Photo Credits: CAITLYN SAMPLEY / AGGIE
To our future patients
As future medical providers, we are faced with the impending challenge of meeting patients’ needs in an era of historic hostility to health care access, including abortion care. One in four women will need an abortion in their lifetime. Yet stigma, as well as barriers like cost and distance, increasingly put this safe, clinically simple medical procedure out of reach. These barriers severely limit access to reproductive health and abortion care, especially for low-income, minority and queer communities.
California college students are our future patients, and part of our job as their doctors is to do all we can to ensure their long-term health, well-being and success. Patients’ ability to make personal decisions about whether to have a child and get the reproductive health care they need without burden or delay is critical to their futures.
Once again, California has the opportunity to set an example as a leader in reproductive rights and access to abortion by enacting the College Student Right to Access Act, Senate Bill 24. The bill requires all 34 UC and CSU campuses to provide medication abortion to students on campus, alongside their existing primary and reproductive health care services.
Every month, up to 519 UC and CSU students seek medication abortions at off-campus health care facilities, according to research by Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, San Francisco. Students, just like all patients, have the right to receive health care in the setting they choose — and for students, it’s often the on-campus health center. They shouldn’t be forced to make multiple, often expensive trips off campus and pay out of pocket when they could easily get medication abortion care from the health center staff they already know and trust.
As medical students, we constantly see the impact of our multi-tiered health care system on our peers who, like the vast majority of UC and CSU students, don’t have a car. And it’s not assumed these students know someone to confide in someone about sensitive medical issues in the hopes of getting a ride to an off-campus health center.
Over half of the students in the UC and CSU system are low-income students, and many struggle to meet their basic needs. ANSIRH research found that one quarter of UC students had to choose between paying for food or housing expenses, and 9% of CSU students suffer from housing displacement. Unexpected expenses, such as paying for transportation to off-campus providers, disrupt both a student’s immediate life and their overall academic career. We should be proactive in caring for these needs; the College Student Right to Access Act tells current and prospective students that their long-term success matters.
Eighty-nine percent of students say that having a child while in school would make it harder to achieve their goals. Only five of the off-site providers closest to UC or CSU campuses have any weekend hours available, and those appointments fill up quickly. Overall wait times at off-campus clinics can be up to three weeks, a timeframe that can potentially delay care past 10 weeks (the latest timepoint for which medication abortion is recommended) and force students to instead seek out an in-clinic procedure.
Additionally, being denied reasonable access to abortion services results in increased mental health issues, including increased incidence of anxiety. The additional burden of mental illness when denied access to abortion care, combined with the financial and transportation limitations of UC and CSU students, may greatly impact their academic, personal and professional ability to thrive. Each month an estimated 1,038 UC and CSU students seeking abortion — whether medication or an alternative form like surgical abortion — must consider these factors and potential hurdles.
University health centers already offer other reproductive health services such as birth control and STI testing. Medication abortion is clinically simpler to provide than many of the services already offered at student health centers, such as diabetes management and mental health care.
By offering medication abortion on our state’s university campuses, we help ensure that all students have an equal opportunity to build the lives they are working so hard to realize.
Written by: Caitlin Esparza and Kevin Mortazavi
Caitlin Esparza is a second-year medical student at UC Davis and Kevin Mortazavi is a second-year medical student at UC Davis, an alumni of UC Riverside and earned his masters degree in public mental health from Johns Hopkins Bloomberg School of Public Health.