US colleges face new dilemma over abortion services

US colleges have become the new battleground over access to abortion services as some students demand schools supply women with medication abortions, but anti-abortion advocates say the pills used shouldn't be handed out on campus after the Supreme Court overturned Roe vs Wade in June.

US colleges and universities often provide a range of sexual and reproductive services to students, including screenings for sexually transmitted diseases, birth control and insurance to cover an abortion. But most don't provide an abortion or medication abortion (done with pills) directly to students. They will, however, offer advice and connect students to reproductive health services.

Anti-abortion advocates say women shouldn't get access to abortion pills on campus, despite women in their 20s accounting for 57 percent of all medication abortions in the US in 2019, according to the Centers for Disease Control and Prevention (CDC).

Carol Tobias, president of the National Right to Life Committee, a pro-life, anti-abortion organization. told China Daily, "The abortion industry refuses to give women complete information about possible complications so, no, abortion pills should not be given to unsuspecting young women on college campuses."

Medication abortion, also known as plan C, is abortion done with pills that a woman can take by herself at home without the help of a doctor. However, approximately19 states have laws requiring a medical clinician to be present as she takes the medication.

To make the abortion pills work, two drugs are needed. mifepristone is the first. It works by blocking the hormone progesterone, needed for a successful pregnancy. The second pills, misoprostol, are taken one to two days later and empty the uterus. Misoprostol alone can be used if mifepristone isn't available.

A handful of colleges including the University of Illinois-Chicago provide abortion pills to students. In Massachusetts, where abortion is legal, the University of Massachusetts-Amherst will begin offering abortion pills in the fall.

In California, a law requires all of the state's public universities to begin providing medication abortion at their health centers on campus by January 2023. The University of California's Berkeley campus already provides the abortion pill.

Students in California must use the University of California's student health insurance plan to cover the costs of a medication abortion. Those who waive the insurance requirement have to pay for the medication themselves. Community colleges are exempt from the law.

A 2018 study by University of California researchers published in the Journal of Adolescent Health found that 300 to 500 public university students in California sought medication abortions each month.

The average cost of a medication abortion was $604, and the average wait time for the first appointment was one week.

Students at Barnard College and Columbia University in New York, a state where abortion is legal, recently demanded that medication abortion be available through the university's health service.

However, a spokesperson for Columbia told students: "Private physicians' offices are usually less crowded, have shorter waiting time, afford more privacy and feel more personal. Clinics or nonprofits such as Planned Parenthood may allow greater anonymity."

A spokesperson for Barnard said it was committed to working with students and local organizations to increase access to reproductive healthcare, including pregnancy termination in a "post-Roe environment".

In the US, abortion pills are widely available with a prescription from a doctor or from an online pharmacy. They are safe and 95 to 98 percent effective in the first 10 weeks of pregnancy. Under federal law, the pills can then be delivered directly to a person's home.

Elisa Wells, co-founder of Plan C, told China Daily: "[The] pills are extremely safe, and [a woman] can safely self-manage an abortion at home."

However, several Republican-led states, including South Dakota, Texas, Kentucky, Arkansas, Ohio, Tennessee and Oklahoma want to restrict access to abortion pills.

That could create an uncertain road ahead for universities that want to offer them but may be restricted by state law. It will also place limits on publicly funded colleges and small colleges with no healthcare center on campus.

In Texas, abortion is restricted and will soon be banned. But in 2019, the majority of women (57 percent) who got abortions in the state were in their 20s and 30s, according to the Texas Health and Human Services Commission.

Nimisha Srikanth, a senior at Texas A&M University, told National Public Radio that any student who found herself pregnant wouldn't seek care on campus as they would fear being reported.

The American College Health Association, an organization that represents more than 700 institutions of higher education and the health of 20 million college students, warned in a statement that the Supreme Court's ruling will "directly endanger college health professionals' ability to provide evidence-based, patient-centered care, and may place them in legal jeopardy".

To safeguard medication abortion, President Joe Biden signed an executive order on July 8, expanding access to abortion pills. But critics say it isn't enough.