On a Thursday morning in mid-October, Abbie Strout-Bentes, executive director of SAFE Maine, sat in a small room in a shared office space in Augusta. The room lingered in a state of unpacking, cardboard boxes stacked in a corner. The walls were relatively bare, save for a few framed images: a floral print of reproductive anatomy, flanked by the phrase “Abortion access is freedom.”
It might be a modest office, but it represents a significant milestone for the Maine-based nonprofit abortion fund, Safe Abortions for Everyone (SAFE), which provides financial support to people seeking abortions in and outside of Maine.
In 2023, after thirty-five years as a volunteer-run organization, SAFE hired Strout-Bentes as its first executive director. Earlier this October, it moved to its first official home and increased its outreach efforts, disseminating educational materials, menstrual products, pregnancy tests, and emergency contraception at local events.
Abortion funds have long provided financial and logistical support for people seeking abortions, either in the form of direct grants to patients or block grants to providers. Since the U.S. Supreme Court decision overturning Roe v. Wade, these groups have seen a jump in both patient need and outside support.
SAFE went from barely breaking even for years to a net income of $678,943 in 2023, according to federal tax filings. The organization’s revenue jumped more than 25 percent between 2021 and 2022, the year Roe v. Wade was overturned by the U.S. Supreme Court, from $213,338 in 2021 to $806,278 in fiscal year 2022.
“We received a bequest donation the same year that Roe fell, and we saw a big increase in donations, because people were rightfully outraged,” said Strout-Bentes. In 2023, SAFE provided $79,753 in patient grants to clinics and served 284 individuals, according to Strout-Bentes, a nearly 15 percent increase from the $69,586 in patients grants provided to clinics in 2021.
SAFE is a member of the National Network of Abortion Funds, a nonprofit that provides financial and logistical support to 100 member funds around the nation. The organization saw a massive jump in funding between 2021 and 2022, from $13.5 million in revenue in 2021 to $53.8 million the following year, according to federal tax filings.
Some of that money was distributed to SAFE, although Strout-Bentes said the group primarily relies on individual donors.
SAFE is one of seven abortion funds active in Maine and the only one based here. Five of the funds are active nationwide; one of them, the Laura Fund, an arm of Planned Parenthood of Northern New England (PPNNE), serves patients seeking abortions at Planned Parenthood locations in Maine, New Hampshire, and Vermont.
Before the fall of Roe v. Wade, Planned Parenthood of Northern New England provided roughly 400 grants to people seeking abortions each year, totaling about $100,000 annually across Maine, New Hampshire, and Vermont. Last year the organization provided 618 patient grants totaling $190,000 across the three states, said Interim CEO Nicole Clegg.
“We know that the majority of people who seek abortion care are already parents,” said Clegg. “They’re often low-income or struggling financially. If they don’t have access to abortion funds, they often don’t have access to abortion.”
Costs, needs rise
The cost of abortion varies from about $525 to upwards of $1,500 in Maine, according to Pregnancy Decision Line, which tracks costs nationwide, but does not include the cost of travel, lodging and childcare, which can add significantly to the procedure. Fees vary depending on the clinic, stage of pregnancy, and the type of procedure.
In 2019 Maine expanded coverage of abortions under the state’s Medicaid program, Mainecare, and required private insurers that cover maternity care to also cover abortion.
But high deductibles can still create barriers to care, and many families do not have enough in savings to cover an unexpected medical expense: in a survey conducted by the Federal Reserve last year, 42 percent of adults nationwide said the largest emergency expense they could cover using only their savings was less than $1,000. Many were prepared to handle far less.
Aside from the direct cost of abortion pills and procedures, additional barriers remain. Among them, the price of transportation and childcare during procedures, and the stigma that surrounds abortion in many communities.
“We imagine stigma as creating an emotional barrier,” says Strout-Bentes, “but it creates [logistical] barriers too: do you have transportation to the clinic? Do you have a safe person in your life to talk to about abortion? Do you have a safe household where a medication abortion can be sent?”
Over the past few years, Maine’s abortion funds have supported a growing number of people, including those traveling from states with abortion bans.
According to data compiled by the state, the number of abortions induced in Maine (either via pill or procedure) increased 12.4 percent following the overturn of Roe, from 2,225 abortions in 2022 to 2,500 in 2023. Most people who got an abortion in Maine last year — 2,368 — were Mainers.
Eighty five patients came from neighboring New Hampshire, 15 came from Massachusetts, and 32 traveled from elsewhere – including states with strict abortion bans, such as Texas.
“We see this increase in demand from people traveling out of state [from states where abortion is banned]. And we’re committed to expanding access in response,” said Clegg, of PPNE. “But our insurance rates for abortion care also increased significantly following Dobbs.”
Maine law protects the right to abortion, and no waiting period is required for abortion seekers. In the summer of 2023, Governor Janet Mills signed into law an expansion of the law, allowing doctors to perform abortions after the point of fetal viability, around 22-24 weeks, when a physician deems it medically necessary. (Abortions later in pregnancy are usually reserved for cases of fatal fetal anomalies or danger to a patient’s life.)
Maine has more abortion clinics per 100,000 women of reproductive age than any other state, and ranks above average on other healthcare indicators for women, according to the Commonwealth Fund. (The Commonwealth Fund’s research focuses on women, but transgender and nonbinary people can become pregnant and seek abortions.)
But it lags behind its New England neighbors on healthcare indicators, and expanding access to abortion care in the state has been controversial — a bill to enshrine access to abortion in Maine’s constitution failed in April, although it could still be revived in the coming session.
As federal funding falters, abortion funds are “crucial”
Abortion providers are also turning to abortion funds due to uncertainty around federal funding, particularly Title X, the only federal grant program targeted solely for comprehensive family planning and related preventive health services, with priority given to low-income families. The program provided hundreds of millions in funding to organizations in 2023.
Title X has been periodically subject to what critics call the “gag rule,” which says clinics that take the money may not refer women to an abortion provider or suggest where to obtain an abortion. The rule, officially called the “Mexico City Policy,” has been fought over by Presidents since it was first enacted by Ronald Reagan in 1984, rescinded by every Democratic president and enacted by every Republican, according to KFF.
For that reason, the Mabel Wadsworth Center, an abortion provider in Bangor, doesn’t accept Title X or similarly “restrictive state or federal funding” said Community Engagement Manager Aspen Ruhlin, out of fear that it could be unstable or subject to certain stipulations. So, “abortion funds are crucial.”
Currently, SAFE is the only abortion fund from which the clinic draws, and nearly 100 patients received funding already this year.
But direct funding is only one component of the abortion access equation, Ruhlin explained. Nearly as important are the gift cards that SAFE allocates to providers to help patients pay for gas and other necessities, like sanitary products for post-abortion bleeding. Sixty-five SAFE gift cards have been allocated since the clinic began tracking in May, Ruhlin reported.
“Mabel is the northernmost clinic in the state that provides in-clinic procedures,” they explained, but it’s located about 230 miles from Maine’s northernmost point. “There are folks who travel quite a ways to get to us.” For these individuals, SAFE gift cards might prove crucial, either facilitating or preventing abortion access.
Both SAFE and the Laura Fund also support out-of-state abortion seekers traveling to Maine. According to the Guttmacher Institute, the proportion of out-of-state patients in Maine increased slightly between 2020 and 2023, from 6 to 7 percent. Ruhlin said those numbers are likely undercounts as many traveling patients provide addresses of friends or family members who reside in Maine.
To support states facing a larger influx of travelers, SAFE began providing “solidarity funds” to clinics outside of Maine starting in January of this year, said Strout-Bentes.
From January to September, SAFE distributed about $87,000 to abortion clinics, 13.8 percent of which went out-of-state to clinics in New Hampshire and the D.C. area. The number of patients traveling out-of-state for abortion care could increase again in coming months and years, said Clegg, of PPNE.
There are three publicly available abortion providers in Maine, including the Mabel Wadsworth Center, Maine Family Planning, which has 18 clinics across the state, and PPNNE.
Funding is an issue for all of them. PPNNE projects a $8.6 million deficit over the next three years, said Clegg — a significant increase from the $5 million deficit seen in 2023, and even more so from the $2 million and $1.5 million seen before the fall of Roe, in 2020 and 2021, respectively.
She attributed the projected shortfall to a combination of factors, including below-market reimbursement rates for reproductive care and high insurance deductibles, which increase the need for free or reduced care, even among patients with insurance.
“Covid had a massive impact, not just on Planned Parenthood but on all healthcare providers.”
Planned Parenthood is preparing for additional threats to abortion access with the incoming administration. President-elect Donald Trump has publicly waffled over the years on his stance on abortion; he did more during his first term to restrict abortion rights than any president since the enactment of Roe v. Wade.
While various experts consider a national ban unlikely, PPNNE isn’t ruling out the possibility, said Clegg.
“Congress doesn’t need to pass a ban for abortion to become harder to access or for providers to [face] incredible threats in providing care.”
Correction: This story has been updated to clarify that abortions later in pregnancy are provided only when deemed medically necessary by a physician and to correct medical terminology on abortions later in pregnancy.
Per the American College of Obstetricians and Gynecologists, the phrase “late-term abortion“ is incorrect. “‘Term’ historically referred to the three weeks before and two weeks after a pregnancy’s due date. ACOG now refers to early term (37 weeks through 38 weeks and six days of gestation), full term (39 weeks through 40 weeks and six days of gestation), late term (41 weeks through 41 weeks and six days of gestation), and postterm (42 weeks of gestation and beyond). Abortion does not happen during this period.”
