hope is that independent funds are preparing for this moment just like us, and I’d love to see more of those."

"A post-Roe era in 2022? It’s so scary to think about. The need for patient navigation is going to increase. This is being worked on at pretty much every level. 

"There are states that have trigger bans, including Oklahoma, Missouri, and Arkansas where I serve, where abortion access would disappear if Roe v. Wade is overturned. Kansas, the other state in our affiliate, is considered a haven state. It’s written in their constitution that you’ll always be able to get a legal and safe abortion. There is a push to change that, which would be awful — it’s in the middle of the country so it would provide a haven for so many people in the Midwest in a post-Roe era, and that would change the landscape even further. 

"[But] with Missouri, Arkansas, and Oklahoma, if Roe is overturned, we’d just jump into action. That’s what patient navigation is for. We’d be helping arrange travel and getting funding for that travel. We’re talking to coastal cities at this point — California, Oregon, New York."

"We always want to make sure the patient is able to access the care they want to access wherever it may be. [After S.B. 8 went into effect] we might have been able to get someone an appointment in two weeks [in Oklahoma], but they didn't want to wait that long, so they wanted to find another option in a further-away state. Maybe Colorado, New Mexico, or California. If they feel that’s where they can get the best care, we want to make sure the person is being accommodated. It’s a personal choice and we want them to be able to access it. 

"There is obviously a capacity with any healthcare provider. We always try to meet the need as it grows by contacting more providers and increasing our hours and days we’re open. We will reschedule appointments. In preparation for the possibility of a copycat Texas bill passing in Oklahoma, we are expanding our days of service in our Wichita, KS, location as well as the kinds of services we offer there. That’s definitely on the radar. Will we be able to help every single Texan and Oklahoman who comes through the door? Maybe not, because that’s a lot of people, but we’re going to definitely do our best. 

"As navigators, a phone is always ringing, a task is always coming in and there’s never a lull in us hearing from patients."

"It can be [me working with one patient] in a very intensive way, with a lot of reassurance and hand-holding. Multiple phone calls. Or it can be one simple phone call, of someone saying I can’t afford this, help me out. We work out their funding, and then we’re done. It really depends on the needs of the patients.

"Once a patient connects to us, we give them our phone numbers and they can call us wherever they want within reason. I’ve done it before where we help with the funding and then we basically hold their hand until they walk through that front door and into that clinic. Sometimes there are a lot of phone calls back and forth between the navigator and patient, sometimes not. Maybe they’re at a hotel and they won’t accept them because they’re under 21 and we didn’t know that so we’ve got to rebook them. We just try to be there for whatever their need is. Sometimes we’ll book someone and they’ll change their mind about having the procedure and that’s okay. Because abortion is their choice. If you decide not to, we don’t ask questions. We just cancel it, no problem."

"That’s a hard one. It’s honestly every patient. Anyone contacting patient navigation is having a hardship. The way the world is right now, people don’t have disposable income, and then, all of a sudden, you have to have this medical procedure and it throws you into a crisis. Truly, every patient is in crisis, and the travel makes it worse. Multiple times a day I have people crying because they’re so relieved that we were able to fund the entire cost of their procedure or help them with transportation. It’s so emotional. There is so much need and every patient is facing a barrier."

"Well, I get a lot of comfort from knowing that I am able to help people. I’ve been working in the nonprofit world nearly my whole life, and, in this sector, you’re always forced to make all these hard decisions about what money is going where. And now with all the support we’re getting — from our Texas partners, from all those funders — it makes this job that I have so worth it. It makes it sound like I’m doing this to make myself feel better, but that’s not it at all. It’s nice to be able to offer this assistance and to have resources to give people. When I’m able to say: Hey, mom of two who just lost your job, I’m able to pay for your $1,500 appointment 100%, plus travel. And she breaks down crying and thanks me profusely and then I never hear from her again? I know that she was able to get the healthcare that she needed and it just warms my heart. Yeah, I might not hear from them again and that’s okay. That’s what we do."

"I kind of fell into the nonprofit world when I moved to Missouri [from California]. I used to work for a Ronald McDonald House and I worked very closely with kids who were battling cancer, and it opened my heart. I see that everywhere now. The people who want to help, and the good people going through horrible things who are helped by nonprofits. I see human beings — I see their fear all day. If I’ve learned anything, it’s: Every once in a while, we all need help. And we should all be okay with asking for it, because we can’t get anywhere in this world if we don’t help each other out. And whether that’s aiding someone in getting an abortion or giving a shoulder to cry on to a mom who has a baby in the NICU, I want to do it. It doesn’t matter to me. If you’re hurting, I just feel compelled to help."

"Well, I have created a fabulous garden in my backyard and have six chickens. But yes, it’s been really hard, to be honest. I have a lot of anxiety over what’s been happening — my entire staff does. The health center staff providing this abortion care are feeling it too, this stress, and the increasing patient volume. This is life or death for some patients, and to know that this is a vital need I’m helping out with every day keeps me going."