How can patients skirt abortion bans? A clinic at sea could be the answer Dr. Meg Autry is raising money to buy and retrofit a vessel that would operate as a reproductive health clinic in federal waters off the Gulf of Mexico, providing services including surgical abortion.

A floating abortion clinic is in the planning stage, and people are already on board

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RACHEL MARTIN, HOST:

Dr. Meg Autry is a professor of obstetrics, gynecology and gynecologic surgery at the University of California, San Francisco. She also runs a nonprofit. It is called PROWESS, and it's raising money to buy and retrofit a boat.

MEG AUTRY: The plan is for a reproductive health clinic on a vessel that provides care in federal waters in the Gulf of Mexico.

MARTIN: This all started long before the reversal of Roe v. Wade.

AUTRY: I've thought about the legalities of providing reproductive health care on the water for a long time and, originally, was kind of looking at the Mississippi River because I grew up in the South, and I was just familiar with the casino boats, and I was like, oh, there must be something about the river or the water that makes the - there's a difference legally from the water and the land.

And so as reproductive health rights have been eroded in our country, doing something that would provide legal access for our patients who are in states where their rights and bodily autonomy is restricted came to the forefront. And so I gathered a legal team, and we looked at the Mississippi River and decided that probably wouldn't be the best option. We looked at the Gulf of Mexico, and we believe that offering reproductive health services in the Gulf of Mexico is legally OK.

MARTIN: First of all, just to clarify, this is not something you dreamed up right after the Dobbs decision came down. You've been working on this for a while...

AUTRY: Oh, years.

MARTIN: ...Because you sort of saw the trend lines.

AUTRY: Right. We knew this decision was coming down, right? And so our plan was to be ready to go public when the decision came down, when and if the decision came down. And then - yeah, and then it happened, and we're like, we got to go. So that's where we are.

MARTIN: So where are you in the planning phase at this point? I mean, you don't have boats on the water doing this right now.

AUTRY: We don't, no. We need funding to acquire a vessel.

MARTIN: OK. So you mentioned the legal hurdles. Have you worked through all those?

AUTRY: I don't think you can ever work through all the legal hurdles, right? I mean, you see that keeping up with what's happening legally in restrictive states right now, it's a full-time job. It feels like it's changing by the minute. But we believe in our team, and we believe that we are secure in our understanding of the law. But we believe that there will be legal challenges along the way all the time.

MARTIN: Let's just talk about how this actually works logistically. How far off the coast are we talking about? I mean, these are Gulf states, right?

AUTRY: So there's a swath of federal waters in the Gulf, and the distance from the coastline depends on the state, but it's somewhere between three and 12 miles off of land.

MARTIN: So say you're a person who wants an abortion. How does that person get to you and your doctors and staff on the boat?

AUTRY: So there's currently a lot of networks in place - right? - that are trying to coordinate care for patients who can't get care in their own state, and we would anticipate being part of those networks.

MARTIN: Can you say more? I understand this is all in the planning phase. But it's just going to be word of mouth?

AUTRY: It's also security issues, right?

MARTIN: Security issues, OK.

AUTRY: I'm not going to be transparent in some of it because we're not willing to reveal that information.

MARTIN: Right, because there would be obvious concerns about whether or not the person seeking the abortion could be prosecuted.

AUTRY: Or shot, right? I mean, the dangers of accessing care or providing care in those states are real. And so security is - along with legal, is our No. 1 concern. I mean, I think - you know, this is my life's work, and it is - it's not OK for people to not have bodily autonomy. And the people in these states that are losing their rights are poor people and people of color and marginalized communities. And, you know, as a reproductive health provider, I feel like we have to be innovative and creative in order to allow these patients to get the care that they deserve.

MARTIN: How long would you spend on the ship itself? What would the rotations be like? Presumably, that's how it would work.

AUTRY: I mean, a lot depends on what size vessel we get, right? Like, we know the size below which we cannot go, but depending on our funding, you know, we can go larger. So, you know, it depends. There are union rules in terms of crew and rest and fuel issues, et cetera. So it just depends on the size vessel that we get.

MARTIN: And then, obviously, that will shape and determine how many procedures you can actually do.

AUTRY: Right. So again, I want to emphasize it's a reproductive health clinic. So while we will be providing surgical terminations, we'll also be providing contraception, point of care testing and treatment for sexually transmitted infections, hopefully vaccinations. But we estimate that we could provide for about 20 patients a day, which would be about 1,800 patients in six months.

MARTIN: What's the response been to your plan, I mean, from reproductive justice groups along the Gulf Coast, from donors?

AUTRY: Yeah. The response has been amazing. It's almost overwhelming. It's been for money but also for volunteer services. Like, the legal and medical community has been unbelievable in terms of offering their services. And we've had a lot of volunteer offerings from maritime crew. And the most heartwarming and overwhelming is the - all of the offers of help from people in the restricted states. We know that the majority of this country doesn't believe in what's happened, right? And so the outpouring that we've received just really emphasizes that.

MARTIN: I know it's hard to determine, but what's your goal for being able to get started?

AUTRY: It all depends on when we can acquire a vessel because once we get the vessel, it has to be retrofitted to meet clinical standards, and that process can take anywhere from six to 12 months. So in an ideal world, we would be operational in a year.

MARTIN: Dr. Meg Autry of the University of San Francisco. Thank you so much for your time.

AUTRY: Yeah, thank you.

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