Protecting Abortion Rights for Everyone

The reproductive healthcare landscape in Missouri is hostile. Post-Dobbs, Missouri’s trigger law made the already tenuous landscape of reproductive health and abortion access in Missouri even more dangerous. People now must cross state lines — which requires transportation and money — to access critical healthcare.

The bottom line: legal, safe abortion is key in promoting equity for all people.

Abortion should be legal across the country, here in Missouri, and here in the City of St. Louis. Know that I’ll be fighting to make sure it is. There is a lot we can do as a City to promote policies that protect and expand rights. Other jurisdictions have taken a variety of paths. Each is worth considering.

First, we can level the playing field, and help people who do not have the means to leave the state to access abortion care do so. Because Missouri law bans abortions, people who need abortion care need to leave the state — which requires resources. So, those with means are better able to access abortion care, which just layers more inequity on top of injustice. That’s why I cosponsored a bill creating a Reproductive Equity Fund in the city Health Department that helps people access transportation for abortion care. It also allocates $500,000 for other reproductive health services such as access to doulas and lactation support. We must extend these supports past temporary ARPA funding.

Second, we can ensure there is access to birth control, emergency contraception, comprehensive sexual education, and menstrual products for all people. A Washington University study in 2012 showed that “providing free birth control reduced unplanned pregnancies and cut abortion rates by a range of 62–78 percent compared to the national rate.” Many of the study participants chose safe and long-acting birth control methods like IUDs and implants. But because both IUDs and implants have high up-front costs, those options are out of reach for many people.

We can — and should — change that. To prevent unwanted pregnancies, people need access to effective contraception and menstrual health resources in our communities. According to the Guttermatcher Institute, sexually active couples who do not use any method of contraception have approximately an 85% chance of experiencing a pregnancy over the course of a year and the average number of children U.S. adults think is ideal is 2.7. To achieve this family size, a sexually active woman must use contraceptives for roughly three decades.

As a community, we have a responsibility to ensure people have access to the resources we need to have the family they want.

Providing free and easy-to-access emergency contraception is also critical, both for people who have been sexually assaulted, and for those whose birth control method has failed. We can and must make that available.

And finally, studies show that providing comprehensive public sex education decreases unwanted pregnancy rates. Making both emergency and regular contraception more accessible and affordable and increasing public education initiatives on birth control and safe sex will decrease the number of unwanted pregnancies and the need for abortion care.

Third, we can be honest with citizens about what services “Crisis Pregnancy Centers” are able to provide: Crisis Pregnancy Centers (CPCs) are organizations that try to intercept people who might be considering abortion. They are not medical centers, and are not required to have licensed medical professionals on staff. Missouri law protects CPCs from city regulation. People who seek care at these facilities are “disproportionately young, poorly educated, or poor.”

Too often, pregnant people go to CPCs erroneously believing them to be medical centers that can provide abortion or medical care. They seek help and medical advice based in science. Instead, staff at the CPC try to convince them not to seek abortion care, often through misinformation. In one Congressional report, 87% of the CPCs provided misleading information about the health effects of abortion. This practice denies people the ability to make informed health decisions. However, because CPCs are not medical facilities, they are not bound by the ethical standards of informed consent.

Because they are not medical facilities, CPCs are also not covered by the confidentiality provisions of the Health Insurance Portability and Accountability Act (“HIPAA”), which puts the private health information of the people who mistakenly seek abortion care at these facilities at risk.

This is even more problematic because the centralized data management system used by many CPCs, Next Level Central Management System, collects “name, address, email address, ethnicity, marital status, living arrangement, education, income source, alcohol, cigarette, and drug intake, medications and medical history, sexual transmitted disease history, name of the referring person/organisation, pregnancy symptoms, pregnancy history, medical testing information, and eventually even ultrasound photos”. Next Level’s privacy policy makes clear that it “may share such information with Next Level affiliates, partners, vendors, or contract organizations, or as egally necessary”. Next Level has 2,700 affiliate organizations.

All of this puts CPCs and anti-abortion organizations in a position to amass a database of private health information, which it explicitly states it can share with “affiliates, partners, vendors, or contract organizations” — including anti-abortion organizations. This practice not only puts the private health information of St. Louisans at risk. It may subject them to ongoing misinformation campaigns through targeting, by social media or otherwise.

This results in unplanned and unwanted pregnancies being carried to term, placing a disproportionate burden on pregnant people and often results in significant economic burden on the person and, eventually, the child. Medical disinformation is more likely in spaces with unlicensed providers and can result in serious harm to both the parent and the child.

We can and should increase awareness of what these centers are and what services they do and do not offer. We can inform our community in honest ways about where people can receive the care that they are actually seeking. And we need to thoroughly investigate the data protection and sharing policies used by CPCs to protect St. Louisans’ confidential health information.

Finally, we must continue to support the work of organizations and communities that have been fighting for reproductive equity. This fight is not new. This fight is not over. We need to convene a special committee through the Board of Aldermen to develop long-term local strategies in collaboration with local advocates to address the gap in services created by the abortion ban. I am proud to be endorsed by Pro Choice Missouri and #VoteProChoice, and to have a longstanding relationship with reproductive rights activists throughout Missouri. I will continue to work with them, side-by-side and shoulder-to-shoulder to fight for reproductive justice, and to help you have access to the services you need to stay healthy.