As abortion rights are being stripped in several states throughout the U.S., some ob-gyns, abortion rights advocates and others are focusing on how to make abortion accessible and safe for those who live in states where the procedure is restricted or banned. The situation has led to some outside-the-box thinking, including, most recently, plans by an ob-gyn to provide abortions on a ship in federal waters.
It’s the brainchild of Dr. Meg Autry, an ob-gyn and professor at the University of California, San Francisco who founded the nonprofit project PRROWESS, which stands for Protecting Reproductive Rights of Women Endangered by State Statutes. Autry is currently raising the $20 million needed to secure a ship that would be retrofitted to serve as a floating reproductive health clinic with volunteer providers, offering low-cost or free surgical abortions up to 14 weeks along with contraceptives, testing and treatment for sexually transmitted infections, and vaccinations.
Autry, who has been an ob-gyn and a reproductive health provider for 30-plus years and is an Army veteran, says she’s no stranger to anti-abortion sentiments and could see that the country was heading toward Roe v. Wade being overturned. “Rights were being eroded progressively over the years,” she tells Yahoo Life. “Then the Dobbs decision was leaked and it’s like, ‘This is happening.’ Even then, there was a sliver of hope — you just kept thinking in your mind this can’t be true. And when it hit, it was devastating.”
However, Autry had the idea for a floating clinic long before Roe was overturned. “This isn’t a recent thought of mine,” she says. “I’ve had it for years. I grew up in the South. I was very aware of this erosion of rights. I was always trying to think of, what are innovative ways we can provide health care to people whose bodily autonomy is under attack?”
Originally, she had her eye on a floating clinic on the Mississippi River. “There has got to be something about these casino boats in the water that is different from land,” she says, referring to riverboat casinos that remain at least 3 to 12 miles offshore to get around state gambling restrictions. “Then [the TV show] Ozark had a similar thing. See — other people think this too, I thought.”
Autry got a legal team on board, working with a reproductive health attorney from the nonprofit the Lawyering Project, along with maritime lawyers and a ship consultant. Ultimately, Autry and her team abandoned the Mississippi River idea. “We just weren’t going to be able to serve the amount of people we wanted to and it didn’t make practical sense,” she says.
Instead, Autry and her team settled on the Gulf Coast — a southern coastline that includes Texas, Louisiana, Mississippi, Alabama and Florida. With the exception of Florida, these coastal states have either “banned abortion or have very restrictive laws,” she says.
These states are also farther away from states where abortion is accessible and legal, making an offshore clinic a more geographically feasible option. “If you’re wealthy in our country, you’ll be able to get whatever you want, whenever you want,” says Autry. “Wealthy people will go elsewhere and you can get medication abortion in the mail. [The floating clinic is] truly for people who are the most affected.”
She adds: “So if you look at the map, there are networks in place that will get people in restricted states to access states and they’re paying for their accommodations and the procedure. But if you look at the southernmost part, like Texas and Louisiana, you can’t get to an access state in 24 hours. If you’re poor, a single parent, the sole caregiver,” a floating clinic may be the closest and most affordable option for those who don’t have time off from work, child care or the financial means to travel far, she points out.
While the idea of abortions at sea will no doubt raise some eyebrows, PRROWESS isn’t the first organization focused on providing abortion care offshore. The Dutch organization Women on Waves — founded in 1999 by Dr. Rebecca Gomperts — has sailed ships to several different countries where abortion is illegal to provide those services.
So what does maritime law say about abortions at sea? “Maritime law, by its own force, doesn’t speak to abortions provided at sea,” Matthew Steffey, a professor of law at Mississippi College specializing in maritime law, tells Yahoo Life. “In theory, a maritime treaty could cover the subject, but I don’t know of one that would. Assuming the vessel is outside state territorial waters, a state’s laws would not apply. Outside of waters controlled by a state or nation, the ship’s flag determines the source of law. So the ship’s home country’s laws apply.”
That doesn’t mean there aren’t risks. While Steffey adds that it’s “entirely possible” an “aggressive” district attorney could “seek to bring charges to someone who travels from their jurisdiction to an offshore abortion provider,” he points out that “there is a very good chance that those charges would be ultimately dismissed as violating the U.S. Constitution. Otherwise, a local DA could prosecute anyone for conduct legal in the state where the conduct occurred — such as consuming cannabis, gambling, etc. — once they returned home.”
That said, Steffey notes that “someone who operates a tender vessel to take patients from shore to ship would be taking a great legal risk, as they’d be operating inside the state.”
Autry isn’t willing to share the details on how exactly patients would be ferried from shore to ship for security purposes, but she says, “What we’re most worried about are the patients. Our plan is that our vessel and the provider and the crew will never touch a restricted state. But obviously, the patients have to get there.”
It is one of the many logistical issues that abortion providers and abortion rights advocates are facing right now. “Abortion providers, policymakers and so many others across the country are dedicated to finding ways to ensure people can get the care they need,” Gretchen Borchelt, vice president for reproductive rights and health at the National Women’s Law Center, tells Yahoo Life. “But the court’s decision has unleashed legal chaos, and as more and more states ban abortion, we face a host of unknown questions about criminal liability, surveillance and potential prosecution.”
Borchelt adds: “We are all navigating a dangerous, appalling and rapidly evolving landscape to help people get care that should be legal, affordable and available but instead is criminalized.”
Since going public with her project, Autry shares that many people in the medical and legal world have “really stepped up” to help. “I just think there are a ton of people doing creative and innovative things because they care deeply about access and bodily autonomy,” she says. “As many creative ideas we have out there to help people, the more the better. The sole point of this is to provide care to people who potentially do not have any other options.”
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