Every week, volunteers with the Northwest Abortion Access Fund field calls from people seeking assistance with paying for abortions or getting to appointments. They start Mondays with money in the bank, then distribute it to one caller after another until it’s gone. The hotline’s been especially active lately.

Since the Supreme Court overturned Roe v. Wade on June 24, NWAAF volunteers have received an influx of callers from outside the Pacific Northwest, said Riley Keane, a practical support lead with the nonprofit organization. 

“People are scared and unclear on the legality in their state, so they’re reaching out to the only sure thing they know of,” she said.

NWAAF’s efforts to address gaps in abortion access, one caller at a time, stretches back to the mid-1990s, but only recently caught the attention of elected officials in the Northwest. Since the Roe reversal, Seattle Mayor Bruce Harrell and King County Executive Dow Constantine have committed major gifts to the fund, totaling $750,000. The King County Council is expected to vote Tuesday to authorize the $500,000 that Constantine pledged. The fund, which serves Washington, Oregon, Idaho and Alaska, has also been awarded $1 million from Oregon’s Reproductive Health Equity Fund.

“Where we can counter this, we must. Seattle will remain a place where we lead with reproductive justice and where abortion and reproductive health care are available to all who seek it,” Harrell said in a statement announcing the city’s $250,000 donation.

This municipal funding will directly assist callers, at a time when the remote volunteers are seeing their phones ring more and more, Keane said.

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“So far in 2022, we’ve spent 75% of what we spent in 2021, which had already doubled from our spend in 2020,” she said. 

Some of this is tied to Roe, and the leaked version of the ruling in November, but high-profile state-level abortion restrictions are also a major factor.

After Texas’ six-week abortion ban took effect in September, calls to the hotline “roughly quadrupled,” Keane said. In years past, there had been seasonally predictable periods where calls dropped off. That’s not the case anymore. In fact, calls have only been increasing since 2020, said Keane, reflective of a political reality in which many people were “already living in a post-Roe v. Wade environment.”

This is borne out by data: In 2017, when abortion was legal across the country, 89% of U.S. counties had no abortion provider, according to the Guttmacher Institute, a reproductive health policy research organization. Even in Washington state, 59% of counties have no abortion provider.

What the numbers say

Now that Roe has been overturned, access disparities will become more severe, with 22 states likely to restrict abortion and 13 with trigger laws set to ban abortion in the absence of national legal protections.

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Abortion funds try to address these disparities by helping people get abortion care when they need it, whether they face barriers due to geography, state policy or financial cost. In 2021, NWAAF assisted about 1,000 callers, but in the first half of 2022, it’s already surpassed that number.

“These callers are reaching out to us because their insurance doesn’t cover abortion,” Keane said. “Or they’re not sure if they’ll be prosecuted in their state for seeking medical care, or the clinics closest to them are booked out so far that they can’t be seen before they’re outside legal limits where they live.”

Keane said abortion stigma might even play a role: “People reach out to us for all kinds of reasons, but one we hear frequently is that they can’t talk to their family and friends about the decision they’ve made.”

In a typical week, NWAAF volunteers assist 10-15 callers with practical support, funding or both. The group sends funding vouchers directly to clinics, coordinates patient transportation, books flights and lodging for clients traveling for care or undergoing multiday procedures, and even orders groceries. The organization also recently incorporated a new program offering clients support from full-spectrum doulas.

These volunteers respond to hotline calls at 1-866-692-2310 within 24 hours, calling back from a blocked phone number to protect their privacy. The nonprofit collects donations and offers support through its website, nwaafund.org.

The gifts from Washington elected leaders, like Constantine and Harrell, represent the first time they’ve received municipal funding, Keane said.

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“While we are deeply appreciative of the funding and recognition as leaders in this space, 13 states have trigger bans,” Keane said. “If they all go into place, it’s difficult to predict what that increased volume will look like for us and how far that funding will stretch.”

Similar funds are active in other parts of the country, but the Roe reversal has impacted their work.

NWAAF’s funding already extends to callers from Texas who lost local support when Fund Texas Choice paused operations after the ruling. Some larger funds in states with stronger abortion access protections, like the Midwest Access Coalition based in Illinois, have continued operations, said Keane, but that hasn’t been an option for smaller local funds in states whose trigger laws include criminal provisions. In Texas, both the Lilith Fund for Reproductive Equity and the Texas Equal Access Fund suspended operations after the state attorney general there said prosecutors could pursue criminal charges.

Like many abortion rights activists, Keane and her colleagues expected Roe v. Wade to be reversed, but watching it unfold has been a completely different experience.

“We’re busier than we’ve ever been. There are people who are reaching out to us who are in more desperate situations, because they don’t know if even calling us is legal,” she said. “They don’t know if calling us is something that’s putting themselves and their families at risk.”

Volunteers take these calls on a weekly schedule, as they have since the nonprofit’s inception, when two separate abortion funds in Washington and Oregon merged to form NWAAF in 2017. Dollars are replenished at the beginning of the week and disbursed among callers in the following days. In 2017, the money would often run out by the end of Monday or Tuesday. These days, said Keane, it lasts longer, but most weeks it’s still exhausted.

Still, she said, the organization has been fortunate that it’s never run out of money entirely; every year, many abortion funds do and have to start turning people away.