A year ago, the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade (1973), terminating the constitutional right to abortion. The decision has had immeasurable impacts all over the nation, especially on women of color and sexual and gender minority people, who often face inequitable access to health care.
Even in states like Hawaiʻi, where abortion is legal, the overturn of Roe has highlighted the barriers to safe and affordable abortion access in rural areas. Kaua‘i in particular has certain obstacles that make it difficult for a person to terminate an unwanted pregnancy. For instance, Wilcox Medical Center, Kauaʻi’s largest hospital, does not offer abortion services.
Earlier this year, Colleen Bass, certified nurse midwife and part owner of Hua Moon Women’s Health, spoke about the current state of abortion access on Kauaʻi. Bass feels it is negligent not to provide individuals safe access to abortions. Bass and her business partner at Hua Moon, Sharon Offley, sought to discover the policies in place that were creating barriers to care in a state where abortion is legal.
While medical abortion (or medication abortion — taking approved drugs to induce a miscarriage) can be accessed on Kauaʻi, people have to travel off-island to Oʻahu or Maui to receive a surgical abortion. Even still, practitioners like Bass and Offley were not able to keep abortion medication in stock due to policy incongruence and legal disputes.
Additionally, patients seeking medical abortion would experience delays because of limited access to ultrasounds and a lack of funding. Someone close to 10 weeks (the time limit for medical abortion) could lose their window if they couldn’t afford to expedite the pill being shipped to their home. It was challenging to get the answers Hua Moon needed to ensure that they were able to keep abortion medication in stock and bill legitimately.
Thus, in the aftermath of the overturn, the work has continued to identify barriers and strengthen abortion access on Kauaʻi. YWCA of Kauaʻi helped to convene the Kauaʻi Abortion Access Workgroup (KAAW), an interprofessional group of community members, leaders, lawyers and health care providers.
KAAW is working to remove logistical, social and financial barriers to on-island abortion access and to support statewide and national efforts for reproductive justice. The tireless work of KAAW and other reproductive justice advocates has brought some notable successes in abortion access over the last year.
While 26 U.S. states have made moves to ban most abortions, which has led to numerous accounts of people’s lives being at risk and people dying due to the lack of medical care, Hawaiʻi has made moves to increase abortion access and protect providers.
The Hawaiʻi Abortion Guide, which is a “how-to” guide that explains the resources available to people on each Hawaiian island is available online for anyone in need. And today, Hua Moon is able to do ultrasounds in-house and dispense abortion medications day-of. These successes certainly do not erase the barriers faced by many people in the Continental U.S. However, our recent advancements in Hawaiʻi are an example of how communities can support reproductive justice.
The work is far from over, though. There are unmet goals in regards to abortion policy, such as government funding for services, care coordination and access to medical training and equipment. With the Kauaʻi Abortion Access Workgroup, YWCA of Kauaʻi is working to fill these gaps. We will continue to advocate for reproductive justice in a post-Roe world until full-spectrum abortion services are accessible on Kauaʻi and abroad.
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Abigail Naaykens is the YWCA Kauaʻi Social Justice Advocate. Renaé Hamilton-Cambeilh is the YWCA Kauaʻi Executive Director. Emiko Myeris is YWCA Kaua‘i President.
