“If the government controls our reproductive rights, we are not free,” the ACLU of Iowa posted on social media July 4. The sobering message was a reminder that on this Independence Day, the hard work is just beginning.

Iowans who can get pregnant will soon be less free than at any time since I was three years old.

There is no simple path to restoring reproductive freedom in Iowa. Unlike many other state constitutions, our founding document provides no way for citizens to force a statewide vote on whether abortion should be legal.

Even so, Iowans can take concrete steps to help those who will have no legal option to terminate a pregnancy here, once the state is able to enforce a near-total abortion ban (sometime after July 19).

1. DONATE TO AN ABORTION FUND

Obtaining an abortion is about to become far more costly for Iowans.

Although Planned Parenthood North Central States and the Emma Goldman Clinic will continue to provide abortion services at some of their Iowa clinics in compliance with state law, most patients won’t be able to confirm a pregnancy and schedule an appointment before embryonic cardiac activity can be detected using an ultrasound. More than 90 percent of abortions happen beyond that point, which varies for individuals but often occurs around six weeks after the last menstrual period.

The vast majority of those facing an unwanted pregnancy will need to travel out of state to exercise their rights.

The Iowa Abortion Access Fund announced on July 1 that due to the Iowa Supreme Court’s ruling, the organization will partner with the Chicago Abortion Fund “to provide comprehensive support to Iowans and Quad Cities area residents in need of abortion care.”

Iowans seeking grants to help pay for abortion services should contact the Chicago Abortion Fund at (312) 663-0338, or using this intake form.

The Iowa Abortion Access Fund will continue to provide financial assistance to Iowans to help cover “wrap-around support costs, such as gas, travel, lodging, and childcare.” Supporters can make a one-time or monthly gift online through the group’s website or contribute using Venmo, or mail cash or checks.

Iowa’s leading abortion providers have also promised to help patients obtain care out of state. Ruth Richardson, the president and CEO of Planned Parenthood North Central States, told reporters on June 28 that the organization has “spent months planning for this moment.” She said patient navigators have helped more than 4,000 people access abortion care since the U.S. Supreme Court overturned Roe v. Wade two years ago. A majority of those patients came from Iowa, which Richardson attributed to the “manufactured chaos” and confusion surrounding efforts to ban abortion here.

Richardson said about 80 percent of the clients aided by Planned Parenthood navigators during the past two years “would not have been able to get access to abortion care but for the financial support that came from working with our navigators.” Abortion bans disproportionately impact lower-income people.

“While any time a patient is forced to travel across state lines for essential health care is devastating,” Richardson said, the organization has made “long-term” investments across their five-state region to address the expected needs. Planned Parenthood has expanded health centers in Mankato, Minnesota (where abortion is legal) and Omaha, Nebraska (where abortion is legal up to twelve weeks). Abortion services are also available at the Planned Parenthood clinic in Rochester, Minnesota, which may be more accessible for northeast Iowa residents.

Francine Thompson, executive director of the Emma Goldman Clinic in Iowa City, told reporters on June 28 that her organization “remains committed to helping connect Iowans with the essential, life-saving health care they need and deserve.” Like Planned Parenthood, the Emma Goldman Clinic will continue to provide other services, such as contraception, gender-affirming care, STD testing, and cervical cancer screenings.

2. OBTAIN SUPPLIES FOR YOURSELF OR SOMEONE ELSE

Now that four Iowa Supreme Court justices have determined that only the government’s interests matter, and what pregnant Iowans want or need counts for nothing, it has become more important to prevent unplanned pregnancies or confirm them as early as possible.

Free birth control options

The Family Planning Council of Iowa, a statewide nonprofit, launched a Free Reproductive Health Kits for Iowans initiative during the summer of 2023. The kits contain “two doses of emergency contraception (EC, or the morning-after pill), condoms, lube, and a reproductive health guide to help Iowans navigate sexual and reproductive health decisions.”

As the Family Planning Council’s executive director Allison Smith told Bleeding Heartland this week, “No amount of funding for or access to contraception will ever negate the need for abortion. Both are essential health care services that must be made available to everyone who seeks them. However, in a world where access to abortion is severely limited, it is even more important for people who want contraception to be able to affordably and easily access it.”

Anyone can request a kit through the Family Planning Council’s website. (The organization also accepts donations to help cover the costs.) Alternatively, Iowans of any age can pick up a free reproductive health kit, no questions asked, at any of the following locations:

• Community Health Care – Edgerton Clinic in Davenport
• Crescent Community Health Center in Dubuque
• Great River Family Planning of Southeast Iowa in Burlington
• Planned Parenthood locations in Des Moines, Sioux City, and Iowa City
• Primary Health Care in Ames and Marshalltown 
• Siouxland Community Health Center in Sioux City
• Trinity Muscatine Public Health in Muscatine 
• Women’s Health & Family Services in Clinton and Maquoketa

In addition, the My IA Condoms program “allows Iowa residents to receive a free envelope of sexual wellness supplies delivered discreetly to their door, up to twice per 30 days.” The envelopes include regular, non-latex, or internal condoms, as well as sachets of silicon lubricant.

Low-cost pregnancy tests

Robin Marty, author of the New Handbook for a Post-Roe America and an employee of a women’s health center in Alabama, recommends ordering bulk pregnancy tests for anyone living in an abortion ban state. The most affordable tests have only strips, without plastic holders. This week, I found several options for packages of 20, 30, or 50 pregnancy test strips at prices ranging from $8 to $20.

Those who think they may be pregnant need to test promptly and not wait a week or two to see what happens—even if they have irregular menstrual cycles. Confirming a pregnancy at five weeks rather than seven or eight weeks could determine whether someone can get an abortion close to home or will be forced to travel hundreds of miles.

Emergency contraception

Emergency contraceptives are valuable as a backup, and some (such as “Plan B”) are available without a prescription. Marty discourages stockpiling, because doing so could lead to supply shortages for those with an urgent need. She recommends that people who could become pregnant keep one emergency contraception package for themselves and possibly a second one, in case a friend needs it.

Note that Plan B can typically prevent pregnancy for up to three days after unprotected intercourse, but may not be effective for people weighing more than about 155 pounds. The prescription pill known as ella is effective for up to five days, and for people weighing up to about 195 pounds. Some health care providers may arrange for patients to have an advance provision of the prescription on hand.

The most effective form of emergency contraception is a hormonal IUD (intrauterine device). It may be challenging for Iowans to schedule an appointment for an IUD insertion within five days of unprotected sex or a birth control failure, but that option is worth exploring.

Use caution if ordering abortion medications

Self-managed abortion has become more common since the U.S. Supreme Court overturned Roe. The ban Iowa will soon be able to enforce (House File 732) regulates when physicians can or cannot perform abortions, but is silent about pregnant people administering their own abortions.

Planned Parenthood will provide medication abortions to Iowans who travel to their clinics in other states, but will not mail medications for Iowans to use at home.

While some funds offer medication abortion supplies, Marty warned during an Access podcast episode from 2021 that there is no guarantee those will arrive quickly after an order is placed. Mifepristone—which is still legal for now—is most effective when used up to 11 weeks after the last menstrual period.

Online safety is essential for anyone seeking out abortion-related resources, and Marty discusses that at length in the second edition of her handbook.

3. BE VOCAL ABOUT SUPPORTING ABORTION RIGHTS

A clear majority of Iowans think abortion should be mostly or always legal, but not everyone feels comfortable talking about it in public. Posting about reproductive rights on social media is an easy way to let your contacts know the issue matters to you.

Planned Parenthood Advocates of Iowa encourages supporters to share personal stories, which “are powerful tools for change” and “can humanize the issue and highlight the real-world impact of restrictive abortion laws.” Planned Parenthood North Central States collects accounts from former clients but doesn’t share those publicly before following up with storytellers.

It’s also important to be supportive of people you care about who have had an abortion or are planning to terminate a pregnancy. Speaking to reporters in 2022, after it became clear the U.S. Supreme Court was going to overturn Roe, Iowa Abortion Access Fund board member Frieda Bequeaith urged like-minded people to discuss the topic with co-workers, family, and friends.

Let people know that you are a safe person to talk to it about, that you would help provide child care, provide money, transportation, that you would cover a shift for them. Let them know that you would support them through that.

Another way to express your views is to attend a rally or demonstration, like the one reproductive rights advocates organized outside the state capitol on June 28. In The New Handbook for a Post-Roe America, Marty shared tips for activists who may want to counter an anti-abortion protest or do civil disobedience in the service of reproductive rights.

4. VOLUNTEER WITH REPRODUCTIVE FREEDOM ADVOCATES

The ACLU of Iowa is building a network of political volunteers focused on protecting reproductive freedom in Iowa. You can sign up here or by emailing outreach@aclu-ia.org. Planned Parenthood Advocates of Iowa have volunteer opportunities as well.

If you prefer to avoid the political arena, there are many other ways to help, such as assembling the Family Planning Council of Iowa’s reproductive health kits or taking Iowans in need of transportation to appointments.

Speaking to The Cut in 2022, Oriaku Njoku, the co-founder and executive director of Access Reproductive Care–Southeast in Atlanta, suggested contacting a local abortion fund or clinic offering reproductive health care. In addition to obvious ways of volunteering like serving as a clinic escort, you may have other useful skills, such as IT support or helping with event planning or media outreach.

5. VOTE FOR CANDIDATES WHO SUPPORT LEGAL ABORTION

As Bleeding Heartland explained here, Iowans can’t collect signatures to force a statewide vote on abortion rights. Only the Iowa legislature can put a proposed state constitutional amendment on the ballot. That won’t happen for the foreseeable future, because Republicans know their stand on abortion is deeply unpopular. That’s why they never followed through on their anti-abortion amendment, phrased like one that voters in deep-red Kentucky rejected in 2022.

Republicans have majorities of 64-36 in the Iowa House and 34-16 in the Iowa Senate, and Democrats are not positioned to win back control of either chamber this year. Nevertheless, every seat gained could help deter further efforts to regulate abortion, restrict contraception, or adopt “personhood” language that threatens fertility treatments.

That’s especially true if the majority party suffers surprising losses in state House or Senate seats that neither party targeted.

Conversely, if Iowa Republicans hold all four U.S. House districts and maintain or expand their large legislative majorities in November, they will interpret those results as a mandate for their agenda, including stripping bodily autonomy from Iowans.

For decades, Republicans benefited from an asymmetry in U.S. politics: while a majority of Americans believed abortion should be mostly legal, those seeking to ban the procedure were more likely to be single-issue voters. An October 2022 Iowa Poll by Selzer & Co for the Des Moines Register and Mediacom found that 33 percent of respondents who planned to vote for Governor Kim Reynolds also thought abortion should be mostly or always legal.

National polls suggest the dynamic has shifted since the U.S. Supreme Court’s Dobbs decision; now abortion is a more salient issue for voters who think government shouldn’t interfere in medical decisions.

It remains to be seen whether Iowa Democrats can attract pro-choice voters who have backed GOP candidates for other reasons in the past.

During a virtual press conference on June 28, Democratic legislative leaders and all four of the party’s Congressional nominees promised to make abortion a central issue of this fall’s campaigns. They predicted that voters would hold Republicans accountable for overreaching and taking away women’s freedom. Iowa Democratic Party state chair Rita Hart said enforcement of the ban would “be a game-changer” and “slap people in the face.”

Iowa House Minority Leader Jennifer Konfrst added that the change was “theoretical” for Iowans in 2022, but now “it’s reality.” Thanks to media coverage of horror stories from other states, Iowans are also more aware of how abortion bans harm women.

Electing more pro-choice candidates won’t undo the damage wrought by Republican legislators and conservative Supreme Court justices. Nor will it replace the ongoing need to help pregnant Iowans access services in other states. But it is an essential step toward restoring what we’ve lost.

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Top image was first published on Facebook by Planned Parenthood Advocates of Iowa. Many other photos from the June 28 rally following the Iowa Supreme Court’s abortion ruling are available here.