Is Vegas The New Destination For “Abortion Tourism”?

Daniela* spent the night before her abortion in a chair among a sea of video poker machines. It was late November of last year. She was stranded at a Las Vegas casino, having just flown 1,400 miles from her native Houston to end her pregnancy, on a flight paid for by an abortion fund in Texas. By the time she figured out she was pregnant, she was well past Texas’ early first trimester deadline to have an abortion. Now she was at 22 weeks, necessitating a two-day procedure, and the longer she waited, the fewer options she had. A representative from the Texas fund helped Daniela book the appointment, purchase the plane ticket, and on the way Daniela tried to find the $2,600 she needed to cover the procedure itself. She used donated Lyft credits to get from the airport to the casino, but she couldn’t afford the security deposit on her donated hotel room. Sleep evaded her amid the slot machines’ “bings” and “ding-dings” and her own unease. Her appointment was at 9:30 a.m. At 3:08 a.m., she sent a request to a Nevada abortion fund: Please pay for this abortion.

It was nearly 9:30 a.m. when Carla Ramazan, 23, a recent college grad just waking up in Reno, picked up her phone bleary-eyed and found the rare middle-of-the-night request. While she usually requires 24-hour notice, she immediately got it: Even Nevada bans almost all abortions after 24 weeks. Daniela was out of time. Ramazan got to work.

Young women have advocated for abortion access since before Roe v. Wade guaranteed it in 1973, and especially in recent years, as individual states have passed ever more restrictive laws challenging it. For decades, those laws have been ruled unconstitutional, either by lower courts or the United States Supreme Court, but in the last few years, the landscape has shifted. In December, the court’s conservative justices, who have a 6-to-3 majority, hinted at a willingness to reverse the precedent outlining a constitutional right to an abortion. This summer, the court will rule on Dobbs v. Jackson Women’s Health Organization, a case that could do just that. If Roe is overturned, 26 states, largely those in the middle of the country, are certain or likely to roll back abortion access. That would cause tectonic shifts in where abortions happen in the United States and how Americans access them. In Texas, it has already happened.

In May, Greg Abbott, the governor of Texas, signed SB 8, a state law banning abortion once a “fetal heartbeat” is detected. That’s before many pregnant people know they are pregnant, forcing any Texan carrying a pregnancy past that time limit to consider finding abortion pills on their own or, if they can afford it, leaving the state. Young women in Texas were furious; Ramazan, who graduated from a Texas university that month, was one of them. She planned to move home to Reno in July and take a gap year to study for the LSAT. She wants to practice abortion law, a goal inspired by the death of her aunt from an infection related to a back-alley abortion. It happened in the family’s native Romania, where abortion was illegal at the time, and her aunt, a mother of two who was the same age Ramazan is now, didn’t seek treatment in a hospital because she was terrified of being caught. The ban was “Russian roulette” for desperate women, Ramazan says on a Zoom call from Reno. For decades, thousands of Romanians died trying to quietly end their pregnancies. “I worry about that becoming a reality for people more and more in the U.S.”

Now she saw a way she could help while applying to law school: Girls in Texas needed abortions, and flights to Las Vegas, in her home state, were cheap and frequent. She would start a Nevada-based nonprofit to help women travel to Vegas specifically to end their pregnancies. “Abortion tourism,” she thought.

Since then, Ramazan has added a co-founder and some 30 volunteers and raised tens of thousands of dollars to help people access abortion there. But until Daniela messaged her, she’d never helped a Texan.

Ramazan started Wild West Access Fund of Nevada solo, while she was still packing up her college life in Texas. She recognized that the state already had at least eight established abortion funds, but with SB 8 going into effect in September, she figured they were going to be devoting a lot of funding to getting women out of Texas for abortions elsewhere. What if she could be helpful on the receiving end? Ramazan didn’t know of a single reliable group based in Nevada that helped pay for abortions. She admired an organization in Texas known as Buckle Bunnies and modeled her launch strategy for Wild West on theirs. Attention on their fund had exploded over Instagram, so she leaned on an artistic friend to design Instagram posts for hers. One day in June, she put up Wild West’s first post, sharing her aunt’s story. The next day she posted a cute illustration of a saguaro cactus sheriff mascot and the words, “Need an abortion in Nevada?” Three days later, she had raised $800.

Over the next few months, she devoted any time she wasn’t studying or working at her part-time job to building the fund: soliciting donations, opening the Venmo and Cash App accounts needed to accept and distribute them, talking to abortion seekers, and reaching out to clinics about referring patients she might be able to help. To raise awareness of the fund, she told her aunt’s story before hundreds of people at a Rally for Roe in Reno. She was running Wild West by herself, but in social media posts and on calls, she referred to “us” and “we” as a way of manifesting other pissed off young women she hoped were out there and interested in joining her, she says. “I really held out hope [that] over time people would trickle in.”

They did. Fans, mainly from Nevada, began DMing her, offering to volunteer. She didn’t know most of them, but all seemed serious about helping out, especially Maureen Scott, a 25-year-old from Sparks, Nevada, who emailed Ramazan in July that she was totally in. She had taken a year off to study for the MCAT, she explained, and plans to become an abortion provider, a goal inspired by a friend’s struggle to access an abortion following a sexual assault. Scott wrote that she had tried to launch her own fund around 2015 and “always felt remorse for not being able to get it off the ground and make more of a difference.” The two hit it off, helped by being at the same stage in life: “I was relieved to know there’s someone else like me when I realized we’re both in a gap year working on this,” Scott says. Ramazan soon made Scott a co-founder. “We’ve been attached at the hip since,” Ramazan says.

Ramazan, an extrovert who loves public speaking and donor wooing, focuses on community outreach: building a board of directors, planning events, onboarding volunteers and teaching them how to have hard conversations with clients, and running social media. Scott, an introvert good at thinking through organizational puzzles and streamlining operations, created a more efficient intake process, set up the fax system and a P.O. box, and helped write a volunteer manual that allows those who’ve gotten involved to share the load. “It’s not us doing 100% of the work anymore,” Scott says.

The other young women who’ve joined Wild West hail from various backgrounds and occupations. Lauren Beal, whose day job involves providing technical assistance to the courts around opioid use disorder, worked with a Baltimore abortion fund before moving to Reno. College student Clair Monteith reached out over social media. Macy Haverda is the director of finance and administration for the Nevada ACLU. Some of them joined because they’ve had abortions themselves and want to help ensure access for other pregnant people. Some want to become OB-GYNs or abortion doulas. One woman used to be Ramazan’s high school debate partner.

At first, thanks to the pandemic and eight-hour drive between their hubs in Reno and Las Vegas, the volunteers only knew each other on Zoom. Since being fully vaccinated and boosted, they’ve attended rallies and fundraisers together, like a bingo night fundraiser at a drag bar in December, although meetups are on hold while they wait out the omicron surge.

Today, the fund has raised $77,758 through grants and small donors, and in December the fund was granted 501(c)3 status for federal tax exemption. Wild West has helped more than 166 people by paying for at least a portion of their medication or surgical abortion, and if needed, supplying a place to stay and rides. They assemble and deliver free aftercare kits to all clients, which include Plan B pills, pads, packets of Tylenol, Gatorade, and condoms, and have driven as far as 30 miles to deliver them. The WWAF offers a standard $200 for each abortion with costs of $600 or under, although with an influx of about 18 callers a week lately, they’ve reduced that pledge to $168, though they offer larger pledges for especially difficult circumstances, such as rape, domestic violence, and homelessness. Overall, WWAF clients average about $800 in costs for their abortion.

“My least favorite part of this work is the unfortunate reality that we cannot help everybody” cover all of their costs, Ramazan says. Referrals are now coming more from clinics than Instagram, like West End Women’s Medical Group in Reno and Birth Control Care Center in Las Vegas. “We can very easily blow through all of the money we have raised in a month, if not more than that, but we want to ensure that this resource is sustainable.”

Could they scale up if federal abortion rights disintegrate? Ramazan doesn’t want to see that happen, but expects people with the ability to donate will open their wallets if it does.

“Fundraising is most effective when it comes to times of tragedy, and I think that will be extremely applicable if Roe is overturned,” she says. Wild West raised $3,000 the week the Texas law went into effect in September — huge for an organization with almost no name recognition or community connections. Ironically, if Roe is overturned and abortion law is left to individual states to decide, WWAF is likely to see its donor base go national. “We will be able to fundraise a lot more money than we have from Nevadans… and perhaps from states where Roe might fall as they realize people will have to travel to these safe harbor states where abortion will remain legal.”

Five of the women WWAF has helped so far came from out of state, including an unhoused woman from Arizona, a woman from Southern California who found the closest abortion clinic in Vegas, and Daniela. Ramazan thought there would be more from Texas, but so far Texans going out of state seem to be driving, and Oklahoma, Louisiana, and Kansas, all of which currently allow abortion up to 22 weeks, are closer. People late in their pregnancies with the means to fly are going to Colorado and New Mexico, which have no state-imposed abortion time limits at all, compared to Nevada’s 24 weeks. Realizing that Texas women so far have support, Ramazan has expanded her scope. She says she is telling funding groups in Texas, Arizona, California, New Mexico, Florida, and the Midwest that WWAF is willing to help anyone flying to Las Vegas to end their pregnancies with financial and practical support on the ground. Depending on the balance of the fund, they could also contribute to airfare, she said, or sew together pledges from multiple funds to cover the cost of a flight.

“What I’ve learned in this work is it’s very much a cross-the-bridge-when-you-get-there type thing,” she says. “We’re always learning.”

When she got Daniela’s message, Ramazan committed $600 immediately and was working the phones when a previous donor called to check in. Carla told her what was going on, and the donor gave $2,000 on the spot to fund the remaining balance of Daniela’s two-day abortion procedure. Ramazan was about to send it when the clinic emailed that the National Abortion Federation found the money to cover the abortion.

Ramazan switched gears to finding Daniela transportation while she was in town. She personally sent Daniela cash via PayPal to cover the deposit on the previously donated hotel room, ensuring that for her second night in Vegas, Daniela would sleep far away from the sounds of a casino. The $2,000 from the donor went into the fund. “That just means it can go to somebody else who needs it,” Ramazan says. For abortion access, “I fully expect people to be traveling a lot more.”

*Name changed for privacy.