One year ago this Saturday, the Supreme Court struck down Roe v. Wade with predictably devastating consequences. As of June 20, abortion is banned in 13 states and unavailable in Wisconsin because of ongoing legal uncertainty. A six-week abortion ban is now in effect in Georgia, and Florida is expected to soon follow suit. Last month, Nebraska and North Carolina approved 12-week bans.
The impact of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization fell hardest on people who were already struggling to access abortion care even while Roe was in place. This includes those with few financial resources, Black and brown people, the young, immigrants, those in rural communities, and people with disabilities. The regional clustering of bans in the South, Plains states, and Midwest has made the situation worse, forcing those who can afford it to travel vast distances to get care.
Recent research shows that almost 26,000 people were unable to get an abortion in the first nine months post-Roe. Additional attacks loom large, in particular the baseless lawsuit challenging the FDA’s approval of mifepristone — the drug used in more than half of all abortions in the United States.
On the positive side, many progressive states were equally quick to respond. This included enacting protections such as shield laws, which protect doctors from states that attempt to enforce abortion bans beyond their borders; enshrining abortion rights in their state constitutions; and demonstrating the popularity of their efforts at the ballot box during the 2022 midterm elections, including the passage of several abortion-related ballot initiatives.
Through all of this, philanthropy has stepped up in important ways, with many swiftly answering the call for greater giving. Abortion funds, which ensure reproductive care is affordable, saw a sharp increase in donations. For several years before Dobbs, the funds worked collaboratively to prepare for a post-Roe world and were poised to manage the flood of donations and the complex coordination required as abortion access eroded.
Debasri Ghosh, managing director at the National Network of Abortion Funds, told us additional funding across the network enabled a 75 percent increase in financial aid to people calling the funds seeking help from June 2021 to June 2022, and she estimates that total disbursements tripled in the year since.
A similar story has played out for organizations working to provide legal defense to people ensnared in abortion-related investigations and prosecutions. In 2021, the organization If/When/How, anticipating the fall of Roe, launched the Repro Legal Defense Fund. Mariko Miki, interim executive director of the group, reports a “deluge” of support for the new fund post-Dobbs, including unsolicited gifts from individuals and family foundations. The influx of funds has allowed the organization to respond to an urgent and growing need for legal support as individuals face abortion-related prosecutions.
Support for advocacy and community mobilization has also paid off. State-based and local organizations trying to protect and expand access to abortion have won impressive policy victories working in tandem with supportive legislators and governors. For example, efforts by advocates in California, including Access Reproductive Justice, helped to mobilize $200 million in state funding for abortion — a historic investment for those otherwise unable to afford care. Massachusetts, New Jersey, New York, and Oregon also carved out state funds to help people pay for abortion services.
These investments attest to the vital role of philanthropy in a post-Roe world. At the same time, experts we spoke with across the field expressed the need for a more strategic approach to giving that ensures equitable access to abortion in the long term. As Jessica Pinckney Gil, executive director of Access Reproductive Justice, has told many of her organization’s donors, “it took many years for abortion opponents to dismantle Roe, and it will likely take just as much time — if not more — to build a future in which abortion is accessible to all.”
Sustained Long-Term Response Needed
In several conversations with experts in the field, some key themes emerged about how philanthropy can both respond to the immediate crisis and equip organizations for the long road ahead. These themes can help guide donors as they develop giving strategies in support of abortion access.
Fund with flexibility. Unrestricted grants enable the long-term financial security and planning this fight requires. In the case of abortion funds, for example, Ghosh points to the need for contributions that aren’t restricted to a particular geographic or program area. Restrictions of this kind create additional burdensome reporting requirements that take focus and resources away from the urgent task at hand.
Experts also stressed the importance of ongoing donations and multiyear grants. While abortion groups welcomed the rage-fueled giving that followed the Dobbs decision, several sources noted that many individual philanthropists have not renewed their gifts and called for more no-strings-attached recurring donations.
Think local. The abortion-access crisis began at the state and local levels, where anti-abortion donors invested heavily for decades to make abortion illegal. Abortion advocates must take a page from this playbook. While national organizations have a role to play in coordinating efforts across states and developing regional and national programs and policies, grassroots groups working in communities most affected by abortion restrictions are best positioned to lead this work.
Those we spoke with emphasized the importance of supporting reproductive-justice organizations led by those who are Black, Indigenous, and people of color. Wen Brovold, director of communications and donor organizing at Groundswell Fund, which works with reproductive-justice groups nationwide, says many nonprofits in its network have not seen the same levels of increased support as larger groups, even though they were the earliest to sound the alarm about the abortion-access crisis and are now called on to drive efforts to lift restrictions.
Support new abortion-care infrastructure. Abortion-service delivery is changing significantly in the post-Roe era. Within just the first 100 days of the Dobbs decision, at least 66 abortion clinics across 15 states had stopped offering the procedure. Several donors have responded by shoring up abortion services, including the David and Lucile Packard Foundation and Charles and Lynn Schusterman Family Philanthropies. Some states have also stepped in with additional funding. Most notably, New Mexico Governor Michelle Lujan Grisham committed $10 million to build a new clinic on the Texas border.
Beyond investing in clinic infrastructure and provider training, more support is needed for those who choose to self-manage their abortions or who may have no other option given state bans. Self-managed abortion outside the formal health care system, most often with the safe and effective use of pills, allows individuals to end pregnancies on their own.
Inspired by activists in countries such as Colombia and Mexico where abortion was illegal for many decades, several visionary organizations began building understanding of and support for the option of self-managed abortion in the United States. The work of these organizations, supported by foundations with long roots in abortion funding, led to last year’s launch of the Abortion On Our Own Terms campaign.
That groundwork proved essential in meeting the massive spike in demand post-Dobbs. Groups requiring sustained investments in this area include Aid Access and Plan C. Funding is also needed to educate clinic-based abortion providers and others in the health care system on how to help people navigate self-managed abortion.
Mount a holistic response. Attacks on abortion access are part of a much larger assault on bodily autonomy that includes a record surge in bans on gender-affirming care. These attacks are often fueled by state legislatures that are far to the right of the state’s electorate, thanks to gerrymandering and voter suppression. Without the federal protections of Roe, state courts — and especially state supreme courts — are now central to many legal battles. The April 2023 state supreme court election in Wisconsin, where abortion featured prominently, attracted nationwide attention and became the most expensive state judicial election in U.S. history.
Investments in progressive legal infrastructure that already exists in most states but often lacks adequate resources can help claw back lost ground and act as a bulwark against regressive policies, including by supporting the vetting, nomination, and election of state judicial candidates.
Expanding access to the ballot box is also vital. That means supporting reproductive-justice organizations such as United for Gender and Reproductive Equity, or URGE, that work at the intersection of abortion access, racial and gender justice, and civic engagement, while helping to mobilize the next generation of activists.
The deepening crisis of abortion access undermines self-determination, dignity, and well-being, particularly for those who already bear the brunt of health and socioeconomic inequities. Philanthropy responded generously during the past year, but this is a crisis with no clear end in sight. Resources must be fortified for the long battle ahead.
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