The day I talk to Leah Coplon, she's at home because Maine is expecting 12 inches of snow and a blizzard in a matter of hours.
"There are seriously harsh winters here," says Coplon, who is the director of abortion services at Maine Family Planning. They closed 18 clinics across the state by 12:30 p.m. in order to keep staff and patients safe from the effects of Wednesday's snowfall. This isn't even the first time this year that they've had to close because of inclement weather. And in Maine, where the lowest rate of annual snowfall is 50 inches and the highest rate tops out at 110 inches, inclement usually means much more than just a slight inconvenience.
As severe weather, natural disasters and climate change affect our daily lives, these same weather patterns are affecting how people make reproductive decisions. If clinics like Coplon's close due to weather, there's a domino effect of how many people can seek care and how soon. When unforeseen weather is combined with a state-level push by conservatives to legislate away abortion access, it becomes a complicated storm of medicine, access, and affordability.
Hurricane Harvey rammed into the coast of Texas late on a Friday night at the end of August. Even with advance monitoring, there was no way to adequately predict the extent of the flooding, housing insecurity, and damage that the storm would leave its wake.
In the immediate days following its landfall, thousands were displaced from their homes. Amy Hagstrom Miller, the founder, president, and chief executive officer of Whole Woman's Health, knew her organization would step in to alleviate at least one financial burden of those affected by Harvey: The organization would offer free abortions in September.
"People need abortion care because circumstances change if you lose your house or lose your job and you have to evacuate," Hagstrom Miller says. Social media, and the increased visibility of Whole Woman's Health after their lawsuit at the Supreme Court in 2016 to defend abortion access in Texas, meant their offer became visible to many more people than similar offers they'd run during previous storms, including Hurricanes Ike, Rita, and Katrina. Whole Woman's Health has so far gone on to pay for 85 abortions through their Stigma Relief Fund.
SATANISTS JUST MADE IT A LITTLE EASIER TO GET AN ABORTION IN MISSOURI: During oral arguments for a lawsuit between the Satanic Temple and Missouri over abortion restrictions, the state solicitor general debunked the notion that an ultrasound is legally required for any woman seeking an abortion. That in itself is a minor miracle.
"To me, it fits into our philosophy: Abortion care workers are human rights workers. We see our work as human rights work, so of course we have a natural disaster plan in our minds because we know the kinds of situations that really affect people's lives and how these kind of emergencies can greatly affect families," Hagstrom Miller says.
Between 300,000 and 500,000 cars were damaged by Harvey. If you were lucky enough to be a person in Houston whose home was spared and whose clinic got to re-open, there was still a chance your ride wouldn't be there for you.
This was where Clinic Access Support Network stepped in. The Houston-based non-profit provides free transport and accommodations to those seeking abortion care in the area. CASN saw a 30 percent increase in requests for support after the storm. Weeks after the storm, the organization did an emergency onboarding for new volunteers because they had so many clients to take on.
The post-Harvey work culminated with 141 drives in December, the group's largest month ever. One organization that CASN frequently works with, Fund Texas Choice, ran out of money at the end of the year and had to shut down in December. "So, we took over the Houston area," says CASN executive director Angie Hayes. CASN spent more in December than the rest of the year combined. In 2017, about 80 volunteers gave 11,000 hours to the organization's mission.
As clinics and organizations look for ways to work through extreme weather, one solution has been tele-abortion, or medication abortion provided via a secure Internet connection.
Maine Family Planning started in 2014 at some of the most rural sites before expanding into all 18 locations in 2016. (Planned Parenthood operates 24 telemedicine locations around the country and will open another 10 before the end of the year.)
Maine is a rural state, and staff routinely drive an hour to work. Weather wasn't the only reason for these systems, but telemedicine has been well received by patients and staff. It was incredibly helpful during the January storm that closed their sites for an entire day. When combined with electronic health records, it lessened the severity of the clinics closure.
"In the past it just would have been such a scramble to make sure everybody's needs were met but because of our telehealth system, what we did is we had many of our patients instead go to their local clinic and have a medication abortion via telehealth," Coplon says.
Whole Woman's Health also uses telemedicine for medication abortion in its rural Illinois clinic, in addition to facilities in Maryland, Minnesota, and Virginia. It's been great for patients who have difficulty traveling to clinics, and also reduces doctor travel time, Hagstrom Miller says.
"If the doctor can tele-communicate, we can still offer services," she adds. "They get to be seen sooner and have their care earlier in the pregnancy."
As natural disasters continue to rack up with growing frequency and increasing severity, services like the kind that Whole Woman's Health are providing are much more than just temporary stopgaps. "Knowing that people who needed abortion care might not be able to afford it or their lives might be in peril because of the hurricane ... [it] felt like a way we could use our expertise and our mission to help the community," Hagstrom Miller says.