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 it’s available across the state. In Bristol Bay, patients seeking abortions have always faced obstacles to care. Like many medical procedures, the long-held understanding is: If you need an abortion, fly to Anchorage. Beyond that, figuring out how to access care is like trying to solve a puzzle. There are multiple healthcare providers in the region, but none provide abortion services.
Mary Swain, executive director of Camai Community Health Center in Naknek, emphasized that the clinic offers contraception and the morning after pill. But, for abortions, they only make referrals.
“We refer everybody to Planned Parenthood in Anchorage,” she said.
Cynthia Rogers, a public information officer for the Bristol Bay Area Health Corporation in Dillingham, echoed Swain’s information in an email. She said that anyone seeking an abortion in Bristol Bay can arrange an appointment with a provider in Anchorage.
Even Safe and Fear-Free Environment, a Dillingham organization that offers support for victims of sexual assault and domestic violence, doesn’t have a clear policy for people who seek abortions.
Executive Director Marilyn Casteel said they do provide the morning after pill for anyone, no questions asked. But, they would also tell people to travel for an abortion.
“Well, maybe we could say, well, there's a Planned Parenthood in Anchorage, have you given them a call?” Casteel said.
So, is it even possible to have an abortion in Bristol Bay? For Bristol Bay residents, many other healthcare services are only available by traveling to Anchorage, so abortion is not unique in that regard.
But in areas where in-person healthcare services are limited, telehealth has the potential to fill the gap. For medication abortions, all that the patient requires is two pills, mifepristone and misoprostol, which can be taken at home. The pills are 98% effective with a hemorrhage complication rate of less than 0.5% percent. In comparison, the hemorrhage rate of giving birth in a hospital is around 3%.
Yet it’s unclear how accessible telehealth services are to residents, and the medical experts interviewed for this story declined to provide more information on the availability of self-administered medication abortions.
Each local representative cited different reasons for not providing or assisting with abortions. At the Camai health center, Swain said they don’t have the facilities to address possible complications from an abortion, either medication or surgical. Casteel said SAFE would have to receive grants specifically for abortion in order to support access, and they have never received those grants in the past.
Camai and BBAHC also pointed to restrictions on abortion connected to funding from the federal Health Resources and Services Administration and Indian Health Services. Both funds do include exceptions for victims of rape or incest, or in cases when the health of the parent is in danger, but when asked about these exceptions, Rogers repeated that BBAHC does not provide abortions and that patients can make appointments in Anchorage.
Other Bristol Bay providers were contacted for this story and declined to comment, including Southcentral Foundation and the Dillingham Public Health Center.
The hesitancy around this topic isn’t just in local circles. When KDLG called the State Medical Board for more information, the person who answered the phone speculated that Board members might decline to talk because the board is “non-partisan.” However, the Board’s director of the Division of Corporations, Business, and Licensing, Sara Chambers, said questions about access to and legality around abortion are not partisan.
Chambers said that in Alaska, it’s legal for patients to be prescribed abortion pills via telehealth appointment and then receive the pills by mail.
She added that individuals who obtain abortion pills without a legal prescription will not be penalized.
“There’s no law penalizing a person for receiving a prescription that has been shipped to them illegally. The penalty would come to the person or the company who is either providing a false prescription or the company that's shipping illegally without a prescription,” Chambers said.
Rose O’Hara-Jolley, the Alaska State Director at Planned Parenthood, wrote via email that in practice, it’s difficult for Alaskan providers to offer telehealth abortion services due to factors like outdated telehealth infrastructure and insurance coverage restrictions.
They also said that pills obtained without an appointment can be safe and effective.
Planned Parenthood does not currently prescribe pills to pregnant people remotely, and O’Hara-Jolley said the organization is working on making that service available from their Alaska clinics.
For residents of Bristol Bay, the lack of telehealth abortion access leaves them with limited options. The most obvious choice is to travel to a Planned Parenthood clinic, which has locations in Anchorage, Fairbanks, and Juneau. However, the price tag can add up quickly.
A roundtrip flight to Anchorage ranges from $443 to $643, while tickets to Fairbanks and Juneau are even more expensive and can surpass $1000. Beyond that, there’s the cost of lodging, food, and the abortion itself.
According to Zhenia Peterson, a volunteer with the Northwest Abortion Access Fund, the average cost of an abortion appointment is $550, but it varies depending on the provider. Peterson said the Access Fund aims to provide financial assistance and help patients who can’t meet those costs.
“The services that we provide are pretty extensive," she said. "The main one is we do fund abortion and we help folks travel to their appointments. You know, we help folks with airfare, any type of lodging. We also do rideshares and we have volunteers that give rides. And then we have emotional support as well.”
The Fund has helped many Alaskans in the past, and their coverage includes Bristol Bay. Once a patient has an appointment, the Fund provides varying levels of support, depending on each person’s income and needs. Alaska’s Medicaid program includes coverage for abortion care, so Peterson encourages patients to apply for Medicaid as well.
In Anchorage, Planned Parenthood has trained staff to discuss all of a patient’s choices. This includes abortion, adoption, and parenting. The clinic provides abortion pills 11 weeks after the patient’s last menstrual period and surgical abortions up to 17 weeks and 6 days. Past that timeframe, patients are referred to providers outside the state. Appointments can be made on Planned Parenthood’s website.
If you have an appointment with an abortion provider and need financial assistance, you can call the Northwest Abortion Access Fund hotline at 866-962-2310.
If you live in Bristol Bay and have considered or sought an abortion, we want to hear about your experience. You can contact KDLG at 907-842-2200 or email Katherine@kdlg.org.
Get in touch with the author at Katherine@kdlg.org or call (907) 842-2200.
This story has been updated with information from the Division of Corporations, Business, and Licensing at the State Medical Board, including new information on liability for providers of abortion pills mailed without a legal prescription.