For more recent information, see Abortions in Bristol Bay: Legal but difficult to navigate.
In the wake of the recent reversal of Roe vs. Wade, abortion remains legal in Alaska and is protected by the state constitution’s right to privacy. But that doesn’t mean abortion is available across the state.
Earlier this month, KLDG’s Katherine Moncure reported on abortion access in Bristol Bay. She spoke with fellow reporter Brian Venua about the experience of searching for information on a highly polarized issue.
Brian Venua: Last week, you were working on a story about abortions, and that's a difficult topic to talk about at all. But it also seems like you've had a hard time even trying to talk to medical professionals about accessibility here in Bristol Bay.
Katherine Moncure: Yeah. My main goal was just to kind of get a lay of the land, especially with Roe vs. Wade being overturned. I was wondering – if someone in Bristol Bay were to seek an abortion, what's available?
So I figured sources like Planned Parenthood, for example, would be difficult to get in touch with because they're huge. They have a really broad footprint and I'm sure a lot of people were contacting them as well.
I think what I didn't anticipate as much was just the lack of information from local providers and organizations. Some sources that I reached out to declined to comment or speak on the record. Some were also very polite and happy to make themselves available for me, but just didn't have information. And I think that's what surprised me the most, was just that local providers referred everyone to Anchorage for all abortions and then just stopped at anything beyond any other information, any other advice or help.
Venua: Yeah, so I'm from here. That's kind of not really surprising for me and for a lot of our listeners even. But I just kind of grew up knowing that like for most major medical procedures, you just kind of have to go to Anchorage. Like when I was 14, I broke my arm and I ended up having to go there to get it realigned. But you're from a city downstates. So what was your reaction to just learning about what accessibility was like here?
Moncure: Yeah, I think that, because of course, we're in a rural place, right? This is not a city. So it makes sense that there's a lot of other health care services that you can only get from going to Anchorage.
But the thing about abortions is that they can be really simple and straightforward. So there are two types of abortions. There's medication abortion and surgical abortions. And for a surgical abortion, sure, maybe local providers have the right equipment, the right training. That makes sense.
For a medication, abortion, which patients are eligible for in the first 11 weeks of pregnancy, it's just a matter of taking two pills. And those pills are highly effective. They're safe. This can be done at home. You don't need access to special equipment, an operating room, anything like that. You just need the pills. I think that was what was striking, and it doesn't seem like anyone in this area prescribes those pills or carries them.
For most sources that I spoke with, when I asked about abortion pills, they couldn't provide information. Or they said, it's an abortion, they don't provide abortions, period.
A few sources indicated that providing medication abortions just carries too much risk. So if the patient were to have complications, which basically means excessive bleeding, then the best safe place for something like that would be to go to Anchorage where there are more resources and donated blood available. Everyone I spoke to, they all were just pointing toward just go to Anchorage.
Venua: So if someone does go to Anchorage, I guess it just becomes a question like what are the benefits of being there? Versus like if they just wanted to administer pills themselves, like why go to Anchorage?
Moncure: So Anchorage would have the right equipment. In theory, they would have plenty of donated blood available if the worst case scenario were to happen.
Now, the likelihood of that worst case scenario happening is less than half a percent. So it is very rare. The likelihood of someone hemorrhaging or bleeding like that when delivering a baby in a hospital, just for reference, is six times higher, 3% versus 0.5% from a medication abortion. A medication-induced abortion is basically the same biological processes having a miscarriage. So definitely Anchorage or another well-resourced area is going to be a safer place for a medication abortion in case those odds do get tested.
The reality is that logic – it makes sense when you're just thinking about that risk. But when you take a step back, if someone can't make it to Anchorage, if they don't have the money, it's very expensive, if they can't take off of work – it's a risk. But the individual also needs to weigh, what's the risk of this less-than-half a percent hemorrhage complication versus the consequences of never getting that abortion and carrying the pregnancy to term. For someone who can't get to Anchorage, maybe that's a risk that they would be willing to take. Maybe that less-than-half a percent risk is something that is very much worthwhile for them if it means the outcome of the rest of their life.
Venua: Especially living in a rural area and especially even during the pandemic, telehealth has become a big thing. And in your story, I know you talked a little bit about telehealth being legal, but in practice it could be really difficult to talk about or access. So could you expand on that a little bit and talk about some of your findings there?
Moncure: So that's correct. Telehealth appointments to be prescribed abortion pills are legal. In terms of why telehealth services for abortion aren’t actually available in practice, that was also something that was a little bit difficult to find information on.
When I talked to my source at Planned Parenthood, they could only give me general information why they don't offer telehealth services [for abortion] in Alaska but no specifics. My understanding is just that it's extremely complicated and that the status of political influences and insurance and telehealth providers, the nitty gritty stuff that I guess is just constantly changing, is being fought over right now.
Venua: So it seems like the entire system surrounding abortions is just murky from the information that you can try to get to the entire approach, especially if you can't make it to Anchorage.
Moncure: Exactly. Yeah. When there are certain topics that just have so much political or emotional charge, it can create a lot of hesitancy in people wanting to talk. I'm sure the fact that I'm a journalist going to sources, asking these questions has a lot to do with it, too, the fact that it's this very polarized thing and I'm also the media, put together. But even in that process, I tried to be really clear that I was only asking about what health care services people provide, not their personal opinions around it. But yeah, there were a lot of people who just didn't even want to get near the topic.
That political polarization just makes accessing care and understanding what is and isn't legal just that much more complicated for a pregnant person who's trying to find that information.
Venua: There's definitely a lot to unpack about abortions and the conversation surrounding it. So thanks for coming in and talking about that.
Moncure: Thank you, Brian.
Get in touch with the authors at Katherine@kdlg.org and Brian@kdlg.org or by calling (907) 842-2200.
