On a recent Saturday morning, the protesters are in their usual spot outside Pilgrim Medical Center. There are four of them—a woman and three men, one of whom is flicking water at the building’s façade as if to exorcise demons. When a car slows in front of the Montclair abortion clinic, another man steps in front of the vehicle, holding up two signs. One reads, “KANSAS,” the other, “SHE IS 10.” The message may be cryptic, but it’s easy to perceive it as threatening, especially if you’re among the out-of-state patients who’ve been arriving at the clinic in increasing numbers since the Supreme Court overturned Roe v. Wade, the landmark constitutional decision establishing the right to abortion that was the law of the land for nearly half a century.
The protesters, who’ve been a presence outside the clinic for decades, have been emboldened since news of the court’s decision in the case known as Dobbs v. Jackson Women’s Health Organization was leaked in early May. “They definitely feel a bit more empowered by the overturning of Roe,” says the clinic’s administrator, who asked that we not use her name out of fear for herself and her family. Patients, on the other hand, have exhibited increasing anxiety since the decision. “We have patients calling to ask if they could get in trouble for coming to us,” says Pilgrim Medical’s administrator, and they include both out-of-staters and New Jersey residents still unsure about what the overturning of Roe may mean on their home turf.
Abortion remains very much legal in New Jersey. In January of this year, the state passed the Freedom of Reproductive Choice act, enshrining the right to an abortion in state law. Then, in June, in response to Dobbs, the Legislature passed two additional acts, one protecting the privacy of both abortion providers and out-of-state patients, and another protecting those providers and patients from extradition to, and possible prosecution in, states in which abortion is illegal or seriously curtailed.
Assemblywoman Lisa Swain, (D–Fairlawn) in the State Assembly and a supporter of the bills, notes that now, “anyone who needs to make choices about their reproductive health care has free rein on those choices, and people can come from other states and exercise their freedoms right here in New Jersey.” In a June 29 tweet, Governor Phil Murphy summed up his hope for the legislation: “The Legislature just sent two bills to my desk to make New Jersey a safe haven for anyone seeking an abortion and for health care professionals providing them.” But while advocates for reproductive choice have hailed the legislation, it remains to be seen whether the state will fully earn that designation of safe haven.
The Legislature just sent two bills to my desk to make New Jersey a safe haven for anyone seeking an abortion and for health care professionals providing them.
I will sign this legislation into law. The women of our country can’t wait.
— Governor Phil Murphy (@GovMurphy) June 29, 2022
Certainly, many out-of-state women already see it that way. Jasmine Winters, coordinator of reproductive health at the Cherry Hill Women’s Center, says that the clinic is seeing an influx of patients, mainly from Ohio and Florida, but also from Texas, North and South Carolina, Alabama and Mississippi. New Jersey also appears to be attracting medical students from states where abortion has been banned or restricted. Lauren Naliboff, an assistant professor of obstetrics, gynecology and reproductive health at Rutgers New Jersey Medical School, says that last year’s applicant numbers to the school were substantially higher than the previous year’s. “I can’t say that’s all attributed to the overturning of Roe,” she says, “but having access to abortion-care training is something that applicants are routinely asking about in their interviews.”
If those out-of-state medical students decide to remain in New Jersey, they could help to address a significant barrier to the state’s transformation into a true safe haven: a shortage of abortion providers. “We keep learning that legal and accessible are not the same thing, and part of accessibility is having enough providers,” says Laura Lindberg, a professor in the department of urban-global health at Rutgers School of Public Health. The state, she notes, has already taken steps to mitigate the problem by making it legal for advanced-practice clinicians like physician assistants and certified nurse practitioners to provide abortions. But a wave of out-of-state patients is likely already straining a system still suffering from a practitioner shortage, which could mean longer waits for all abortion patients, including state residents.
Another major barrier is cost. For lower-income patients, in addition to the cost of the procedure itself, they have to consider whether they can shoulder the expenses of travel and lodging. Some need to bring their children with them, and if they’ll be undergoing general anesthesia, they’ll have to bring along someone who can drive them home after the procedure—in both cases, increasing the cost substantially.
At present, clinics, nonprofits and other abortion rights supporters are offering a patchwork, partial solution to these financial challenges. Pilgrim’s staff, for instance, have approached local hotels, many of which have offered reduced rates to patients, and a few of which have waived charges altogether. And a number of nonprofits, including the National Abortion Federation (NAF) and the New Jersey Abortion Access Fund (NJAAF), offer funds to help defray the cost of the procedure. But Quadira Coles, NJAAF’s president, acknowledges that “there are always gaps in access to abortion, especially for folks who are undocumented or just not in touch with the resources that are available.” In addition, the overturning of Roe has raised potentially thorny legal issues. The NAF, for example, recently announced restrictions to their financial support of the costs of the so-called abortion pill—actually two pills that must be taken 24–48 hours apart. Patients receiving NAF support for the pills can now only take them in states where they are legal, which could mean an extra day’s lodging expenses for those traveling from out of state.
Murphy and his allies in the Legislature have proposed plans for a state-funded reproductive-health fund that would pay for abortions for uninsured patients and enhanced security for abortion providers, as well as an insurance mandate that would require insurers to fully cover abortion with no out-of-pocket costs. Thrive NJ, a statewide coalition of groups advocating for reproductive rights, is actively lobbying for these plans, but as of this writing, their passage is far from assured, with many on both sides of the aisle balking at the idea of creating an abortion fund out of the public coffers. Winters, who is also coordinator of Thrive NJ, doesn’t go so far as to say she thinks the plans will become law, but she does say she and her allies are “100 percent hopeful.”
Even if her hope is borne out, it won’t put an end to the fight against abortion in the state. Marie Tasy, executive director of the pro-life advocacy organization New Jersey Right to Life (NJRTL), says the group will “redouble our efforts” to help the state’s 50-plus “pregnancy help centers grow and thrive.” The centers counsel women who are considering abortion, but some critics, including the abortion-rights advocacy group NARAL Pro-Choice, have attacked the centers for misrepresenting themselves as reproductive health clinics while actually working to convince women not to undergo abortion. Although NJRTL hasn’t announced plans to fight New Jersey’s pro-choice laws, Tasy does characterize them as “among the most extreme abortion laws in the nation.”
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No legislation—or constitutional right, as Dobbs recently demonstrated—is written in stone. While supporters and providers of abortion in New Jersey are overwhelmingly convinced that the state can indeed become a beacon for all women seeking safe, legal abortions, many, like Pilgrim’s administrator, acknowledge that “we definitely have been put on notice not to feel comfortable, as things could change in the blink of an eye.” Still, she’s largely positive about what she sees as a change in the overall atmosphere. “The only way I can describe the support providers are seeing from the state is ‘unrelenting,’” she says. Winters, who believes that “there’s definitely a lot of work still to be done,” also feels positive about the direction the state is taking: “We’re very lucky here in New Jersey,” she says, “because we have a governor and a first lady who understand what reproductive freedom looks like.” The question now, as Murphy and his allies work to further the state’s status as a safe haven, is whether that luck will hold out.
Leslie Garisto Pfaff is a frequent contributor to New Jersey Monthly.
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