Final year the Family Planning of Martha's Vineyard clinic administered 333 pregnancy tests; 22 were positive. Of those, roughly half the women chose to stop.

But for Vineyard women looking to terminate a pregnancy, the just option is to travel off-Island. The closest clinic is in Attleboro. The second closest is in Boston.

For some years, the Martha's Vineyard Infirmary has not offered abortions. Dr. Daniel Pesch, an obstetrician/gynecologist who is vice president of the hospital medical staff and chairman of the equality committee, said that was the case when he joined the staff seven years ago.

"There were other practitioners here who weren't comfortable providing that service as well," he said. "And if nosotros tin can all be on the same folio, information technology'southward ameliorate."

Dr. Pesch said for some women who use his practice, going off-Island is the preferable route.

Dr. Daniel Pesch, hospital obstetrician/gynecologist. — Jeanna Shepard

"No one has expressed a huge concern to me considering information technology's not bachelor on Island," he said. "Fortunately we're in Massachusetts where in that location are options, nosotros're not forced into a situation where we tin can't provide options. Potentially there are certainly psychological pressures [of having to get off Island]. Other people volition say, 'I'm leaving the Island to have this done.' It'south a small Island, they will run across people who they know."

The infirmary is participating in a needs assessment survey nigh reproductive wellness past the Rural Scholars this calendar month, and abortion access is one of the topics.

The scholars are expected to nowadays the results of the piece of work side by side calendar week.

"If information technology turns out [abortion] is something felt to exist needed, we're going to have to look at this much more than closely," said Dr. Pesch. "1 of those things is institutional inertia. I joined a exercise that had a policy and this was where nosotros were. At that place's the feeling it was something we didn't have a lot of demand for, but if people know we don't practice it, they will expect elsewhere."

In 2014, half of all American women of reproductive historic period lived inside 11 miles of the nearest abortion dispensary, according to an analysis past Guttmacher Institute researchers published early on this month. Ane out of five women traveled at least 43 miles to reach the nearest abortion dispensary. Island women must travel twice that distance.

Cape Cod's but abortion dispensary closed in 2008, following the death of a patient. The Cape Cod Times reported that the clinic performed most 80 abortions a calendar month the yr before it was closed.

Now the closest clinic is Iv Women in Attleboro. In 2016, that clinic provided 1,840 abortions according to state Department of Public Health data. Four Women does non continue records of where patients are from.

In 2016, Planned Parenthood in Boston provided v,955 abortions, by far the most of any provider in the city.

Last year the Family Planning of Martha's Vineyard clinic administered 333 pregnancy tests; 22 were positive. Of those, roughly one-half the women chose to terminate. — Jeanna Shepard

Taylor Leininger, a nurse in the hospital obstetrician/gynecology section, said most women who come up in for ballgame counseling end up going to Boston — often they are familiar with the metropolis and with Planned Parenthood. But traveling to the metropolis comes with its ain hurdles.

"I had someone go to Boston and they ended up leaving because of all the protesting in front of [the clinic]," Ms. Leininger said.

Dr. Jennifer Childs-Roshak, president and principal executive officeholder of Planned Parenthood League of Massachusetts and Planned Parenthood Advocacy Fund of Massachusetts, said geographical barriers to abortion care tin bear upon women in multiple ways.

"Those barriers filibuster care, brand it more than costly, reduce options, for example, a medical abortion is available up to 10 weeks, after 10 weeks . . . in that location is a decreased power to have a choice," she said. "If it'south an ballgame or any kind of wellness care, the closer the health care is delivered to where a patient lives or piece of work, the better."

Ms. Childs-Roshak said her group has no plans to open a clinic on the Island but is working with Family Planning, the reproductive health intendance dispensary in Vineyard Oasis owned past Wellness Imperatives.

"Nosotros're impressed with the work that they practice, and the commitment to the customs," she said.

Because it is federally funded, Family Planning does not provide abortions. It does provide counseling on options for women who are pregnant.

Elizabeth Torrant, vice president of health intervention and prevention programs at Health Imperatives, said the Vineyard dispensary focuses on sexual practice education and long-term birth control.

"Nosotros do equally much as we can in prevention work, to forestall people having to make this very difficult conclusion and perchance become off Island," she said.

A Vineyarder in her 20s who did not want her name used, found herself with an unplanned, unwanted pregnancy iv years ago. She made an date at Family Planning.

"They walked me through my options," she told the Gazette. "Information technology was surprising to me that I was going to have to go off-Isle."

She scheduled an appointment at a clinic in Holyoke. The arrangements were complicated; she couldn't miss piece of work, she needed a physician who accepted her health insurance and wanted to spend the night in the surface area. Luckily, she had friends who lived nearly the dispensary and let her stay with them. She booked a ferry ticket for her car, herself and her boyfriend. On the ferry she faced an uncomfortable state of affairs.

"You know how the boat is — you run into anybody yous know and they inquire where you're going," she said. "That first level of social taboo is massively amplified through the ferry."

The following twenty-four hour period at her appointment, she was informed that the one doctor who accepted her insurance had not come in that twenty-four hour period.

"The options were pay out of pocket, or come back adjacent week," she said. "I thought, I can't but come up dorsum next calendar week, that ways another round-trip ferry ticket, more time off work . . . we wound up paying out of pocket."

An ballgame can cost anywhere from $420 to $3,450 co-ordinate to a list of in-state abortion providers from NARAL Pro-Choice America, a nonprofit that advocates for abortion access. Vineyard women add together to that the cost of taking their car over on the ferry or a bus ticket. Financial aid is available through the Eastern Massachusetts Ballgame fund, which helps match providers with insurance and also helps with money for transportation, child care and translation services.

In Massachusetts, women under 18 must obtain parental consent to receive an abortion. A judicial bypass can be granted by a superior court estimate, only the process can take time. Also, the Edgartown courthouse does non always take a superior court estimate sitting.

Cape and Islands Rep. Dylan Fernandes has co-sponsored a beak that would remove the requirement for parental consent or court order for women under 18. The bill is currently in joint commission.

"Many women discuss the decision to have an ballgame with their parents, only some only cannot for diverse reasons," Mr. Fernandes said.

Mr. Fernandes was on the Isle in belatedly September to agree open office hours. He said abortion access on the Isle was raised by some constituents. There are no providers in his district, or the other five Greatcoat firm districts.

"If you lot look at a map of abortion providers, you see a large dark spot, I think it'southward a real problem," he said. Mr. Fernandes said he has had conversations with Planned Parenthood and NARAL well-nigh the possibility of a clinic, but the relatively pocket-sized population is a factor.

"They were concerned about whether it would exist feasible to open up up locally on Cape and Islands," he said. "My argument back is, in the summertime there is a huge influx of young adults in the region."

The bulk of abortions provided in the commonwealth in the terminal three years accept been for women aged 20 to 29, co-ordinate to data from the state DPH.

On the Island, there has been some talk nearly the prospect of teleconference medical abortions, where a provider guides a trained medical professional and patient through the process of taking mifepristone and misoprostol, medications used in tandem to terminate pregnancy. The idea is to expand access to a place where the population may not sustain a total-fourth dimension clinic.

Dr. Pesch said medical abortion by teleconference has been a bailiwick in contempo trade journals.

"I call up it would be a viable option," he said, noting the mounting volatility nationwide around abortion. "Well-nigh of these services are under set on, which is not a nifty thing. Our admission to all these things is going to be more than hard."

Dr. Pesch, who also sits on the board of Family Planning, said there is a vocal group of anti-abortion advocates on the Island who protest whenever Friends of Family Planning tries to fundraise, even though Family Planning does non provide abortions. Simply he also said there is a meaning group of people who back up open access. He said the question comes downward to whether there is a demand, and whether health care providers on the Island feel comfortable providing the service.

"Information technology is an issue," Dr. Pesch said. "There is e'er the question of should information technology be washed on the Island, and so does it accept to be done on the Island. Outset is the should we, then the could we."