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Navigators, ‘medical passports,’ Lyft rides: How Planned Parenthood has worked for 5 years with out-of-state clinics on abortion access.


COLUMBUS, Ohio – In 2017, as abortion laws in Ohio and other states reduced access, Planned Parenthood and independent abortion clinics across the country began working together to analyze which states would “go dark,” the term abortion rights supporters use to describe losing them.

They created maps and looked for regional patterns. They considered the states that would likely keep at least some abortion access, and their clinics’ capacities. And they began to plan where to send women if abortion became illegal, said Iris Harvey, Planned Parenthood of Greater Ohio president and CEO.

That preparation helped prepare Planned Parenthood of Greater Ohio for today, now that abortion is illegal when a fetal heartbeat can be detected, around six weeks and before many women know they’re pregnant, Harvey said Thursday during a town hall meeting with supporters of the organization.

Recently, Planned Parenthood established a new position — patient navigators, whose job is to help patients understand the process ahead of them and ensure they’re not alone, from the moment they understand they have to leave Ohio to legally obtain an abortion, Harvey said.

Navigators assess patients’ emotional, medical and financial needs, Harvey said.

Harvey said that it’s not reasonable for an Ohio patient to understand where they can legally obtain an abortion, various clinics’ staffing limitations, state gestation limits, state waiting periods, whether clinics do medication or surgical abortion or both, among other details. The navigators help them.

“The navigators, while they are great emotional support and hand-holders, they are also the people who have the knowledge in our system to help us best figure out where is the best place to send our patient,” she said. “Is the best place the one that requires an overnight stay? Do they need an ultrasound? What will it cost?”

The navigators provide the patients with a map to the clinic if they’re driving, or a plane ticket or a car rental.

Once a travel plan and financial assistance, if necessary, has been figured out, navigators create a “medical passport” they email or hand to the patient, Harvey said.

“When they leave, they’re leaving with a passport in hand,” Harvey said. “Here’s who they’re going to see. Here’s what they can expect. We do everything we can to make it a less stressful experience for them. And we’re guaranteeing that they will receive a warm and welcoming hand at the other end of the journey.”

Navigators also coordinate any after-care a patient may need, Harvey said.

Planned Parenthood also has an agreement with Lyft to provide point-to-point car service for patients who don’t have reliable transportation, can’t afford to drive or are flying to another state and need a ride from the airport, Harvey said.

“What Lyft will do is help us to provide the exact type of transportation that the patient needs and to align it with their schedule. And we, with our funds, can pay for the rides on the patients’ behalf,” Harvey said.

Ohio made national news when the Indianapolis Star reported of a 10-year-old Ohio girl, the victim of sexual assault, who needed an abortion but was too far along to legally obtain one in Ohio. A doctor with experience in child abuse reached out to Indianapolis OB-GYN Dr. Caitlin Bernard, who was able to help.

Harvey said there have been other heartbreaking stories involving patients.

Planned Parenthood employees told an Ohio mother desperate to arrange an abortion for her 14-year-old daughter that the girl was too far along to get a legal abortion in the state, and that she needed to leave Ohio for the procedure.

The next day, when clinic staff arrived at work, they found the mother and daughter on the doorsteps. The mother told the staff, “I don’t believe this,” Harvey recalled. “Maybe this is just what you had to say. Can we just come in, can we just talk?”

The staff brought them in and connected them with a navigator, spending hours explaining an abortion was not possible and looking for a clinic out of state. The mother, who wanted her daughter to remain in Ohio, her home state, for the abortion, reluctantly accepted that they had to leave, Harvey said.

Another woman called an Ohio Planned Parenthood clinic to schedule an abortion. The staff told her she was beyond the gestation age to get an abortion legally in Ohio. She needed to go to another part of the country, Harvey recalled.

“She got very traumatized by this notion,” Harvey said. “She was almost hysterical. And no matter what they said about how they would help her do this she said to them, ‘I’m homeless. I can’t take care of myself. I can’t continue this pregnancy as a homeless person. And if you can’t help me, I have a solution for this. I’m standing here with the only thing I own, which is my cell phone. And I’m talking to you on a corner with really busy traffic. I ‘m going to step off the curb. I’m going to step in front of a car. And I’m going to end all this if you can’t help me.’”

The clinic’s staff was able to track the woman’s location. They reached a mental health crisis center, which took in the woman to ensure she was safe. When she’s less distraught, she can consider whether she wants an abortion and if so Planned Parenthood will help her leave the state, Harvey said.

These real-life stories may wake up people who don’t understand the affects of banning abortion, Harvey said.

“That’s why it’s so important that we are talking about this today,” she said. “And that we continue talking about this for the weeks, the months, the years and the decades that it’s going to take to turn this around.”

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