Adiba Khan was fed up. She’d witnessed her close friend struggle to access abortion in her home state of Oklahoma. Then Khan moved to California, a place she previously deemed a “utopia for abortion” — only to find her seemingly progressive university didn’t provide it.

Khan questioned a university’s responsibility to provide students with health care and found they fell short.

College students can receive comprehensive health care at their university, often through the university’s insurance plan. Have a headache? Head to the on-campus health center. Need a vaccine? Book a same-day appointment.

Need an abortion? Not on campus. Instead, join the growing waitlist at an abortion clinic. While waiting, be sure to secure anywhere from $580 to $800, for a medical abortion, also referred to as medication abortion.

A medical abortion uses medication to end a pregnancy or complete a miscarriage. It is a two-part regimen typically administered before a pregnancy reaches nine weeks.

With one in four women needing abortions and 57% of them in their 20s, access to abortion at universities is critical.

How one woman's voice sparked a movement

In 2015, Khan’s frustration with the absence of abortion care on campus led to a four-year battle for on-campus abortion rights.

Khan and other student activists first brought the idea of having medication abortion on campus to the University of California, Berkeley’s health administration, where they were met with one big question — who is paying for this?

The students were told they would need to raise $150,000 for physician training and advanced security measures. They applied for the university’s student wellness grant, a fund dedicated to ideas that sought to expand student wellness — and they got it.

“I don’t think they expected us to get the money,” Khan said. “But then we did.”

With the money now secured, Khan brought the idea to UC Berkeley administrators, who she said were hesitant to get on board in fear of violent anti-abortion backlash reaching campus.

According to Khan, despite having raised the money for physician training and new security equipment, the university continued to circle back to its safety concerns and the movement was at an impasse.

Adiba Khan, the UC Berkeley student who led a four-year long battle for on-campus abortion rights.

That is until the Institute for Women’s Policy Research, an organization dedicated to improving public policy for women, caught wind of the movement through media attention and decided to help the students turn their idea into a reality by drafting legislation.

“We had students from UC Berkeley come to us,” said California state Sen. Connie Leyva. “They had asked their campus to provide medicated abortion. And they said no… These young people just wanted [abortion] on their campus.”

Leyva said it “worked out” that Berkeley said ‘No’ because the activists, alongside Leyva, expanded the idea to include all public universities in California — and drafted the first version of the bill in 2018.

Senator Leyva recounted being told “shame on you for doing this bill” by women in power within UC Berkeley. “It was just terrible,” she said.

In a statement, Tami Cate, communications manager at UC Berkeley, said, “We support the choice of where students want to get these services and have long provided contraceptives, including the ‘morning after pill’ [emergency contraception] as well as referrals to nearby facilities for abortion services.”

In 2018, then-Gov. Jerry Brown vetoed the first version of the bill requiring public universities in California to provide access to medication abortion through student health. He deemed the bill unnecessary because there were abortion clinics within a seven-mile radius of the university’s campuses.

But a year later — and with a new governor, the second version of the bill, SB 24, also known as the College Student Right to Access Act, was passed and signed by Gov. Gavin Newsom in 2019. Universities have until January 2023 to begin providing medication abortion on campus.

Not everyone agrees with the College Student Right to Access Act. The bill faced opposition from the California Catholic Conference and other anti-abortion rights groups.

Jocabed Torres, a 24-year-old from Los Angeles, called SB 24 a “tragedy” while counter-protesting at a rally for reproductive rights in October 2022.

Torres became pregnant as an undergraduate student at UC Berkeley, chose motherhood and withdrew from her studies. She was one semester away from graduating.

“We shouldn’t pay for abortion,” Torres said. Instead of allocating funds for abortion, she wished money would have been raised to help young student mothers like herself.

Beginning in January 2023, an abortion through California State University will be approximately $50. On average, middle-income families will spend $25,360 on child-related expenses during their child’s first two years alone.

“I hope people can see what we did and see that, yes, we did have some challenges, but we were able to overcome them,” Leyva said. “Everything that we’re engaged in now started somewhere. This is the start of a new normal.”

A New Normal

Students from the University of Massachusetts, Amherst, read about the bill passed in California and decided to push for their state to pass similar legislation. In 2017, they brought their idea to Massachusetts state Sen. Lindsay Sabadosa during a meeting to discuss expanding access to sexual and reproductive healthcare. The senator was immediately on board.

The need for legislation was particularly dire in Massachusetts as students faced unusual geographical barriers when accessing healthcare because the state includes 34 islands and peninsulas.

A student attending the Massachusetts College of Liberal Arts has to travel eight hours round trip by public transportation to reach the nearest reproductive health clinic. Massachusetts Maritime Academy, located on the cape, is eight hours away from the nearest reproductive health clinic — resulting in a 16-hour round trip.

“There’s no reason you should have to go to a special place to have an abortion,” Sabadosa said.

In October 2021, Massachusetts legislators rode the bus with students to the nearest healthcare clinic offering abortion to convey the gravity of the long commutes.

Another reason Sabadosa was passionate about passing this legislation was to help students avoid crisis pregnancy centers — anti-abortion centers posing as health care clinics that offer abortion but, in actuality, do not.

The national ratio of crisis pregnancy centers to abortion clinics is 3 to 1.

“This bill means a student is not going to have to look for a place where they could get an abortion,” Sabadosa said. “They’re going to go to student health services and get real care, counseling and be told all of their options. That’s really important because if they end up at a crisis pregnancy center they’re not going to be given a choice."

Unlike California, the Massachusetts legislation did not receive any pushback from public universities. Instead, the resistance came from private, religious universities in Massachusetts.

Members of Students for Life from Boston College came to testify at a hearing regarding the bill in June 2021 — all of them were men. Sabadosa said their main concern was students who would be “bleeding on campus” as a result of the bill passing.

Despite opposition from Students for Life of Boston College, Gov. Charlie Baker signed Bill H. 5090 into law on July 29, 2022 — making Massachusetts the second state in the nation to require public universities to offer medication abortion through student health.

The bill goes even further than California’s legislation to include public community colleges. Some of the smaller state schools and community colleges don’t have a health center on campus, but they will still be required to provide abortion information and access through a third party.

“Plans can include anything from providing telehealth services to helping students with transportation if they need to go to a clinic,” Sabadosa said.

Universities and colleges without a health center have until November 2023 to submit a plan detailing how they will help students access abortion.

In early October 2022, women, men, children and nonbinary people gathered at the corner of East 1st Street in Los Angeles for the Women’s Rally for Reproductive Freedom with one outstanding message — the fight for abortion rights is far from over.

Among the crowd was Bonnie Abaunza, impact producer and human rights activist of 43 years. She became pregnant as an undergraduate student.

“I didn’t have any money. I couldn’t tell my very Catholic family that I had to do this. And if it wasn’t for the fact that I could go to my university and get it taken care of there I don’t know where I would have gotten an abortion,” Abaunza said.

Abaunza applauded California and Massachusetts for implementing proactive legislation and encouraged everyone at the rally to “ask your work, ask your school [about providing abortion.] It is about healthcare.”

Recently, Adiba Khan ran into a friend who is working on their master’s at UC Berkeley and told Khan that medication abortion is now available at the Berkeley student health center — seven years after Khan sparked the movement for on-campus abortion rights.

“It feels surreal,” Khan said. “I don’t know these students but I know that I’m positively impacting so many of their lives and it just feels like all of the struggle, persistence [and] determination was worth it.”