COLUMBUS, Ohio (WCMH) – Two months after having her first abortion, Lexi Dotson-Dufault was interning at Ohio’s statewide abortion fund, wondering if there was a way to better help patients move through the ever-changing myriad of emotions, legality and logistics to obtain the procedure.
Although the Abortion Fund of Ohio – then called Women Have Options/Ohio – had been around since the 1990s, it wasn’t until 2019 that the fund began building its case management system, in large part due to Dotson-Dufault and others at the fund whose personal experiences seeking abortions left them feeling confused and ashamed.
Like other people she knows, Dotson-Dufault didn’t have a strong support system to rely on while navigating her options. Having grown up in a religious household that didn’t discuss reproductive health, she said negative preconceptions about abortion almost led her to continue her pregnancy, despite her desire otherwise.
“When I came into this world, I came into it very much like, I don’t want other people to feel the way I did,” Dotson-Dufault, now the fund’s patient navigation program manager, said. “You don’t have to feel that way – you can feel empowered, there is support for you, you can get the care you need.”
Demand for the Abortion Fund of Ohio’s patient services has only increased since its launch, culminating in a record number of patients seeking the fund’s support this year, with three months left to go. As of Aug. 25, the fund has supported more than 2,200 patients in 2023 – already 500 more than all of 2022, and more than double the number of patients helped in 2021. More than 1,000 patients sought the fund’s support this summer alone.
As its name suggests, the Abortion Fund of Ohio provides financial support to people seeking abortions. It also provides emotional and logistical support. Dotson-Dufault said people who seek out the fund’s help – whether by filing an intake form, emailing or calling – may have previously been given inaccurate information about their options, or were discouraged from seeking the procedure.
“I press so much about being able to provide that emotional support because the stigma that we have in our society is literally killing us and forcing us to do things – you know, stigma and barriers – it’s forcing us to do things that otherwise we would not do, that we don’t want to do,” Dotson-Dufault said.
After contacting the fund, patients can expect to be connected with a resource coordinator within 48 hours, Dotson-Dufault said. From there, the fund can help patients schedule appointments, coordinate transportation, or work through how they want to proceed with their pregnancy.
The recent, steep increase in demand for the fund’s support has not necessarily correlated with such a rise in abortions more generally.
According to the Society of Family Planning, monthly tallies of abortions in Ohio remain slightly below those performed in the months before Roe v. Wade was overturned last June. That’s coming off a significant decline corresponding with the brief period of time last summer when Ohio’s six-week ban was in effect.
Rather, Dotson-Dufault said like many other things, the cost of abortion continues to rise, and so does the fund’s average contribution per patient.
With just nine abortion clinics left in the state – two of which don’t provide surgical abortions, and all of which are concentrated in urban areas – travel can be a large hurdle for patients to overcome. Travel often comes with additional expenses like lodging, lost wages and child care. Because patients in Ohio must meet with a doctor at least 24 hours before having an abortion, requiring multiple clinic visits, those costs are amplified.
All told, an abortion can cost thousands of dollars, and Dotson-Dufault acknowledged that the people most in need of the fund’s support don’t have such amounts of cash on hand.
“Abortion is a time-sensitive matter. It’s not something you can wait around for a few years and be like, ‘Oh, I’ll get to this when I can,’” Dotson-Dufault said. “It is something very urgent. And with the cost of everything else, it is not feasible for people to come up with that money in the time they need to access this care.”
Increasing costs of abortion mean increasing expenditures for the fund, said its interim executive director Maggie Scotece. The fund’s revenue has blossomed from $1 million three years ago to more than $2.5 million expected in 2023.
“A huge chunk of that money goes right out the door, back to patients,” Scotece said.
The fund has given more than $100,000 directly to patients in August alone. Unlike other abortion funds, Scotece noted that the Abortion Fund of Ohio doesn’t have monthly caps on how much money it can give to patients. With costs and demand expected to continue to increase, she hopes the fund can continue to operate in the same way.
A legal landscape in flux meets an influx of out-of-state patients
The fund’s average financial contribution per patient has risen about $100 since 2021, Dotson-Dufault said, with patients this year receiving an average of $376. Between the uncertain state of abortion’s legality and rising costs of living, it’s difficult for the fund to predict exactly how demand, and overall costs, will change.
In Ohio, multiple paths affecting the legality and availability of abortion have diverged – all leading to a November vote on a constitutional amendment to protect access to the procedure. While many Ohioans’ eyes are on the November election, the state of abortion care has the potential to drastically change before then.
Right now, due to a temporary block on the state’s six-week ban, abortion remains legal up until 22 weeks gestation, calculated from the first day of the pregnant person’s last menstrual cycle. But that may change with the Ohio Supreme Court’s impending decision on whether the block on that ban can remain in place. Oral arguments have been scheduled for Sept. 27, and a decision by the Republican-dominated court may come soon thereafter.
During the period when the six-week ban was in effect, Scotece said travel costs alone drastically rose – costing upward of $1,000 per patient. As other states “go dark” in terms of abortion access, they said the fund is poised for similarly high expenses.
Even with the future of abortion’s legality uncertain and a six-week ban on the books, Ohio has held out as a bastion of access in a region quick to enact near-total bans since Roe fell. Ohio is nearly surrounded by states that have banned the procedure, including Kentucky, Indiana and West Virginia. To the east and north, Pennsylvania and Michigan have protected abortion access, with Michigan establishing a constitutional right last November.
Dotson-Dufault said a rising number of patients seeking the Abortion Fund of Ohio’s help are traveling from out of state – from as far as Texas and Florida – to obtain abortions in Ohio. As more people travel longer distances to access care, financial and logistical concerns continue to increase, leading abortion funds across the country to pool their resources and divide the costs.
“It really comes down to the solidarity that funds use to work together to make sure patients can get care, no matter where they’re going,” Dotson-Dufault said.
How a fund sustains its patient support
The biggest issue facing the Abortion Fund of Ohio, Scotece said, is maintaining the fund itself.
About 70% of the fund’s donations come from individual contributors in amounts ranging from $3 to $1,000. While the fund experienced a large increase in donations after Roe was overturned, Scotece said that boost dried up months ago.
Staying true to its roots is important for the Abortion Fund of Ohio, which started 30 years ago as a grassroots effort. And institutional funding for abortions has not historically been readily accessible. But as rising costs have driven up demand for the fund’s support, it’s not lost on Scotece that those costs are burdening the fund’s donor base, too.
“Our community is tapped out and tired. We are largely a mutual aid fund, so most of our donations are coming from people in the same communities that we’re serving,” Scotece said. “But as finances for the average Ohioan get tighter, it is harder for our community to show up in that way for us.”
Dedicated to meeting patients’ demand, no matter the cost, Scotece said the Abortion Fund of Ohio is currently spending more than it’s taking in -- although they hope that changes. For the fund’s patient navigation team, staffed by people who have had abortions, continuing to meet that demand is vital.
“It is such an intimate reality that we get to walk with patients through their journey,” Scotece said. “There are people on the ground who have made this their life, to make sure that if somebody calls and needs help, we will do everything in our power to make sure they get the care they need.”