More than a year since the U.S. Supreme Court struck down national abortion protections, reproductive health advocates are, of all things, hopeful.

The Martha’s Vineyard Hebrew Center hosted a panel Thursday titled “What has happened in the year since Dobbs?” to mark the status of the reproductive justice movement on the Island and beyond. Elizabeth Barnes, a longtime Vineyarder and president of the independent clinic network the Women’s Centers, served as a panelist alongside Andrea Miller, president of the National Institute of Reproductive Health (NIRH), and Elizabeth Torrant, chief program officer of Health Imperatives, the sexual and reproductive health clinic on-Island.

“I’m literally preaching to the choir here,” Ms. Barnes joked, addressing an audience of friends, family members, and fellow Hebrew Center members.

The Dobbs decision that came out last June reversing Roe v. Wade has had cascading effects on reproductive health access, but not all of them negative, Ms. Miller said.

While 15 states currently ban abortion care, 18 states including Massachusetts have enshrined abortion rights in their state law, most by statute and one in their state constitution. Moreover, ballot initiatives to further restrict abortion access in states like Kansas, Montana, and Ohio have been soundly rejected by voters, bolstering advocates’ assertions that despite the legal backlash, abortion rights are a popular issue.

To keep up that momentum, Ms. Miller urged attendees to focus on grassroots-level organizing where the most impact can be made.

“The local level is an arena absolutely rich with possibility,” she said.

Ms. Miller also warned attendees not to succumb to black-and-white thinking that separates pro-abortion states from anti-abortion ones. Local battles can be won anywhere, she said, and conversely, barriers to reproductive health access exist even in the bluest states.

Martha’s Vineyard, for example, received direct access to medical abortion services for the first time in years this July. Medical abortions, unlike surgical abortions, are induced through oral medication that, thanks to recent state funding, can now be prescribed to local pharmacies. Previously, Health Imperatives could only prescribe abortion medication through Telehealth physicians in Rhode Island.

Although direct access is still new, Ms. Torrant said that services have gone smoothly so far.

“It’s going pretty well,” she said. “We’re very excited.”

Terre Young, the president of the board of Friends of Family Planning, also attended the panel and shared some of the conversations she’s had with Martha’s Vineyard Hospital staff to bring surgical abortion care to the Island.

According to Ms. Young, OBGYN and chief medical officer Daniel Pesch said that although the hospital does currently provide medical abortions, many patients still prefer to undergo surgery, leading them to seek care on the mainland.

“I said, ‘Okay, Dan, that’s what you need to do next,” Ms. Young said.

In a statement to the Gazette after the event, Martha's Vineyard Hospital chief nurse officer Claire Seguin said the hospital collaborates with a team at Mass General Hospital for surgical abortions.

Other barriers advocates discussed were hospital staffing shortages and the possibility that providers might invoke conscience clauses that allow them to abstain from medical procedures they personally disagree with. Conscience clauses are legal in most U.S. states, Ms. Miller explained, and, in some cases, entire institutions can invoke conscience clauses to refuse to provide a service.

In spite of these barriers, Ms. Miller believed that advocates could put public pressure on Martha’s Vineyard Hospital and its parent organization, Mass General Brigham, to begin providing surgical abortions on-Island.

“This is not hard unless they make it hard,” Ms. Miller said of abortion access.

Above all, panelists acknowledged that the current moment could not be met with one “magic bullet” solution, but rather years of hard work and persistence.

“It’s like ordering a package here,” Ms. Barnes said. “You’re not getting it tomorrow, but eventually you might get it.”