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Most universities don’t provide on-site abortions – but that could soon change


A bill that would require California universities to provide medication-based abortions through student health centers passed the state’s Senate in January and could make the state the first to provide this service through universities.

California’s legislature said it has an interest in making sure young people have enough options to respond to their health concerns. Abortion is a constitutional right and an integral part of comprehensive sexual and reproductive health care, the bill said.

The movement to provide full access to reproductive health services in California began with Students United for Reproductive Justice at the University of California, Berkeley two years ago. Adiba Khan, the group’s director, said she noticed the school provided a wide variety of invasive contraception, like intrauterine devices, but didn't provide something as simple as a medication-based abortion.

Medication-based abortions were approved by the Food and Drug Administration in 2000 to terminate pregnancies up to 10 weeks. The procedure makes up 45 percent of abortions before nine weeks as of 2014, but according to a 2015 study, only two universities provide medication-based abortion at student health centers.

Khan said it's a problem that student health centers aren't providing comprehensive reproductive health care because universities have a duty to help students graduate in four years.

“Universities have student health centers to cater to common student health issues,” she said. “College students are in the age group that receives the largest number of abortions.”

Individuals aged 18-24 account for 42 percent of abortions administered in the United States each year.

“My health center has the capacity to provide a medication abortion," Khan said. "But it doesn’t because it doesn’t want to take the responsibility for providing such a controversial service."

She said she would prefer if universities decided to provide comprehensive reproductive health services on their own but will continue to support the legislation as it goes through California’s House if that's what it takes.

Students at UNC have about the same reproductive health coverage as students at U.C. Berkeley. The student health fee paid through tuition and fees covers unlimited visits to the Women’s* Health Clinic, which includes contraception and pregnancy counseling among its services. Also like at U.C. Berkeley, campus health doesn't provide any abortion services.

Antoinette Nguyen, a family planning fellow at the UNC Department of Obstetrics and Gynecology, said this is likely because students can be referred to UNC Medical Center. The Women’s Options Clinic provides contraception, counseling and abortion services through the second trimester.

Although students on the health plan provided by the school have to opt in for abortion coverage, it does not require an extra fee, Nguyen said.

While California has few restrictions on abortion access, North Carolina is on the other end of the spectrum and limits what insurance can cover and what services are provided.

People in North Carolina with public insurance plans don't have access to abortion except in the case of rape, incest or risk to maternal health, and public employees – like professors at UNC – don’t have abortion coverage, Nguyen said.

A lot of plans exclude dependents from abortion coverage, so a student may have good insurance because of their parents but may not necessarily be covered, she said.

She said educating the N.C. General Assembly about the reality of abortion could ensure equal and fair access to essential reproductive services.

College students in California often went off campus to seek abortion services because they weren't provided by their campus health centers, but UNC students still have close access to these services even though it is not technically on campus.

Statistics about the number of abortions sought by UNC students are unavailable, so it is unclear whether only providing abortion services at UNC hospitals is a barrier. Nguyen said she is not worried.

“We have a good relationship with the Women’s* Center at student health, and they are well aware of the referral network,” she said. “I don’t think that women are falling into the cracks.”

UNC students may have a wide access to reproductive health services, but that doesn't mean the fight is over, Khan said.

“Abortion is a marginalized service that is not included in primary care,” she said. “We are trying to normalize it as a common and normal part of many people’s lives.”

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Anna Pogarcic

Anna Pogarcic is the editor-in-chief of The Daily Tar Heel. She is a senior at UNC-Chapel Hill studying journalism and history major. 

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