At the Planned Parenthood Coliseum Health Center in East Oakland, Debbie Bamberger sees the writing on the wall. She’s worked as an abortion provider in several Bay Area clinics for more than 15 years and in the field of abortion care for 35 years. But only in the last six months, since the state of Texas passed SB 8 — which bans abortions after roughly six weeks in almost all cases — has Bamberger faced the prospect of women outside California losing their reproductive freedoms.

“I feel heartbroken,” said Bamberger, 55, a nurse practitioner who lives in Berkeley. She believes that the Supreme Court, considering its ideological makeup and past statements made by justices, will decide this summer to overturn Roe v. Wade, the landmark 1973 decision guaranteeing the right to an abortion.

In December, the court in effect upheld the controversial Texas abortion ban, paving the way for states like Ohio, Missouri and Idaho to write similarly restrictive legislation. The fear among pro-choice advocates is that if Roe is overturned, many states will outlaw abortions or make them extremely hard to access.

Reproductive rights groups anticipate that as many as 28 states would move quickly to outlaw abortions.

“Some states have trigger bans on their books,” explained Shannon Olivieri Hovis, the director of San Francisco-based NARAL Pro-Choice California, the state’s leading grassroots, pro-choice advocacy group. “So the effect would be immediate. As soon as Roe falls, [in 13] states, abortion would be illegal immediately.”

The Guttmacher Institute, a pro-choice research institution, predicted in September 2021 that up to 1.4 million women within driving distance might travel to California from Republican-led bordering states to access abortion services if those states limit or outlaw abortions. That estimate does not include women coming from states farther away, including Texas.

The effect would be immediate. As soon as Roe falls, in 13 states abortion would be illegal immediately.

In response, Planned Parenthood is expanding the size and staff of health centers in San Jose, Oakland, Visalia (Central Valley) and Reno, and investing millions of dollars in abortion funds for women traveling to California from out of state.

“The health centers will be larger, updated, state-of-the-art medical facilities that will provide comprehensive reproductive health care and family medicine services,” said Dianna Zamora-Marroquin, director of public affairs of Planned Parenthood facilities across Silicon Valley. “Being able to have a larger staff, we can more readily handle the influx that we’ve already seen and that we know we will continue to see as more states go dark on access to abortion.”

In December, Gov. Gavin Newsom declared California a “sanctuary” for women across the nation seeking abortions, affirming the Proclamation on Reproductive Freedom he signed in 2019 that safeguards women’s reproductive choices in California.

“There’s still a lot of work that we need to be doing, especially if we anticipate a post-Roe world in which the consequences for people all across this country … are going to be incredibly severe and dire, and put women and pregnant people in desperate positions around the country,” Olivieri Hovis said. “They need states like ours to step up and make sure we actually live up to our designation [as a reproductive freedom state].”

For Bamberger, who was the first nurse practitioner in the state trained to provide first-trimester, in-clinic abortions, the work has always felt “like a spiritual practice” that follows in the footsteps of the midwives of the Torah. These days, however, she’s finding a new way to understand her role as it relates to Judaism.

Bamberger cites the “image of welcoming the stranger and giving somebody sanctuary for something that is so integral to their future.” She adds that “getting to decide what to do about a pregnancy changes the course of somebody’s life. And being able to assist somebody in that time is very meaningful.”

Across the country in Washington, D.C., Gina Moore, 26, from Alameda — who previously worked with Olivieri Hovis — sees in her reproductive rights activism a reflection of Eishet Chayil (“Woman of Valor”), referring to the hymn traditionally sung or recited during Shabbat services.

Regarding her Judaism, Moore said she sees women’s work in social justice movements as an act of service.

Moore left her role as a Southern California organizer for NARAL Pro-Choice California six months ago to work in D.C.’s Ballot Initiative Strategy Center, a progressive organization that “leverages” the ballot measure landscape. She’s notified her employer that come June, when the Supreme Court decides the fate of Roe, she’ll be outside the court building holding a pro-choice sign — and her breath.

On March 23, NARAL Pro-Choice California, along with its partners on the California Future of Abortion Council, released a blueprint to protect and expand access to abortion. The CA FAB Council announced its support for key legislation introduced this legislative session, building on the list of 45 recommendations issued in December to shore up abortion access and ensure California can meet the needs of millions of women coming from out of state.

Included in the legislative package is an endorsement of SB 1375, a bill introduced in February by state Senate President Pro Tempore Toni Atkins. The bill would allow nurse practitioners who meet specified criteria and training requirements to provide first-trimester abortions independently, without a supervising physician and surgeon present as current law requires.

In 2013 a similar bill, AB 154, was signed into law, giving nurse practitioners, nurse midwives and physician assistants the right to provide in-clinic, first-trimester abortions. But until recently, many had not received the training to do so.

“The change of law didn’t do as much for expanding access as it was hoped,” said Bamberger, one of about 40 nurse practitioners involved in the research study that led to the passage of AB 154.

“Since 2014, there’s been very little training made available for clinicians who want to learn to provide this care,” she said. Planned Parenthood Mar Monte Community Clinic in San Jose has been one of the only health centers in California offering the training, she said.

Now, as the future of Roe hangs in the balance, one of Bamberger’s top concerns is securing adequate funding to expand training and to enable out-of-state women to afford the travel and medical costs for an abortion in California.

“I think, obviously, the commitment is there,” Bamberger said. “But the ability to make something happen fast is limited by money.”