POLICY IN THE PERIPHERY
Exploring the Impacts of Abortion Restrictions in Rural Arizona
While abortion remains legal in Arizona, getting an abortion is not the same process for everyone. Factors like where you live, how much money you make, whether or not you have access to reliable transportation, and so much more can affect if and how you’re able to obtain care. That — paired with unnecessary laws that target providers — makes Arizona one of the most difficult states to get an abortion.
The Abortion Fund of Arizona receives phone calls from people needing financial assistance for their abortion care every day. Now, we want to better understand how place and policy impact the experiences of real people seeking abortion across the state.
CAN YOU HELP?
We are building a network of supporters in Arizona who want to improve access to reproductive healthcare and abortion throughout the state. We are looking for:
Social and Reproductive Justice advocates, healthcare providers, and pro-choice supporters who want to help develop this work within their communities.
Individuals living outside of the Phoenix Metro area who are open to sharing their experience accessing abortion care.
Through conversation and collaboration, we aim to reach people across Arizona who can speak to the quality and accessibility of reproductive healthcare in their region. By listening to the needs of former abortion patients and those who were never able to access care, we hope to bring this information to policymakers and community leaders to support future legislation that will help pregnant people and their families, not hurt them.
WHAT WE'RE UP AGAINST
There are currently only 7 abortion providing facilities in Arizona, and 6 of those are located in Maricopa County. The Planned Parenthood Center in Tucson only supports up to 15.6 weeks gestation, and the facility in Flagstaff only provides consultations as of May 2020. 80% of Arizona counties do not have an abortion provider nearby and many patients must either travel to Phoenix or out of the state to get care.
Like any other medical procedure, abortions are expensive. The expense begins at $500 and increases to well over $2000, based on gestational stage. Arizona’s medicaid and all private insurers do not cover the cost of care. Although Arizona does not provide abortion care beyond the second trimester, anyone who chooses to travel and have a procedure later in pregnancy will have to spend over $10,000 out-of-pocket.
The state faces some of the most restrictive abortion laws in the country that include a mandatory counseling appointment and ultrasound, followed by 24-hour waiting period; a law that limits who can offer abortion services, making it physician only; and prohibits the use of telemedicine to administer medication abortion. If the Supreme Court were to overturn Roe v. Wade, Arizona has trigger laws on the books that would make abortion illegal unless the pregnant person’s life were in danger, and a law criminalizing birth control.
COVID-19 Related Risks
With the Coronavirus outbreak, traveling and entering medical facilities now pose unique risks. Abortion providers need to take new measures to ensure the safety of their patients and staff, and there are many unknown factors in our future. We need to make sure already limited access isn’t further impacted. We have already witnessed how COVID-19 delays abortion care, as many are choosing not to travel for fear of the virus, are self-isolating, or have lost income due to unemployment from the virus and cannot afford procedure expenses.
ARIZONA'S REPRODUCTIVE HEALTHCARE LANDSCAPE
Arizona is the 6th largest state in the United States, with an estimated population of 7,278,717 people – 352,770 living in rural Arizona. Outside of Maricopa County, the next two largest metropolitan cities are Tucson and Yuma, with approximate populations of 548,073 and 100,198 respectively.
The state faces some of the most restrictive abortion laws in the country that include a mandatory counseling appointment and ultrasound, followed by 24-hour waiting period; a law that limits who can preform abortions to only medical; and prohibits the use of telemedicine to administer medication abortion.
With only 4 independent abortion clinics located in Maricopa County and 4 Planned Parenthood Health Centers in the state that provide abortion up to 16 weeks (located in Flagstaff, Glendale, Tempe and Tucson), there are many barriers to obtaining an abortion, especially for those who live outside of the Phoenix Metropolitan Area. People living in Rural Arizona may be traveling anywhere between 2 and 6 hours to the nearest clinic; if they have the resources to travel, they will also have to arrange lodging for 1 - 3 nights due to the mandatory waiting period, find childcare solutions if they are already parents, and could have to take unpaid time off work.
WE'RE COLLECTING DATA TO MAKE A DIFFERENCE
The Abortion Fund of Arizona has been collecting demographic data from pledge recipients across Arizona since 2017. From this information, we’ve seen a clear need to better serve rural Arizonans seeking abortion that goes beyond funding. With increasingly strict regulations on abortion, it’s become apparent that rural Arizonans are disproportionately affected.
The purpose of this project is to gather qualitative data about the experiences of rural Arizonans who have sought abortion. At the same time, we want to build a movement across the state to support those in need of abortion. Over the next few years, we will be building a report to inform and support future policy and repeal anti-abortion legislation to improve access to care throughout the state.
POLICIES THAT NEED TO CHANGE
Arizona’s lawmakers have passed legislation that harshly target abortion patients and providers. These laws, combined with geographic and financial barriers, make obtaining abortion care a long, expensive and taxing experience.
Arizona Revised Statutes Title 36. Public Health and Safety § 36-3604
This law prohibits healthcare providers in Arizona from using telemedicine to provide an abortion.
Telehealth is an easy, cost-effective, and fast way to see a healthcare provider, especially when distance is a challenge. With so few abortion providers across the state, having the option to see a provider and obtain a prescription for medication abortion from the comfort of ones own home would significantly increase access to care for people in rural communities.
Medication abortion is proven to be safe and is typically taken orally at home, so requiring patients to travel for this care is medically unnecessary.
The benefit of telemedicine has become even more clear during the COIVD-19 pandemic, when traveling and interacting with others poses more risk than ever before. In response to the need for social distancing, providers in states like Maine, Colorado, and more have instated telemedicine programs to make medication abortion more accessible, but this ban prevents providers in Arizona from implementing similar models.
HOW THIS IMPACTS US →
PHYSICIAN ONLY TRAP LAWS
Arizona Revised Statutes Title 36. Public Health and Safety §§ 36-2155
Surgical abortions can only be preformed by an individual who is a physician.
Arizona Revised Statutes Title 32. Professions and Occupations §§ 32-1606
This law prevents the Board of Nursing from allowing registered nurse practitioner or certified nurse midwifes to include abortion in their scope of practice.
Arizona Revised Statutes Title 32. Professions and Occupations §§ 32-2501(11), -2531,-2532
A physician assistant may not preform a surgical abortion or administer medication abortion.
physician only trap laws
Surgical abortions are one of the safest medical procedures, and complications are extremely rare. In fact, risks associated with childbirth far exceed that of abortion.
Registered nurse practitioners have applicable knowledge and skills to provide abortion care with proper training, but Arizona has several laws preventing anyone other than a physicians to preform this procedure.
By limiting the practice of qualified medical professionals’ like registered nurse practitioners, these laws put pressure on the few physicians who provide abortion care in Arizona.
Without these unnecessary constraints, RNPs who would like to offer abortion care could do so in underserved parts of the state.
HOW THIS IMPACTS US →
Judicial bypass law
Arizona Revised Statutes Title 36. Public Health and Safety §§ 36-2152
People under the age of 18 are required by law to get the consent of a parent or legal guardian in order to obtain an abortion in the state of Arizona. If parental consent is not obtained, the individual can alternatively seek a judicial bypass before getting an abortion.
judicial bypass law
While some young people feel comfortable asking a parent or legal guardian to ask for consent to have an abortion, that’s far from the case for everyone. Whether it’s a matter of necessity or choice, no one should have to ask permission from someone else to obtain care.
Even though the state offers the alternative option of judicial bypass, this system still relies on the subjective opinion of a judge, who decides if the pregnant person “is mature and capable of giving informed consent to the proposed abortion.”
This is a complicated and unnecessary process that delays the procedure date and infringes on the individual’s bodily autonomy.
This law presents even more challenges to those living outside of the Phoenix metro area, because courts may be more inaccessible, securing transportation may be difficult, and ensuring anonymity in smaller communities may not be possible.
HOW THIS IMPACTS US →
Do you live in Arizona and are passionate about building the reproductive justice movement in our state? If so, we want to hear from you, regardless of your county or zip code!
Getting involved with Policy in the Periphery is easy, and it all starts by filling out a short survey. From there, one of our volunteers will reach out to you personally to gain a better understanding of your background and interests.