When Roe v. Wade was overturned last summer, grant makers quickly moved dollars to expand the number of abortion providers in states where the procedure was still legal. Such investment was necessary, the thinking went, to accommodate the flow of patients from states where abortion was no longer an option.
While well meaning, this strategy was shortsighted and failed to take into consideration the cultural and political dynamics, safety concerns, travel logistics, and complexity of new legal constraints. Recent developments surrounding the medication abortion pill mifepristone — including an expected ruling soon by a federal judge in Texas that could overturn federal approval of the drug — underscore those complications.
Perhaps most importantly, the narrow focus on emergency abortion services following the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, obscured the decadeslong need for full-spectrum reproductive-health care in communities across the United States, including abortion access, care for transgender and nonbinary people, prenatal and postnatal care, contraception access, and support following miscarriages.
It’s clear that emergency funding is not enough to create sustainable reproductive-health care, especially in rural and marginalized areas. Instead, philanthropy should look to state and local organizations that are getting creative and building new alliances to protect and expand care.
We have seen such work up close in New Mexico, where our organizations are engaged in a new project to expand reproductive-health care in Doña Ana County, the state’s largest majority Latino/a county. Although abortion remains legal in New Mexico, the area has struggled for decades with long wait times and too few reproductive-health centers. One new resident reported spending five months looking for a health care provider that offered gender-affirming care and expressed concern that many lacked an understanding of transgender people’s needs.
In New Mexico, as in other states, barriers related to cost, transportation, and childcare kept reproductive-health care out of reach even before Roe was overturned. Now the challenges are compounded as dangerous and draconian abortion bans leave countless people in dire need of help in Texas and other nearby states.
Using an alternative approach to this escalating crisis, four organizations — Forward Together’s Strong Families New Mexicol Bold Futures, which Charlene leads; the University of New Mexico; and Planned Parenthood of the Rocky Mountains — came together to create the New Mexico Reproductive Health Success Project. The initiative is a unique collaboration between government, nonprofits, philanthropy, and public education that should inspire more meaningful and lasting responses to the post-Roe era.
The project, which will result in a full-spectrum reproductive-health care center in Doña Ana County, is funded by major national philanthropies, including the Collaborative for Gender and Reproductive Equity, where Judy works, and a $10 million pledge from New Mexico Gov. Michelle Lujan Grisham. It is expected to be completed within the next two years.
The center’s initial push came from the University of New Mexico, which, prior to the Dobbs decision and the expected increase in abortion restrictions, began working with health care providers, reproductive-justice advocates, and others to come up with a plan.
From the outset, the four partners agreed that the project needed to empower advocates at local organizations who work directly with those struggling most to get services. Leaders from the two statewide nonprofits — Strong Families New Mexico and Bold Futures — brought together local health care providers, birth workers, community advocates, and mental-health workers to help plan the project. They were soon joined by Planned Parenthood of the Rocky Mountains.
This original working group evolved into an advisory board whose diverse representation helped ensure the center would provide the full range of reproductive-health care services. By the end of the process, what started primarily as an attempt to find the best location for the center, now encompassed specific plans to meet the needs of Indigenous and Latino/a communities who for years have advocated for expanded reproductive services.
This kind of collaboration involving government, advocacy, philanthropy, and public-education organizations is still relatively rare, but similar approaches in other states are already delivering results. In Kalamazoo, Mich., for example, a new Reproductive Health Fund is expanding access to critical services. Local nonprofits, with the support of the National Institute for Reproductive Health, county commissioners, and private philanthropy have made significant progress toward eliminating financial and transportation barriers faced by those seeking care, including offering 24/7 childcare services to residents. The group is also laying the groundwork for additional county funding to increase abortion services.
Despite the enormous influence of political groups dedicated to restricting access to abortion services, partnerships like these demonstrate that pooled resources and collaboration across fields and areas of expertise can offer tangible relief to communities most in need. When donors respect the expertise of reproductive-justice leaders, listen to affected communities, and support local efforts, they engender trust and help ensure the work gets done quicker.
What Philanthropy Must Do
As the nation continues to navigate the abortion-care crisis, the lessons for philanthropy are clear.
First, reactive approaches aren’t enough. Devising long-term solutions for those most affected by abortion bans requires investment in state-based organizations. These groups understand local nuances, have relationships with both the people in power and those seeking care, and can navigate the intersection between providing care and advocating for policy change. These are also the same folks who can be counted on to stick around for the long haul.
Second, philanthropy alone will never solve the reproductive-care crisis. Despite the generosity of many donors, the scale of care needed and the magnitude of the abortion-access crisis will require sustained government funding that moves the legal and cultural needle. For philanthropy, that means investing in groups that can build power to influence policy change. In many instances, those are the same organizations seeking to address immediate care needs.
For example, in addition to developing the new center, the New Mexico Reproductive Health Success Project is working to improve Medicaid coverage of abortion services in the state. Similarly, the Michigan Reproductive Health Fund is advocating for the removal of the state’s targeted restrictions on abortion providers, known as TRAP laws. And each group is working to disseminate honest and accurate information about abortion care that reflects the high levels of support for abortion access in the United States. Such efforts help reduce the stigma facing both patients and providers.
The work of a handful of advocacy groups in two states may not change the entire country, but it can provide a blueprint for action across the United States. By facilitating similar collaborations, philanthropy can help build a future where access to care is legal and equitable.