Bristelle Larsen lives in Dillingham. Two decades ago, she was pregnant.
“I had a very young during my pregnancy and I was certain in my heart that I didn’t want to become a mommy,” she said.
She was employed seasonally, between processing fish within Dillingham and operating ski lifts in Girdwood, jobs which require physical exertion that she wasn’t able to manage while as a mother or with the birth of a child. She decided to terminate her pregnancy.
She was forced to go to Anchorage as one of only three states that offer these services. She was not clear about her visit to employers due to the stigma associated with abortion.
“I just informed them that I had to go to Anchorage for medicaltreatment, which is quite common,” she said.
She stayed in the “shady” hotel since it was cheap and she was able to pay in cash for the service. She claims she was fortunate enough to have $2,000 available for travel, and also the cost of the bill.
She stated that a medication abortion, also known as an abortion pill was not an option at the time since she was not close to Anchorage. Her doctor wasn’t keen to take the hundreds of kilometers to Dillingham where they could not examine her. But she told her she could reap some benefits.
“I think it would be less traumatizing physical,” she said. “Not needing to go through the process of putting on the gown and then going through the entire procedure.”
The incident meant that she had to be watching her ultrasound, and then wait 24 hours prior to her procedure.
After returning home after a couple of days, she claimed she was on “light duties” in the office for a week as she recuperated.
It was a long time ago, yet the experience could be similar today. A quarter of the people seeking abortions in Alaska go further than 30 miles to get treatment according to Planned Parenthood. In remote areas away from the highway system some people must travel thousands of miles reach the closest city.
Barriers to treatment
The legality of abortion is in Alaska but doctors and advocates argue that it’s not fair or easily accessible due to the state’s geographical location and its vast rural population. Some believe the state’s attorney general should join a lawsuit that is backed by the attorney general of the state could hinder access to abortion even more by requesting to the U.S. Food and Drug Administration to revoke its approval of mifepristone an anti-pregnancies drug. Doctors claim that it is the best option for abortion available.
A statement by Alaska Attorney General Treg Taylor says he partnered with Alaska in this suit because the federal government permits the medication to be administered via mail, meaning that even those in States where it is not legal can obtain the drug. This isn’t the way that the majority of people in Alaska receive it. Planned Parenthood, Alaska’s primary prescriber, can only do it in person. However, the lawsuit will make the pill inaccessible to Alaskans.
“Mifepristone is completely safe. It’s effective. It’s been utilized by more than four million individuals since FDA approved it nearly 20 years ago.” claimed Rose O’Hara Jolley, the director of Planned Parenthood Alliance Advocates in Alaska. “So this is a bogus case. There is no logic to support it from a scientific perspective from a medical perspective. It’s simply about limiting the access to abortions even in states in which abortions are legal.”
Geographical location is one of the main obstacles to reproductive healthcare in Alaska. Even those living in remote areas who opt to end their pregnancies using the pill generally travel due to the fact that Planned Parenthood isn’t able to provide it via mail even although it is legal.
State statistics show that between 1,200 and 1,300 women seek an abortion each calendar year within Alaska. Most of them go to Planned Parenthood, which is also the primary provider of medical abortions in Alaska. O’Hara Jolley estimated that about 50% of patients at Planned Parenthood prefer the pill for abortion over an abortion in a clinic.
“There’s many obstacles to accessing abortion that taking away an option that is medically tested reliable and safe way to get an abortion likely to be disproportionately detrimental to those who are already experiencing difficulties in accessing healthcare,” said O’Hara Jolley.
O’Hara Jolley said that, particularly for those who live in areas that are rural, the expense of traveling in Alaska is too expensive. The report also noted that half of those seeking abortions have children. Therefore, they also need to locate childcare. Another issue is safety: Alaska has among the most high rate of violence between intimate partners in the country and the risk increases for women who are pregnant.
If the lawsuit succeeds O’Hara Jolley stated that Planned Parenthood will still prescribe abortion pills, however it’ll have to choose the drug that is slightly less effective when mifepristone becomes no longer legal. Planned Parenthood will use misoprostol which is as much as 10 percent less efficient. The researchers said that this could cause more inequities within healthcare, as people are likely to be required to spend more time in the clinic.
“Abortion is still legal and safe within Alaska,” O’Hara Jolley stated. “We only be able to offer one less option for people to pick from.”
Medicine and politics
“We must be aware of where our legal system heading regarding these sorts of issues,” said Dr. Robin Holmes, a primary health care professional in Homer. “The main result is that politicians took away the right of physicians to prescribe medicines that are effective and safe for pure political motives.”
The clinic in which Holmes is employed does not offer abortions in a clinic or prescribe pills to treat abortions. The clinic provides sexual and reproductive health care as well as education for all income levels living in the southern region of the Kenai Peninsula. It’s the sole comprehensive reproductive health service available to an area that’s the size of West Virginia, Holmes said. Her mission is to help women who are pregnant with the options for their health care and decide whether they wish to continue having babies or have them terminated.
The right to abortion is protected by the constitution of the state through rights to privacy. However, Holmes admitted that it may be difficult to find treatment that is comfortable in the small towns of Alaska.
“It’s the geography and insurance, but it’s also stigmatization,” she said. “Alaskans are already so restricted in terms of access to receiving reproductive health services in terms of STI screenings and long-acting contraceptive alternatives. We don’t want to be subjected to another imposition from the political world on our access to health care.”
She explained that for Alaskans living in rural areas, long journeys from Juneau, Anchorage or Fairbanks is typically required. If you want to order online prescriptions for an pills for abortion, they may not have enough internet access.
Options for navigation
Robin Holmes counsels people in the same position as Bristelle Larsen did when she was in Dillingham twenty years ago. This is people who don’t have access to abortion options. Larsen states that finding choices for care and travel was difficult back then and that it was fear that was the most significant obstacle for her.
“If you have someone you know who could be in this position or is willing to talk to you about it you should not make judgments about the decision they’re likely to make,” she said.
She also said that she has heard of women who had abortions went on to have babies when they were well-prepared and led healthy lives.
“It’s not an ominous sentence,” she said.
The decision could be made by the close the week. The decision could lead to more uncertainty about medical care in rural Alaskans.
