As well-publicized fights over abortion play out around the country, particularly in states like Texas and Mississippi, quieter changes to abortion access laws are being made closer to home.
On October 27, the Illinois House and Senate passed HB 370, the Youth Health and Safety Act. The measure now awaits action by Governor J.B. Pritzker.
HB 370 would repeal the Parental Notice of Abortion Act, which mandates that if anyone below the age of 18 wants to have an abortion, a health care provider must notify an adult family member at least 48 hours before the procedure.
For some young abortion seekers, the parental notification law creates a significant barrier in obtaining abortions, according to pro-choice organizations. Human Rights Watch issued a report in March that says the reason young people do not view notifying an adult family member as a plausible choice is usually due to safety concerns. “They often fear physical or emotional abuse, being kicked out of the home, alienation from their families or other deterioration of family relationships, or being forced to continue a pregnancy against their will,” the report states.
The parental notification law includes a judicial bypass option, in which abortion seekers may appear at a court hearing with an American Civil Liberties Union-appointed lawyer to explain to a judge why it is in their best interest to obtain an abortion without alerting parents or other adult relatives.
But organizations like the Illinois Caucus for Adolescent Health say the judicial bypass option is inaccessible and invasive for many, requiring youth from Cook County to find transportation to Richard J. Daley Center and take time off from school. Arguing that the law needs to be repealed, they led the fight for HB 370, which also would create a bipartisan group focused on helping pregnant and parenting youth.
Clinic locations can pose obstacle
While Illinois has some of the firmest legal protections for abortion access in the Midwest – with the Reproductive Health Act and eradication of mandates such as a 24-hour waiting period and required ultrasounds, and now, the likely repeal of the Parental Notification Act – a lack of nearby facilities that provide abortion services still poses an obstacle for many.
Chicago offers the highest level of abortion access in Illinois, but in rural towns and even suburbs like Evanston, abortion access can be a struggle for residents who must travel to obtain care.
According to the Power to Decide Abortion Finder, a national comprehensive directory of abortion services, there are 31 health centers in Illinois where abortions can be obtained, either a medication abortion or an in-clinic abortion.
For Evanston residents seeking abortion care, however, there is no health center listed on the abortion finder website within city limits. Telehealth for medication abortion is legal in Illinois, but for those who may not know about the virtual service, or are in need of in-clinic care, there are five options near Evanston: Careafem in Skokie, Planned Parenthood in Rogers Park, Women’s Aid Center in Lincolnwood, American Women’s Medical Group in West Lakeview and Planned Parenthood in downtown Chicago.
Each health center provides different options for abortion seekers: Rogers Park Planned Parenthood and the Women’s Aid Center have only the medication abortion pill, and Carefem offers in-clinic abortions up to 13 weeks of pregnancy. For Evanston residents who are later in their pregnancies and need in-clinic abortions, they must travel to Lakeview or downtown Chicago, where doctors perform in-clinic abortions up to 20 weeks.
Michelle, an Evanston resident who preferred to share only her first name, has had two abortions. The first was when she was a student at Evanston Township High School.
“I was so clueless about the whole situation; I just had no idea what to do,” she said.
Michelle said her mother was supportive of her choice and found a health center in Skokie (now closed) that performed abortions. Michelle’s second abortion was in 2016 at Planned Parenthood in downtown Chicago, because the pregnancy was further along and that location was the closest one that offered care. Michelle, like other abortion seekers, had to coordinate travel time, time off work and come up with the money to cover the bill. She would like to see Evanston have greater access to abortion.
“A lot of people here don’t have access,” she said. “It can be far, and I would like to see the support of abortion clinics for the residents of Evanston. There is no place you can go; even if you go to the doctor, they will usually refer you out. Some people don’t have cars and can’t make it on the bus – they just don’t have the money. Abortions cost a lot, and then having to find your way to a clinic, it’s expensive.”
Amita Health Saint Francis Hospital of Evanston and the Midwest Center for Women’s Healthcare did not respond to the RoundTable’s requests for interviews, but neither of their websites provide information on abortion.
NorthShore University HealthSystem provided the following statement: “Our providers do offer elective termination of pregnancy to their patients if together they determine that is the appropriate care plan for patients’ health needs. Evanston Hospital does not operate an abortion clinic.”
NorthShore denied requests to interview a member of the OB-GYN department for further details.
Jennifer Johnsen, vice president of digital programs and education at Power to Decide, said the reason that hospitals usually aren’t listed on abortion finders is that even if they offer minimal care, there still may be barriers that make care inaccessible to some who need it.
“The number one thing that determines if a provider goes on abortion finder or not is if they advertise abortion services,” she said. “A hospital who may not be ‘out’ about the services they provide, we don’t feel like we are the right place to add them. We don’t want to elevate providers that have barriers. The whole point of the website is to reduce barriers. If there are places you would have to endure barriers at, we would rather send you somewhere else rather than a hospital.”
After the 1973 Supreme Court decision in Roe v. Wade legalized abortion nationwide, the health care system largely narrowed to two options: reproductive health centers that provide abortion, and hospitals that only provide medically complex abortions needed to save the life of the pregnant person.
Health centers can be less expensive and hire staff members that support abortion care and access, but they can also attract the attention of anti-abortion protesters. In the late 1980s, 86% of abortions were performed in health centers nationwide. By 2017, the number had grown to 95%.
ETHS health center offers counseling, aid
Ida Joyce Sia, a registered nurse at the ETHS health center, and Julie Russell, a nurse practitioner, said Evanston’s rates of teen pregnancy are similar to national rates. The health center works in partnership with the school, city and NorthShore University HealthSystem to provide comprehensive primary care services to students, regardless of health insurance status, including reproductive health.
The center offers pregnancy and sexually transmitted infection (STI) testing, as well as contraception, including the morning-after pill, free to students. Sia and Russell also have worked with students to help them find abortion care, if that is what they are seeking.
“If one of our patients has a positive pregnancy test, we counsel them about all of their options, including abortion, adoption and continuing the pregnancy,” Russell said.
Russell and Sia help provide resources for students to use parental notification judicial bypass programs and abortion funds, like the Chicago Abortion Fund, that offer financial assistance, as well as explain other options, such as carrying the pregnancy to term and adoption.
“We as a school-based health center refer to organizations that do abortion, versus hospitals that do not advertise abortion as a service,” Sia said, explaining how they determine where to refer students. Students are often referred to the five closest health centers, but not to NorthShore.
Sia explained that a concern of hers is that students may not know all the services the school health center offers and that they can utilize them, even if they aren’t NorthShore patients.
“We don’t want there to be any stigma about coming to the clinic,” Sia said. “We try to be really transparent with families and parents, but sometimes there is a misconception that we are hiding information. We are trying to respect the confidentiality of students.”
The health center offers birth control pills, including the NuvaRing, the Patch, the Depo-Provera shot and emergency contraception like Plan B.
Maya Acacia, a senior at ETHS and member of the Intersectional Feminists United Club, said abortion access in Evanston is something she and her club members think about, as well as the services that ETHS offers.
She said that although she has attended ETHS for three years, she didn’t know that much about the services at the health center until health professionals came in and spoke to her class.
“Not every school in the nation offers these services, so I think its mission should be spread more around the school,” she said.
Acacia said abortion access is something she feels like she just started thinking about because of the fight over Texas’ law and joining the club at ETHS.
“I feel like it is absolutely crazy you can’t get an abortion in Evanston,” Acacia said. “It makes it less accessible to students; there is a time limit to do so, and it is important that we have a place in Evanston to get abortion care because, for some, Chicago can be a long commute. There is always a stigma around abortion access. People should do what is best for them.”