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Mobile abortion clinic extends access to rural Minnesota

Medical director Dr. Julie Amaon wants everyone to get the health care they need while the pandemic's on -- including abortions.

Medical director Dr. Julie Amaon wants everyone to get the health care they need while the pandemic's on -- including abortions. Just the Pill

Dr. Julie Amaon has seen what happens when people need health care and can’t get it. Before she became an abortion provider through a University of Minnesota family medicine residency program, Aamon worked for Planned Parenthood in Austin, Texas, and ran her own clinic for four years.

Her time there happened to align with a Texas state government push to siphon money from family planning clinics into "crisis" pregnancy centers, resulting in one in four of the state’s clinic’s closing in 2011. There weren’t enough providers or resources to go around, and fewer patients sought reproductive health care of any kind.

“It was a disaster,” she says.

Aamon enrolled in medical school the next year.

Access to reproductive health care is better in Minnesota than in Texas, but there are still gaps to cross, hoops to jump through. For one thing, there are only a handful of clinics in the state that specifically provide access to abortion. Three are in the Twin Cities, one's in Duluth, and another is in Rochester.

That means people must drive for hours to reach a clinic that can help with an unplanned or unwanted pregnancy, sometimes from states where access was even more limited – assuming they knew where to go at all.

That’s to say nothing of the gauntlet of stigma and public pressure directed at people seeking abortions and abortion providers. There’s always the risk of being accosted, intentionally misdirected or misinformed, or even threatened or intimidated.

This year brought yet another obstacle to coverage: COVID-19 hit just as Amaon finished her residency. Clinics started restricting services. Seeing a doctor became scary for a whole new host of reasons, chief among them the risk of catching or spreading disease. Any existing difficulty seeking an abortion was instantly compounded.

This presented an opportunity to try something new.

Amaon is now the medical director of Just the Pill, a new mobile reproductive clinic based out of Minneapolis. Patients can check in on their phones or computers and receive medication by mail for a variety of services, including STI treatment, birth control, and yes, abortion by pill. It’s just now getting up and running, thanks to funding from organizations like NARAL and Gender Justice.

The irony is, before the pandemic, it would have been largely illegal to use mail-in pharmacies to send someone the abortion pill (mifepristone). The only reason Amaon and her colleagues can do so these days is because of an injunction lifting some of the restrictions on the drug while social distancing is enforced. She’s hopeful the laws can be changed to make this permanent, but just in case, Just the Pill is stocking supplies in its brick-and-mortar office.

She’s hopeful about a lot of things, in fact – and that’s not because things are necessarily looking great right now. Like a lot of people, the death of Supreme Court Justice Ruth Bader Ginsburg hit her hard. She’s trying not to think about what a more conservative court might mean for abortion rights.

“I don’t like to guess what they’d say,” she says.

Instead, she contents herself to do what she believes Ginsburg would call her to do.

“I can’t rest on my laurels and just be sad and not fight,” she says. “Whatever happens, Minnesota is going to be a safe place to seek health care.”

Within the first six months to a year, Just the Pill is also looking to provide gender affirming hormone therapy – another service that’s often extremely difficult for rural Minnesotans to access. It works “beautifully,” Aamon says, over telemedicine. A great fit for the clinic. But right now, they have to “start small.”

For someone willing to change her career and the entire reproductive healthcare paradigm to get people the services they need, Amaon has simple, mundane visions for the future. She’d love to be a general medical practitioner one day. She’d love to be able to help people with their sinus infections, their prenatal care, their flu shots, their birth control, and yes, their unwanted pregnancies.

She doesn’t want to have to send them somewhere else, to a new doctor they’ve never seen, just because this one procedure has been deemed somehow different, somehow less necessary, than the others.

“That’s just part of regular primary care for me,” she says.