More Than Medication
Barnard says they’re ready for the post-Dobbs world. But their reluctance to provide medication abortion has left many doubting the level of their commitment.
By Andrea Contreras
Lorena was the only person in the waiting room at the Columbia University Fertility Clinic on 5 Columbus Circle. It was spring 2021—her first spring in the city as a Barnard first-year—but from the clinic window she couldn’t see the Callery pear trees blooming. Her boyfriend loitered outside, unable to enter the building to wait with her: Covid protocol, the nurse explained as Lorena took a seat. (Lorena is a pseudonym.)
Lorena’s first appointment was on Barnard’s campus the week prior with nurse practitioner Anne Herlick. She had known she was pregnant for a few days beforehand. After the initial emotional whirlwind, she researched her options and decided that the medication abortion pill was the right choice for her. For Lorena, who grew up in a low-income household with inconsistent access to health care, the thought of any medical procedure was enough to send her reeling. A surgical abortion seemed like the worst possible iteration. The pills would be easy and discrete.
Barnard Primary Care wasn’t Lorena’s first stop for reproductive care. She tried Planned Parenthood, but the months-long wait time meant she would be unable to get a medicated abortion by the time she got an appointment. So she turned to campus services, hoping they could provide her with pills and the support she needed.
Herlick tried to comfort Lorena: A lot of students go through this, don’t worry. Not usually first-years, though.
Herlick made her dislike for medicated abortion clear. She told Lorena the surgical route is better; medicated abortion would be extremely painful. With the surgery, at least Lorena could get an IUD installed at the same time. But Lorena didn’t want an IUD—she hadn’t said a thing about contraception. You know, so that it won’t happen again, Herlick said.
Offhand comments like these replaced in-depth explanations of the advantages and disadvantages of Lorena’s choices. After being told to think about it, Lorena was finally referred to the Columbia University Fertility Center in Midtown, where she would see an OB-GYN the following week. If nothing else, the Columbia doctor in Midtown was kinder than Herlick; her tone made Lorena feel “a little bit more like a person.” But when it came to asking Lorena what she wanted to do about her pregnancy, the doctor discouraged medicated abortion. She echoed Herlick’s warning that medicated abortion would be painful, probably the worst pain Lorena would feel in her life, and added that it wouldn’t be covered by her school insurance. “She didn’t really describe what the symptoms will be like with the pill,” Lorena said. “She just kind of brushed it off. She’s like, ‘don’t consider that, just go with this route.’”
Despite the warnings, Lorena requested the pills and paid the $80 bill. Both appointments left her with stark feelings of shame and alienation. Lorena felt her proudest accomplishments had been soured by her experience at the clinic. She left feeling like she had become a stereotype—a scared pregnant teenager. “Going into [the] Barnard Health office was—I want to say humbling, but it was kind of degrading,” Lorena said.
Nurse Herlick and the Columbia Fertility doctor’s views on the MA pill may not reflect those of the Columbia health care community as a whole. (When asked for comment, a Barnard spokesperson did not address inquiries about campus medication abortion provision or collaboration with student activists, instead sharing links to two existing public statements.) According to a former staff member, though, Lorena’s experience indicates the biases and misinformation held by many individuals at Barnard Primary Care. “I think Barnard students maybe felt a little bit of, maybe, paternalism, or like they weren’t actually being heard because providers felt like they knew best in that scenario,” said Dr. Payal Patel, a former primary care physician at Barnard. Patel said that fear of pregnancy, not a desire to help pregnant people, was at the forefront of reproductive care at Barnard. “The way that we think about pregnancy, I think that it clearly doesn’t come from a reproductive justice lens. Pregnancy is not a bad outcome. I think the bad outcome is the patient not receiving the care that they wanted.”
Before receiving her prescription, the doctor warned Lorena not to take the pills alone. But Covid rules on campus meant that complying with this order might take some maneuvering. She decided to borrow her roommate’s ID card and building key to swipe in her home friend from Fordham, the only person she trusted enough to tell about her pregnancy. But Lorena and her friend were caught by the security guard at the front desk and her friend was sent home, leaving Lorena to take her pills alone in the bathroom of her dorm.
A few weeks later, Lorena was no longer pregnant. She wasn’t asked to come in for a follow-up appointment at the fertility center, nor did she receive any further communication from them. She doesn’t know her doctor’s name. What she did receive was a surprise bill on her Barnard Health portal: $130 for the ultrasound, in addition to the charge for the pill.
A few days later, another surprise arrived in her inbox—a request for a meeting with her RA and hall director regarding the guest policy. She met with them, apologized for breaking the rules, and assumed the situation was resolved. Then, at the beginning of the summer semester, Lorena was kicked out of her housing. Her appeal, which cited a medical emergency for the rule violation, was rejected.
One year later, Lorena’s inbox was flooded again. This time, it was with communications from Barnard condemning the outcome of Dobbs v. Jackson Women’s Health Organization, the Supreme Court decision which overturned federal protections for abortion. Barnard organized informational panels with Terry McGovern from the Mailman School of Public Health and Janet Jakobsen from the Women’s, Gender, and Sexuality Studies Department; they set up Zoom calls where students could offer feedback on steps the University could take. Their official emails responding to the decision cite Barnard’s mission statement, which “calls on us, individually and collectively, to help lead and inform this national conversation.” It solicited proposals from students for new initiatives that the College could lead. President Beilock even co-signed a New York Times op-ed with the presidents of the six other sister colleges, stating that “we will continue to provide reproductive health care on our campuses, which are situated in states where it is possible to do so.”
Now, some students are wondering what reproductive health care Barnard was referring to. Barnard offers contraceptive services through Primary Care (which they offer appointments for one half-day a week) and has a Plan B vending machine; however, these resources are not what has come under threat with the Dobbs decision. The decision backtracked on abortion and abortion services, of which Barnard has none. The college’s statements were particularly frustrating to the Reproductive Justice Collective, who have encountered numerous administrative roadblocks in advocating for abortion justice on campus for the past few years.
Founded by Barnard students Niharika (Nix) Rao, BC ’23, and Maya Corral, BC ’22, in 2020, RJC began as a way to address the need for intersectional health care on campus, including birth justice, doula programs, queer, trans and gender-expansive inclusive care, and medication abortion at Barnard. Rao, who is nonbinary, said that RJC’s diverse membership of people of color, queer, trans, and low-income individuals informs their fight for medication abortion. “Abortion care in New York is a very two-tiered system, if you are low income and a person of color versus white and high income, because the care options are just so different,” Rao said. “And one of the biggest benefits, I think, of providing this on campus, is just that it helps with so many of those barriers that low-income students of color, queer, and trans students face.”
RJC’s first year of action before their official club recognition in 2021 involved surveying the current reproductive justice landscape on campus, fundraising for abortion clinics, and compiling resources for awareness campaigns. When it came to medication abortion, RJC thought it would be a relatively smooth process to make pills available on campus.
“We genuinely thought that if we garnered enough [support] and explained that students wanted this, that they would work with us. Same for Columbia—we thought that they maybe just needed students to do some level of groundwork around it,” said Rao. But initial conversations with Barnard Health in February 2020 did not go as expected.
Barnard Primary Care makes a point to employ some administrators who boast lengthy backgrounds in justice-oriented care. Executive Director of Student Health and Wellness M.J. Murphy touts experience in “providing health services to underserved, at-risk populations, from various backgrounds” on her CV. One of Dr. Marina Catallozzi’s positions prior to being hired as the first vice president of health and wellness at Barnard and Columbia University Irving Medical Center was as the co-director of Mailman’s Sexual and Reproductive Health certificate. Despite this expertise, RJC claims that much of the institutional reasoning against providing abortion pills has been rooted in “not knowing” crucial information about the medication. In meetings, along with concerns about the pills’ safety, student organizers have been told about the score of logistical uncertainties providers face: whether the University could be held liable for malpractice concerns, questions as to what training staff on ectopic pregnancies would look like. These non-answers have at times been coupled with misinformation: concerns that students might bleed out in their dorms, speculations that private physicians’ offices would be less crowded and offer more privacy, and generalizations that there wasn’t sufficient need among the student population.
A quick look at RJC’s website provides the answers to many of these common questions—answers which RJC organizers have repeated to administration in countless emails and Zoom calls. Barnard and Columbia student health insurance does cover abortion with a copay of $0. If a student doesn’t use student health insurance, there are funds that help them cover costs. New York City Council also recently passed laws making medication abortion pills free for in-state and out-of-state users. Training is not required to prescribe medication abortion, as New York State law allows all nurse practioners, physician assistants, and nurse midwives to provide the pills in-clinic. Medication abortion is considered to be safer than Tylenol and has been FDA-approved for 20 years. Despite bleeding being a side effect of Misoprostol, a recently approved abortion pill, it is considered to be similar to a heavy period. At private physicians’ offices and Planned Parenthoods, patients often experience extremely long wait times and anti-choice harassment. They would also be seen by a new doctor rather than their primary care provider, with whom they might already be comfortable. And, as demonstrated by Lorena and other Barnard students with similar stories, there is considerable and urgent need.
December 2021 marked the first proceedings for the Dobbs hearing in front of the Supreme Court. The threat presented by outlawing abortion in half the country meant that New York City’s clinics and abortion providers would imminently be overwhelmed. The first days of 2022 brought new organizing initiatives, including mobilization and direct action. RJC started spring semester by collaborating with Patel to draft a medication abortion protocol right before her resignation. The protocol includes information on how the University could order medication and how to instruct the patient to take the medication. Patel noted that in her half-year of employment at Barnard Health, the office had no standardized practice for referring students to abortion or reproductive care, apart from providing a handout. Patel, who is now an abortion provider, views the ability to provide abortion pills in-clinic when her patients ask as an important part of her philosophy for everyday care. For her, fulfilling on-demand requests for the pill is important for depoliticizing, normalizing, and destigmatizing abortion care, and for showing students what equitable and just reproductive medicine looks like.
During her brief period at Barnard, Patel never received any bias training. It was not because the staff at Primary Care didn’t need it. Assuming gender pronouns was common, she said, as was the ubiquity of non-affirming white bodies in the clinic’s medical imagery—flowery white vaginas on the wall and in office models. Patel expressed concerns that the demographics of the Primary Care staff weren’t reflective of the student body and tried to implement training to start conversations with staff about affirming reproductive justice health care. When it came to the medication abortion protocol she helped to draft, she expressed uncertainty about whether anybody in her office took the time to consider the materials. “When I was told to assemble this, there seemed to be some interest in medication abortion care, but I think it’s hard,” Patel said.
For Abortion Advocacy Week in mid-April, RJC turned to direct action, releasing their petition demanding pills to the student body, and collaborated with political art collective The Illuminator to project their demand for abortion pills across Low Library’s exterior. Both actions spotlighted RJC’s social media and their mailing list grew from 25 to around 300. Increased attention facilitated RJC’s collaborations with the broader New York City abortion advocacy community, including NYC for Abortion Rights, the New Women Space, and NYC Democratic Socialists of America. When the Supreme Court decision to overturn Roe v. Wade was leaked, RJC organized protests and rallies across the city. Conversations with highly experienced organizers were enlightening for RJC as they developed their strategic toolkit. “We were approaching this as, like, Barnard being our ally, Columbia is an ally, they want to do this, and they told us to model this as a government or a state you’re demanding rights from,” Rao said. “And once you do it with that lens, which is the lens that they’re used to, we’ve actually had so much more success.” Now, RJC’s petition has garnered almost 1,300 signatures, including support from the WGSS Department, the Barnard Zine Library, and multiple tenured faculty members.
For the collective, however, “more success” is relative and far from perfect. At one point, it referred to Murphy and Catallozzi finally responding to RJC’s requests for a post-Dobbs meeting. Catallozzi and Vice President of Inclusion and Engaged Learning Jennifer Rosales had mentioned—and included a website hyperlink for—RJC in a June 27 “community message” in response to the Supreme Court ruling, encouraging students “to learn from Barnard and Columbia students leading the Reproductive Justice Collective, which advocates for and shares resources for reproductive equity and justice.” This led RJC to believe that the administration was ready to come to the table. The meeting was meant to be the culmination of their efforts: a public forum at which any Barnard student could speak openly about the state of reproductive justice on campus. Initially, Catallozzi was cordial, thanking RJC for their work. She agreed: Abortion is great. She then referred attendees to existing Alice resources and reverted back to old talking points. “It sort of felt like Dr. Catallozzi was at a press conference fielding questions from us and got very defensive at times; it felt like a deferral time after time. And it got a little comical,” said RJC member Alyssa Curcio, CLS ’23. “Non-conversations that keep happening again and again, which they like; [they] are able to say something over doing something because they’re having this conversation.”
Barnard may not identify an urgency in providing medication abortion on campus due to its availability in the city. They may think it is enough to say the right things and take meetings with students and collective members to consider offering the reproductive health care that they claim to support. Yet, many students understand this inaction as a familiar failure. Low-income students such as Lorena see it as Barnard further marginalizing their underrepresented students. “This school is just so painfully performative,” she said. “The administration is just not as supportive or liberal really as they like to advertise.”
Performative is not an uncommon word to describe Barnard’s (re)actions. Roxane Gay, invited to speak at Barnard in 2020, famously challenged Barnard during her address, claiming that “public intellectuals, writers, and other interesting thinkers are brought to college campuses as part of splashy initiatives that administrations hope will absolve them of any long-term responsibility for creating a genuinely inclusive institution.” The longstanding critique about Barnard’s performative rhetoric exists uncomfortably but simultaneously with evidence of actual change: Barnard’s 2022 admissions cycle demonstrates a diversity it has previously lacked, with two-thirds of admitted students being people of color, 21% being first in family, and 41 being QuestBridge scholars. For students like Lorena, coming to Barnard Health might be the first time they have consistent access to a medical provider; it might also be the first time they step into a city or state which supports reproductive autonomy or are confronted with a choice to make about their reproductive health.
“A lot of students are coming here with a lot of fear,” said Claire Burke, BC ’25, an RJC member. “There is a need to meet this fear with a solution. And not just a number like, ‘oh, we only get two students a month.’ Well, those students need your help. Why are you not helping them?”