Planned Parenthood navigators help abortion patients arrange for travel, costs and other needs

Even before the U.S. Supreme Court overturned Roe v. Wade, being able to terminate a pregnancy was not a choice available to everyone who wanted it, particularly for those with low incomes living in rural areas with no health care providers in their community. And since the 2022 Dobbs v. Jackson ruling that returned the regulation of abortion to states, many state legislatures severely restricted the procedure, including medication abortions, which comprise more than half of all abortions in the U.S.

In Oregon, the two branches of Planned Parenthood have seen an increase in the numbers of people from Idaho, Texas and many other states coming here for abortions. One of the ways that the reproductive health organizations ensure access is to hire abortion patient navigators to help those who need an abortion meet the challenges that may stand in the way, such as travel or costs. Nova Newman is one of four abortion patient navigators that work for Planned Parenthood statewide. She joins us to talk about how she approaches her job, the kinds of questions she gets from those seeking abortions and the ways she helps facilitate their access.

Note: The following transcript was created by a computer and edited by a volunteer.

Dave Miller: From the Gert Boyle Studio at OPB, this is Think Out Loud. I’m Dave Miller. Yesterday, we talked to leaders of Oregon’s two Planned Parenthood affiliates. We heard about their overall approach to reproductive health and abortion access, at a time when access to abortion has been severely limited in about half the country. The affiliates have both seen big spikes in patients coming from Idaho, Texas and other red states. One of the ways they’ve responded is by creating a new position. They’re called abortion patient navigators. They serve as short term case managers to help people access abortion care. We wanted to hear more about what this work entails. Nova Newman is one of four abortion patient navigators statewide. She joins us now. Thanks so much for joining us.

Nova Newman: Happy to be here. Thank you.

Miller: How do you describe your position?

Newman: Typically, I describe it as responding to patient requests for assistance and then that assistance can really just vary as far as what it looks like. Sometimes it’s really straightforward, as simple as just needing to schedule them at the correct health center.

Sometimes we’re talking more in depth about funding or other logistical needs. And other times we’re just really answering questions and concerns for the patient.

Miller: Why was this position created in the first place? I mean, what was the problem it was intended to solve?

Newman: I believe the position was created because we’re just really acknowledging the reality that even though we’re so lucky to live in Oregon, a state that has protective laws for abortion care, it doesn’t really equate to access for a lot of people. So we’re just looking at the logistical hurdles for this service so that people can actually get the care that they’re needing.

Miller: How do people end up in your queue?

Newman: Typically, the way that we get connected with patients is at the point where they’re scheduling. So whether that’s calling our call center and scheduling over the phone … the call center can do a warm transfer to me or they can essentially create an appointment request in my work queue. And then I’ll respond typically within 24 hours. Also, a lot of patients book online, and if they’re doing that, we recently launched a patient assistance form online, so they can essentially just click that they need help or further assistance from a patient navigator. And again, it’ll go into my work queue and I’ll respond that way. Or even if they show up to a health center in person and just say that they have a lot of questions or just certain needs, they can get connected through me that way as well.

Miller: By the time they get to you, have they already decided that they want to have an abortion? And then the question is, how do I get access to one, or do they arrive on the phone with you with bigger questions about what they want to do?

Newman: Typically, all the people that I’m speaking to have already decided that they are seeking an abortion and they just need either help with logistical needs or have questions or concerns. Of course, at any point, the patient can change their mind. But by the time we’re in conversation, they know that they want an abortion.

Miller: In general, where do your patients or clients come from?

Newman: So it’s honestly just such a variety. We, of course, see a ton of local patients where all our health centers are located, but we’re also seeing a lot of people traveling from other states that have more restricted abortion access.

Miller: Other states, like where?

Newman: Idaho, of course, is a big one just location-wise since we’re so close to that state. Recently, I’ve also helped a patient from Texas and a patient from Arizona. So it really varies.

Miller: If you’re talking to a patient from Texas or Arizona, I imagine that travel or lodging are among the issues that they have to be thinking about.

Newman: Correct. Yeah, that’s usually a big hurdle for a lot of people that are needing to travel, is just the cost alone of travel and lodging, but also the extra time needed from work or other logistics like having to figure out childcare while they’re away. And of course, if they’re needing to travel from further away, they’re gonna be gone for longer periods of time. So those are all really big variables that people have to kind of work through and I try and help work alongside them.

Miller: What can you do? I mean, some of those things I imagine are completely out of your control in terms of getting time off from a job that may be very restrictive. What about travel costs?

Newman: So it really depends, each situation is so unique. So as far as what we can help do is, first, we always try and address the cost of the actual procedure itself. So of course, some people have health insurance that can cover it. A lot of people don’t. So we address that cost, and sometimes just addressing that cost lets people be able to reallocate their funds to be able to then pay for travel themselves or lodging themselves. If that’s still not the case, we see what funding programs we can use to help assist in that. We also have other community partners like Northwest Abortion Access Fund and Cascade Abortion Support Collective that we work really closely with. They also are able to help with some of the cost of travel and lodging.

Miller: How do you deal with the anxiety or fear that you encounter, that I imagine you can encounter in some of these calls?

Newman: As far as anxiety and fear from the patient’s perspective?

Miller: Exactly.

Newman: Well, I think something that’s really important in my role that can help address some of the anxiety and fear is that I have the time. I have all the time in the world throughout my shift to be able to speak to these patients and really address all their concerns. Oftentimes, abortion patient navigators are the first person that patients are speaking to that have a lot of knowledge around this subject. And there is so much misinformation, that I just spend a lot of time being able to address all their questions. I try to hold a lot of space for them and to let them know that I am here to listen to their concerns and try and answer all of them.

Miller: But it’s interesting – it seems like the fact that you have the license to take time, that you’re thinking, that alone can go a long way to allaying their fears, because you’re not rushing to get off the phone?

Newman: Yeah, I believe so. I think being able to take the time to really address all their concerns, as well as being able to just answer questions. Sometimes a lot of the anxiety is just with the unknown. Often, patients don’t really know what to expect, so I can explain every step for them along the way, essentially. At my time at PPCW, I’ve worked in quite a few different roles. I’ve worked in the front office, in the check in area. I’m also fully trained as a back office clinic assistant. I also worked as the assistant manager at the Bend Clinic. I really feel like I have a pretty well-rounded perspective on what the patient can expect when they’re seen at one of our health centers. So I can really help give them a better understanding of what to expect.

Miller: You mean physically, what the procedure entails, and that can be where some of the anxiety stems from, not knowing what it will actually be like?

Newman: Yeah, exactly. Just being able to explain the process. But even just the conversations that they’ll be having and how we’re going to prepare them to be well informed for the whole visit, from start to finish.

Miller: You said that part of this is also dealing with misinformation. What kind of misinformation do you find is most common?

Newman: I would say a really common one that has come up a few times recently is sometimes people from out of state are worried to even use their health insurance. So if they are insured, but they live in Idaho per se, they’re worried that they’re not allowed to use their health insurance in Oregon. So something like that, where I’m not sure where they got that information, but it could have created a barrier for them not to be able to get care if they didn’t know that support was available through me, or just being able to have a conversation with someone that can correct that information for them.

Miller: Does this job mean that you actually have to be up on abortion laws or insurance laws nationwide?

Newman: I always tell patients, I am not an expert in other states’ laws, but what I can tell you is that abortion is safe and legal in Oregon. And if coming to Oregon is what makes the most sense for the patient, then I can help.

Miller: In the end, for clients who call you up and say, “I need help in accessing an abortion,” do they always then end up having an abortion done at a Planned Parenthood clinic or might you help them go to some other center?

Newman: Yeah, I could definitely facilitate some sort of warm transfer to a different clinic if that’s what made the most sense for the patient. Just because I’m the first person they speak with when they’re seeking an abortion, doesn’t necessarily mean that Planned Parenthood is going to be the place that they have their abortion. If it makes sense for them to go elsewhere, I can help kind of facilitate a warm transfer in that way as well.

Miller: You mentioned the luxury, in a sense, of being able to spend as much time as you need with any particular client. How long might that be? I mean, how long, on average, do you think you spend with any particular client?

Newman: I think, on average, I probably spend about 20 or 30 minutes, but that can really vary too. Sometimes the phone calls are really quick. If they just need help scheduling, it can be five minutes, but I’ve been on the phone with patients for an hour at a time. And sometimes too, it requires a few follow up phone calls as well. So it can really just depend on the patient’s needs.

Miller: Have there been times when, despite your best efforts, you actually don’t feel like you can help people? I’m imagining, say, low income people who can’t get away from a job, who live in states with severe restrictions on abortion. Are there times when you actually can’t help them get access to the abortion that they’re seeking?

Newman: As far as not being able to help them based on any sort of logistical need, around cost of procedure, cost of travel or cost of lodging, no. Those are all barriers that we can help people navigate through. Outside of those logistical hurdles, if they have other things, like not being able to get time off of work, stuff that are completely out of my control, I’m sure that has been an issue for patients. But as far as anything cost-wise, I can help with that.

Miller: What do you find to be the biggest barriers that your in-Oregon clients face? We are, I think, the only state that has no state-based restrictions on access to abortion. But that doesn’t mean that it’s easy for every Oregonian seeking an abortion to get one. What are the barriers that you hear about?

Newman: The barriers – it really depends. Also, another thing to kind of keep in mind is the barriers also vary depending on location in Oregon. So someone that lives in Portland may have fewer logistical barriers to travel for their abortion appointment versus someone that lives in Eastern Oregon or even someone that lives in Bend or Central Oregon, where we don’t have a really robust public transportation system. If someone doesn’t have a vehicle or a driver’s license, even if they can make an appointment, even if they have health insurance, it might be really hard to just physically get to their visit, which is why it’s so important that I’m connecting to as many patients as possible. So that we can figure out what barriers are in place for them, individually, and then just address them one by one.

Miller: In this conversation so far, the implication I think, has been that we’re talking about medication, surgical procedure. But according to the Guttmacher Institute, – and as we talked about yesterday – medication abortion now accounts for almost two-thirds of all abortions in the country. How much do you talk with clients about medication as an option?

Newman: Yeah, I would say that honestly, it’s pretty even, as far as the amount of patients I’m seeing that are scheduling for surgical abortions versus medication, pill abortions. So it’s really up to their personal preference and also what they qualify for medically.

Miller: Three years ago, state lawmakers in Texas passed a bill that basically outforces enforcement of their abortion ban to any Texan who wants to go after somebody who has helped to enable an abortion. In a sense, that is your job to help enable people to get abortions. Do you worry about being sued for the work that you’re doing?

Newman: I’d answer no. What I know is that there are protective laws in Oregon that make it so I don’t have fear about getting sued for the work that I do in the state of Oregon.

Miller: Why did you want this job?

Newman: I love working for Planned Parenthood. I was really drawn to the mission, providing sexual and reproductive health care no matter what. And in particular, it’s the no matter what part that really resonates with me. I feel like abortion patient advocates really are able to put action behind those words. And that’s what I’m really proud to be a part of.

Miller: What’s a good day like for you at work?

Newman: A good day for me at work is a day where I’m able to not play too much phone tag with patients, when I’m able to reach them and we’re able to have a productive conversation, where it’s clear to me what their needs are. And then I can kind of give them that sense of relief that we can help.

Miller: Nova, thanks very much.

Newman: Thank you.

Miller: Nova Newman is an abortion patient navigator, one of four statewide. She is with Planned Parenthood Columbia Willamette.

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