By Sophia Harris
News Editor
Massachusetts public colleges are now required to create an abortion readiness plan and provide medication abortion if the institution's health center has the capacity to provide it.
In July 2022, former Gov. Charlie Baker signed bill H. 5090 making the state the second, after California, to ensure that students enrolled in public universities have access to medication abortion or abortion readiness plans available through their health centers.
The legislation was sponsored by state Rep. Lindsay Sabadosa (D-1st Hampshire).
Framingham State’s Health and Wellness Center is “current on the new bill,” according to Ann Lyons, interim director of the Health Center.
Lyons said, “At this time, university health centers are tasked with making sure they have a plan in place for access to medication abortion for their students,” whether it is providing access through telehealth or directing students to local centers to access this medication.
She said FSU’s health center does have a plan in place for students who request information regarding their options if they are in need of an abortion.
Framingham State, as of now, will not offer medication abortion access to college students, only an abortion readiness plan.
Sabadosa said this bill ensures any student in Massachusetts who is attending a public higher education institution has access to an abortion readiness plan provided to them through their on-campus health center.
Lyons added, “We don't anticipate the need to change our plan. However, we will be waiting for the Massachusetts DPH [Department of Public Health] guidance and will review it carefully to make sure that we are in compliance with the new legislation and providing the best access to care for our students.”
The bill requires public institutions to propose a plan to the DPH by November 2023.
Lyons said the health center will supply students with a list of local providers to refer patients to who provide both medical abortion and surgical abortion.
She said, “We have had no problems with access to abortion up to this point and are able to get our students care in a timely manner.”
Taylor St. Germain, communications director of Reproductive Equity Now, a non-profit Massachusetts-based organization that “works to make the full spectrum of reproductive health care available and accessible for all people,” regardless of their identity or socioeconomic status, spoke on the “access deserts” that many college students face when in need of reproductive health care.
St. Germain said the goal of this bill is “to really have students be able to access this essential health care where they're already accessing the rest of their health care.”
Regarding the bill, she said the Massachusetts Legislature “acted really boldly and really swiftly to pass this major health law that would not only expand access to reproductive health care, but put money into abortion access.”
She added, “Part of this law is to include a provision to how Massachusetts public colleges and universities create these readiness plans so that students know how and where they can access medication abortion on college campuses.”
St. Germain said, “It's a way to bring abortion access to where college students are, to close some of these access deserts that a lot of students live in and to break down costs and travel barriers to care that students across Massachusetts have been facing.”
A December 2021 study published in Contraception Journal.org by Carrie N. Baker, professor of law and reproductive justice at Smith College, and Julia Mathis, a legislative aide for Lindsay Sabodosa found that 50 to 115 of Massachusetts public university students obtain medication abortion services each month, or 600 to 1,380 each year.
The study goes on to address the access deserts that students face. “Students have to travel between 2 and 42 miles to reach the nearest abortion-providing facility, with a population-weighted average distance of 19 miles each way,” according to the study.
In regard to the cost students will have to pay for medication abortion access, the study found the average cost of medication abortion was $680.
The average wait time for the first available appointment was eight days.
Additionally, “Eight of 13 abortion-providing facilities did not have weekend appointments. All of the nearest abortion-providing facilities in Massachusetts accepted MassHealth, but one nearest facility was out of state and did not. All accepted multiple private insurance plans.”
The study concluded, “The barriers to medication abortion experienced by students attending public universities in Massachusetts fall particularly hard on female and low-income students, who are disproportionately students of color. Offering medication abortion on campus would reduce these barriers and enhance gender and racial equity on campus.”
Lyons said, “We have had no problems with access to abortion up to this point and are able to get our students care in a timely manner.”
She said when considering whether it is feasible to provide medical abortion at a clinic, the following factors need to be taken into consideration: financial and staffing considerations; security of the building that houses the clinic that provides medical abortion; ability of the clinic to confirm gestation dates if unsure; ability to manage complications if they occur.
Lyons added because of the lack of some of the necessities that would be needed to provide medication abortion on campus, FSU refers students to outside providers.
For example, FSU would not be able to provide an ultrasound to confirm gestation dates, or a uterine aspiration if needed, Lyons said.
There are accessible facilities that currently have all of these protocols in place. The providers the health center refers patients to are Planned Parenthood Greater Boston Health Center, Planned Parenthood Worcester, and Women’s Health Services of Brookline,Massachusetts.
All three providers offer medicated abortion access.
All of these providers are approximately 20 miles away from Framingham State’s campus.
Additionally, Lyons said, “The demand has been historically very low at this clinic, and it is in the best interest of the patient to be provided these services from a provider who frequently and routinely prescribes medical abortion and is experienced in dealing with complications that may occur.”
Lyons added the decision was made not to provide medication abortion access on campus, but to “evaluate what we do and does it align with what the new legislation is, which we found that it did. So at this time we have decided not to make any changes.”
She added at this time, “We are not ready to make a change, but it's definitely something that we're talking to other universities about to see what they're doing and how they're able to provide it, or how many are providing it.
“We feel really good about the fact that there have not been barriers to getting students medication abortion,” she said.
Lyons said, the health center will continue to follow DPH guidance to ensure FSU students have timely access to abortion care.
Ann McDonald, chief of staff and general counsel, said the UMass Amherst Medical Center, which operates 24/7, has the capacity to offer the medication abortion. “Take that and parallel it with what we have at Framingham State.”
McDonald said, “We're a residential institution, but we have an FSU health center that has pretty traditional hours. We have emergency services where people can get services after hours, but primarily from outside providers, not from folks within the campus.”
She added in regard to the legislation, “What the governor and the lawmakers were trying to do is not put a one-size-fits-all requirement to each of the campuses that they might not be able to fulfill.”
“That's why I think the way it was written was to have a plan that satisfies the requirement that you're going to support and you're going to fulfill that responsibility,” McDonald said.
“But we're going to respect that depending upon how your staff, you may be able to do that in a number of different ways and it's not sort of a one-size-fits-all approach,” she said.
McDonald said, “In theory,” if a student was an out-of-state student from a state that prohibits payment of costs for abortion, “our staff would work with them to try to see what they might get for protections and coverages.
“So, for example, even our University student health insurance policy would cover that because it's offered by a university provider for the Commonwealth. But in theory, you could have a student out there who had their health insurance from, let’s say, Texas, or one of the states that have prohibited [abortion access] who might find themselves in a bind, and I know our health services staff would work with them to find some protections and coverage,” she said.
St. Germain said, “Framingham State University is clearly already a resource for students to access a lot of reproductive health services on campus, whether it's emergency contraception access or free pregnancy testing.”
She added, “We think they'd be a great place for students to be able to continue to access reproductive health care, including medication abortion.”
She said, “We're looking forward to continuing to work with a lot of universities across the state to get these readiness plans prepared for their due date in November. And we're really looking forward to ensuring that Massachusetts college students are able to continue to access care where they are without barriers.”
St. Germain said although public institutions might not be able to carry medication abortion, the bill that was passed in July will “hopefully ensure that students are able to go to their health center and either receive medication abortion or referrals for medication abortion throughout the state.”
She added, “Medication abortion is available also via telehealth. People can access the medications mifepristone and misoprostol via telehealth and get the pills shipped directly to them.”
St. Germain said, “Our work isn't going to stop until everyone's able to access either in-person abortion care or medication abortion care in their communities near them without cost, travel, or insurance barriers.”
Abortion care remains legal and available in Massachusetts “despite the recent news about what's going on with mifepristone in the courts. Right now, mifepristone remains legally available and accessible in the state, so medication abortion access goes unchanged for the time being,” St. Germain said.
According to St. Germain, Reproductive Equity Now has been working with the legislature and Gov. Maura Healey to “brainstorm how we can respond and ensure that access for a person goes uninterrupted here in our Commonwealth.”
Healey has been leading reproductive equity initiatives in Massachusetts since being sworn in January 2023.
In an email, Gov. Healey said she is “committed to protecting and expanding access to reproductive care in Massachusetts, including emergency contraception, medication abortion, full-spectrum pregnancy and birthing care, and postpartum mental health care.”
She added, “We’re going to protect patients and providers and ensure that Massachusetts remains a beacon of hope for all those seeking care.”
Healey said students in Massachusetts have a “right to access reproductive health care here.”
She said, “Our administration is working closely with schools to implement their plans, and we are committed to collaborating with advocates, public health officials, school officials, and students to evaluate how we can best protect and expand access to reproductive health care for students.”
According to an article published by GBH News, “Healthcare providers in Massachusetts have also agreed to purchase more mifepristone, and the state will dedicate $1 million to help pay for those doses.”
According to the article, Healey’s administration asked the University of Massachusetts Amherst to purchase approximately 15,000 doses of mifepristone.
Healey said the dosage amount is enough “to ensure sufficient coverage in the state for more than a year,” according to the article.
In her email, Healey said her administration was “anticipating” the Texas judge would “attempt to block FDA approval of mifepristone given his extreme views.”
She said,“So we got to work before the ruling came down to determine how we could access care.”
She added, “UMass already had all necessary certifications to purchase mifepristone and currently provides medication abortion through their university health services. And they were willing and able to jump into action quickly when we made the request.”
She said the University of Washington also purchased doses.
Healey added, “The only change we want to be seeing to reproductive care is that it becomes even more accessible here in Massachusetts.”
Leora Mallach, district 7 city councilor in Framingham, submitted a reproductive rights proclamation on behalf of the Framingham Coalition of Bodily Autonomy in February.
The council passed it unanimously.
The proclamation states Framingham will protect every person’s right to access the full range of reproductive health care options, in full compliance with the laws of the Commonwealth, including preventing unintended pregnancy, bearing healthy children, and choosing safe, legal abortions, according to an article published by the Framingham Source.
Mallach said the proclamation “that we passed was really an affirmation of the right to bodily autonomy.”
She added, “There was a lot of community input in conversation over the course of the couple of months that we looked at it, and I'm really proud of what got passed.”
The Framingham Coalition for Bodily Autonomy was established to protest the overturning of Roe v. Wade, said Grace Snedden, organizer of the coalition.
She said the coalition aims to be impactful locally “to give opportunities for people in our community, to contribute to being a solution, and to do the advocacy, and really, we're trying to be proactive.”
Snedden said the group is learning as they go.
She said they are trying to “grow in the right way,”
Snedden added the group is “Small enough to be nimble and respond to this changing environment, but big enough to be impactful.”
Samela St. Pierre, a member of the group, said their mission “is to gather in the community, organize and mobilize in response to the overturning of Roe v. Wade, while defending equitable access to information, healthcare, and the right to make decisions about one's own body.”
Snedden said the group put all of its efforts behind passing the local proclamation.
She added Reproductive Equity Now was very supportive throughout that process.
She said they provided specialized knowledge that the group would not have been able to produce themselves.
Snedden said the proclamation outlines the “values that Framingham holds.”
She added, “We want to get our arms around what access looks like in Framingham and where it needs some enhancement - where we can really be a vehicle for information for people.”
Snedden said college students in Massachusetts are “very, very lucky right now,” adding, “I want them to know that they're in the right place - that there's support and resources for them here in their community. It's the mission of the members of this community to support their right to full control over their bodies.”
St. Pierre said it is important for college-aged people to understand “abortion is such a normal part of many, many, women's lives, and the choice to have one or not is what most women go through.”
Abesikayo Ajao, a sophomore, said she knows the health center offers reproductive health care such as emergency contraception and sexual health barriers.
She said if one of her friends was contemplating getting an abortion, she would support them by listening to what they need.
“No one ever talks about the effect that can have on you mentally,” she said.
A student who asked to remain anonymous said she would support a friend who was thinking about getting an abortion by “being a friend to them and loving them.”
She said it is important to “love them as a person and help them through this because regardless of whatever choice they make, it's going to be difficult, and they just need people there to love them and encourage them, regardless of whatever the choice is.”
Ashanti Greene, a junior, said she would support someone she knew was thinking about getting an abortion by supporting them both “emotionally and physically.”
She added, “I would suggest going to a good doctor and possibly seeing a therapist if they feel that they need it.”
Molly-Maxine Willow, a freshman, said they know the health center offers reproductive health care such as condoms and STI testing.
They added in order to support a person who was thinking about getting an abortion, they would first send them to the health center for information and do some of their own research about what the best options are.
Oscar Rubyck, a freshman, said if he had a friend who was thinking about obtaining an abortion, he would make a supportive poster and say, “Hey, I know you're going through this and it's hard, but I’m going to support you.”
Resources available for both FSU students and residents:
Reproductive Equity Now’s Provider finder
Framingham Coalition of Bodily Autonomy Facebook Handle
Resource from Gov. Healey