A4 • Friday, May 20, 2022 | Seaside Signal | SeasideSignal.com
Lack of access to abortion can complicate choice
By KATIE FRANKOWICZ
and NICOLE BALES
KMUN and The Astorian
Before her son turned a year old, Chel-
sea Johnsen had cervical surgery to remove
cells that had the potential to become cancer-
ous. Then she found out her copper intrauterine
device, or IUD, had failed.
She was pregnant.
There was a chance her cervix had not
healed enough to carry a baby to full term. A
pregnancy could be dangerous for her. They
also couldn’t find her IUD.
The timing wasn’t right, Johnsen decided.
She wanted to end the pregnancy. Her doctor
at Columbia Memorial Hospital in Astoria said
she respected Johnsen’s decision and offered
her support, but the hospital did not provide
abortion services.
“I will never forget that feeling,” Johnsen
said, “because it’s like you have to be so vul-
nerable and tell someone something that has
such a stigma around it and you’re already a
mother and just to tell someone, ‘Hey, this is
the choice that I’ve made and I’m comfortable
with.’ And then for them to respond with, ‘I
fully support you. However, we don’t do any-
thing for that.’ It was like … OK. Well, great.”
Johnsen set up an appointment for an abor-
tion with Planned Parenthood on her own.
Then the results came back from an ultrasound
to locate her IUD.
Johnsen was told the abortion she had ago-
nized over was now a medical necessity. The
IUD was embedded somewhere in her body. It
would be too risky to proceed with the preg-
nancy not knowing where the IUD was located.
In mid-December, Johnsen, who owns the
Doe & Arrow boutique downtown, had an abor-
tion procedure at Oregon Health & Science Uni-
versity Hospital in Portland. Right after Christ-
mas, she had surgery to remove the IUD that
doctors found pushed up against her colon.
While her doctor in Astoria could make
referrals on her behalf, most of the logistics —
like the initial appointment with Planned Par-
enthood — were left to Johnsen.
Abortion rights are protected in Oregon at
all stages of pregnancy. There are no waiting
periods, no mandated parental involvement, no
limitations on publicly-funded abortions.
As the U.S. Supreme Court appears ready
to roll back Roe v. Wade, the landmark 1973
decision that legalized abortion nationwide,
Oregon is poised to become a destination for
women seeking to end their pregnancies.
But despite the legal protections and the
promise of expanded access to reproductive
health care, the Guttmacher Institute found in
2017 that most Oregon counties — 78% — did
not have any clinics that provided abortions.
Rural counties, like Clatsop County on the
North Coast, are especially lacking in abortion
services, creating barriers for women that com-
plicate their health care choices.
‘A very big political hot topic’
On the North Coast and across the Colum-
bia River in Pacific County, Washington, abor-
tions are not available at any local hospital. Not
at Columbia Memorial, Providence Seaside or
Ocean Beach in Ilwaco.
Health care providers instead refer women
to Planned Parenthood or hospitals and clinics
in the Portland metro area and cities along the
Interstate 5 corridor hours away.
This could mean a trip out of town, time off
work, maybe the need to arrange for child care.
For pregnant teenagers, women who live in
controlling or abusive situations or people who
lack their own transportation, the logistical dif-
ficulties are compounded.
At Columbia Memorial, which is Luther-
an-affiliated, obstetrician-gynecologists offer
phone and office consultations when patients
want to discuss abortion. The women’s center
provides information on abortion options and
offers ultrasound and blood testing in advance.
Patients can also follow up with health care
providers afterward if needed.
Social workers and a board-certified chap-
lain are available to provide unbiased sup-
port and counseling throughout the process if
patients pursue abortion.
The hospital also provides assistance with
logistics, such as insurance, travel and financial
issues. Staff is available to help manage poten-
tial complications or medical emergencies for
patients who terminate pregnancies.
Providence Seaside, part of a Catholic
John Bruijn/The Astorian
Women on the North Coast have to travel to the Portland metro area or cities along the Interstate 5 corridor to access abortion services.
health care system, declined an interview for averted 59 unintended pregnancies.
this story.
The number of abortions among people
Tracy Erfling, a naturopathic doctor who from Clatsop County has remained relatively
serves as Clatsop County’s reproductive health constant over the past five years. The Oregon
provider, said she is not aware of any clinics or Health Authority tracked 60 abortions in pre-
hospitals in the region that offer or plan to offer liminary data from 2021, 46 in 2020, 47 in
2019, 64 in 2018 and 67 in 2017.
abortion services.
Oregon, like many states across the country,
“It’s a very big political hot topic,” she said.
“So some people just don’t want to dip their toe has seen abortions steadily decline over the past
in that pool and just would rather utilize the sort few decades.
“If the good teachings of contraception (are)
of functioning entities that are already there to
do those services rather than try to take that on.” out there, then this whole thing” — the ques-
Without meaningful access, Planned Par- tion of abortion — “is potentially avoided,”
enthood has said, “abortion is a right in name Erfling said.
only.”
Medication abortion
Barriers to reproductive health care are often
A recent change by the federal govern-
higher based on race, income and distance from
ment could expand local access to one type of
urban centers.
“Oregon has worked very hard – even in abortion.
For women who are still early in their preg-
more conservative parts of the state – to be a
state where women and people who need abor- nancies, a medication abortion — achieved
tions have complete and
by taking the prescrip-
tion drugs mifepristone
total access to that ser-
vice free of charge,” said
RURAL COUNTIES, and misoprostol — is an
Anne Udall, the presi-
increasingly
common
LIKE CLATSOP
dent and CEO of Planned
method. Planned Parent-
hood, which provides
Parenthood
Columbia
COUNTY ON THE
about 75% of the abor-
Willamette.
NORTH COAST,
tions in Oregon, said
“From sort of a finan-
cial support, Oregon is just
most choose medication
ARE ESPECIALLY
truly one of the leaders in
abortions.
the country for sexual
Last year, the Food
LACKING IN
reproductive heath care.
and Drug Administra-
ABORTION
tion lifted a restriction on
We know that the rural
abortion pills, allowing
parts of the state — it’s
SERVICES,
patients to have telemed-
much harder,” Udall said.
icine appointments with
Planned Parentood has
CREATING
providers who can pre-
been focused on Eastern
BARRIERS FOR
scribe and mail abortion
Oregon, she said, “but we
pills directly to them.
are also increasingly pay-
WOMEN THAT
ing attention to the lack
Before the rule change,
COMPLICATE
of abortion access on the
the first dose of the
coast.”
two-medication regimen
THEIR HEALTH
In Erfling’s experience,
was required to be dis-
pensed at a health care
the more rural a popula-
CARE CHOICES.
tion, the more acceptable
facility.
it is to have unintended
In Oregon, some health
pregnancies.
care providers have already been conduct-
“If someone wants to have a kid, even if ing telehealth appointments and mailing pills
it’s unintended, we all have to be OK with that through the TelAbortion Project, a research
project authorized by the FDA.
because it’s going to happen,” she said.
The federal agency decided to stop enforc-
But Erfling still thinks about a patient she
saw 20 years ago: a pregnant 13-year-old who ing the in-person requirement in April 2021,
came into the county Public Health Depart- and in December it was lifted permanently,
ment with her mom.
allowing the pills to be mailed directly to
“I’ll just never forget the look on her face,” patients.
she said. “She just had this blank stare. I don’t
Reproductive health care experts say the
even think that information was filtering into decision could make access to abortion eas-
ier, particularly in underserved places like rural
her mind.”
The teenager’s mother was nonchalant Oregon.
Restrictions on abortion in neighboring
about the situation, saying she and others she
states could draw more women seeking to end
knew also got pregnant at a young age.
Education about contraception and the abil- their pregnancies to Oregon.
ity to have conversations about the options
Idaho has sought to enforce an abortion ban
during pregnancy are critical, Erfling believes. after about six weeks of pregnancy by allow-
In 2020, the county’s reproductive health pro- ing family members to sue abortion provid-
gram averted 49 unintended pregnancies due ers. The law is modeled after a similar law in
to access to contraception, according to the Texas that was crafted to get around constitu-
Oregon Health Authority. In 2019, the county tional protections.
“What Idaho is going to do is really shut
down access for people in Idaho with this new
law,” Udall said. “We believe that we will
begin to see high percentages of people com-
ing into Oregon.”
A report by the Guttmacher Institute, a
research and policy organization that favors
abortion rights, estimated that even a 15-week
abortion ban could mean a 234% increase in
the number of people whose nearest abortion
provider would be located in Oregon.
Given the reality of abortion access in Ore-
gon and the anticipated demand coming from
other states, Planned Parenthood is provid-
ing medication abortions by mail. People who
live out of state can access the pills if they pro-
vide an address in Oregon or Washington state,
which can be a friend’s house or clinic.
‘A scary and stressful time’
If the Supreme Court overturns Roe v.
Wade, as a leaked draft of a ruling indicated,
more than two dozen states are likely to ban or
significantly restrict access to abortion.
Oregon, Washington state and California
have taken proactive steps to protect access.
The Reproductive Health Equity Act, passed
by the Oregon Legislature and signed into law
by Gov. Kate Brown in 2017, codified abortion
into state law and required private health insur-
ance plans to cover abortions with no out-of-
pocket costs. The law also covers abortion ser-
vices for undocumented immigrants.
Bracing for an influx, new legislation this
year established a $15 million fund intended to
cover, in part, the costs for patients who travel
across state lines and the costs for abortion
providers.
In Astoria, news of the Supreme Court’s
potential decision ignited something in Johnsen.
Fresh in her memory was her own abortion and
the lack of local resources she encountered.
In a matter of days, she launched the non-
profit Lemonade Foundation. She is still final-
izing the nonprofit status, but the foundation’s
mission will be to help people who want to end
a pregnancy through every step of the process:
from scheduling appointments and organizing
companionship so no one goes through a pro-
cedure alone to providing funds to cover things
like transportation or child care.
Johnsen plans to reach out to other local
nonprofits and find ways to connect with the
people they see. She feels there are likely many
in the community who don’t know about the
resources that are available to them or how to
access those resources if they are considering
an abortion.
“It can be such a scary and stressful time,”
she said.
With the Lemonade Foundation, Johnsen
wants people who have chosen to or who need
to end a pregnancy to know “that you are not
just being denied care from every provider in
our region. That there is someone here that is
going to aid you with care and can connect you
to care and be present for it.”
This story is part of a collaboration between
The Astorian and Coast Community Radio.
SignalViewpoints
LETTER TO THE EDITOR
Appreciate writer’s
local flavor
We recently returned to Seaside after
being away for a few weeks traveling. Our
neighbor saved some of the Signals for us
which normally pick up at Safeway.
It was nice seeing an article once again
from the nephew of our beloved Claire
Lovell (Dave Nelson). We originally met
Mr. Nelson at a church event his aunt was
at. Nelson actually wrote for the Signal
in 2010 and during slow times, provided
Blazers information in the sports section,
PUBLISHER
EDITOR
Kari Borgen
R.J. Marx
PUBLIC MEETINGS
including quotes from players.
I see we missed an event featuring an
author who writes books on the Blazers.
What a fun event that must have been.
I hope to find someone who may have
attended and can tell me how it was. I’m
guessing it was a lovely time enjoyed by
all.
I hope young Mr. Nelson will consider
writing more again and you publish them
on occasion. It was nice having a local fla-
vor on them.
Jim and Mary Everett
Seaside
CIRCULATION
MANAGER
Shannon Arlint
ADVERTISING
SALES MANAGER
Sarah Silver-
Tecza
ADVERTISING
REPRESENTATIVE
Haley Werst
PRODUCTION
MANAGER
CONTRIBUTING
WRITERS
John D. Bruijn
Skyler Archibald
Joshua Heineman
Katherine Lacaze
Esther Moberg
SYSTEMS
MANAGER
Carl Earl
CONTRIBUTING
PHOTOGRAPHER
Jeff TerHar
Contact local agencies for lat-
est meeting information and
attendance guidelines.
MONDAY, MAY 23
Seaside City Council, 7 p.m.,
989 Broadway.
THURSDAY, MAY 26
MONDAY, JUNE 6
Seaside Budget Committee,
6 p.m., 989 Broadway. (if nec-
essary)
Seaside Housing Task Force,
6 p.m., 989 Broadway.
WEDNESDAY, JUNE 1
Seaside Community
Center Commission,
10 a.m., Bob Chisholm Com-
munity Center, 1225 Avenue
A.
TUESDAY, MAY 24
Seaside Improvement Com-
mission, 6 p.m., 989 Broadway.
Sunset Empire Park and Rec-
reation District Board of Direc-
tors, 5:15 p.m., 1225 Ave. A.
Gearhart City Council, 7 p.m.,
www.cityofgearhart.com.
Seaside Airport Advisory
Committee, 6 p.m., 989 Broad-
way.
TUESDAY, JUNE 7
THURSDAY, JUNE 2
Seaside Library Board, 4:30
p.m, 1131 Broadway.
Seaside Parks Advisory Com-
mittee, 6 p.m., 989 Broadway.
Seaside Planning Commis-
sion, 6 p.m., 989 Broadway.
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