FAIRVIEW HEIGHTS, Ill. (AP) — Dr. Colleen McNicholas is about to perform two abortions when a ringing phone quickly stops her.
“Oh, ugh,” she said, wide-eyed, before storming into another room.
Just a day earlier, 58 women had an abortion at the Planned Parenthood clinic in Fairview Heights, 15 miles east of St. Louis. But the new day is still full of appointments; up to 100 abortion and family planning patients could walk through the doors.
Every day is busy now.
Hundreds of women travel to the southern tip of Illinois every week to secure an abortion, something millions of people across an 1,800-mile stretch of 11 southern states have mostly banned abortion since the Supreme Court overturned constitutional protections , is no longer available to women to terminate pregnancies.
But another barrier awaits them once they reach the clinic in one of the most pro-abortion states in the country. Anti-abortion advocates in neon safety vests try desperately to wave passers-by down the gates, hoping to talk them out of what they’re about to do.
The clinic’s waiting list for abortions has grown from just two days to almost three weeks after the Supreme Court ruling last June — even after staff began working 10-hour shifts and they opened the clinic on Saturdays.
“With every legal battle, with every new constitutional change, with every new abortion restriction in a state that has some access, we’re on the brink of what we can do here to make more room for the people who are going to get out.” flee their home state?” said McNicholas.
With 10,000 abortion patients expected at the clinic this year, there is talk of opening on Sundays. Staff developed an emergency plan that would remodel some patient rooms, normally reserved for birth control consultations or vasectomies, to make more room for abortions. A recreational vehicle has been converted into a mobile clinic that can drive along the state line so doctors can perform abortions.
That still won’t be enough to keep up, McNicholas predicted.
She has her eye on a proposed six-week abortion ban in Florida that could send even more Southern women north to seek abortions. And she’s watching closely as a Texas judge decides a case aimed at keeping the abortion pill mifepristone off the market.
“Each additional decision has the potential to really change demand again,” she said. “It’s like crisis management every day of the year.”
months before Roe v. Wade was tipped, Planned Parenthood and the nearby Hope Clinic were already dealing with a surge of patients from Oklahoma, Arkansas, Texas and elsewhere after Governor Greg Abbott, R-Texas, signed legislation so effective shutting down several abortion clinics in his state and led to long waiting lists in the facilities in neighboring states. Together, the clinics opened a new regional logistics center in January 2022 that will help out-of-state patients book hotels, flights, gas bills, bus rides, or rental cars at both facilities.
Just six months later, on June 24, the Supreme Court ruled that abortion was not a constitutionally protected right. Within hours, states like Louisiana, Mississippi, Tennessee and Texas began passing trigger laws banning abortion.
Now about 70 women call the center every day for help getting to an abortion clinic in southern Illinois, said Kawanna Shannon, director of patient access at the Planned Parenthood clinic. When they reach the line, a navigator first goes through what they can pay for their abortion. There are more details: How does the patient get to the area? Does she have money for food while she stays there? Does she need childcare?
When someone can’t afford the cost of hotels, bus tickets, or air travel, the center books travel for the patient and works with more than 30 nonprofit groups across the country that are asking for abortion access funds to make the trip finance.
The work doesn’t end here.
A staff member is available 24/7 to take desperate calls from patients encountering travel issues. Workers rushed to arrange a ride to the airport in the middle of the night so a patient could flee her abusive partner. They fix errors when a car breaks down while driving to southern Illinois. They navigated through canceled flights during a crushing winter travel season to ensure a woman was returned to her family after having an abortion on Christmas Day.
“It’s not slowing down,” Shannon said. “We really care about the entire southern region. All (patients) in the south really come to southern Illinois because we’re the closest. Almost everyone needs some kind of help – be it travel, be it legal costs.”
Two hours south of the Planned Parenthood clinic, two new abortion clinics opened in Carbondale, Illinois late last year to give women living in prohibited states a narrower option.
After reading the Supreme Court’s leaked draft advisory opinion last May, Andrea Gallegos, the director of the Alamo Clinic, said she jumped on Google and began searching for liberal-minded towns in rural southern Illinois.
“Illinois was just one state that really stood out in this sea of states that would most likely ban abortion,” Gallegos said. “It seemed like a good choice to try and get there.”
The Alamo Clinic moved to the area from Oklahoma last November.
Three doctors travel weekly from Montana, Tennessee or Texas to perform about 30 abortions a day at the clinic, terminating pregnancies before 18 weeks. Gallegos says less than 5% of the patients who come to the clinic are from Illinois.
Most of the patients who come to the Fairview Heights clinic are also no longer local. In the last six months of last year, the clinic saw 2,042 abortion patients from outside of Missouri or Illinois — down from just 314 in the previous six months.
Women are now seeking abortions later in their pregnancy at the Planned Parenthood Clinic, which offers the procedure over 26 weeks. About a quarter of patients need a second-trimester abortion, McNicholas said.
But the most difficult change to contend with has been the steady increase in children coming to the clinic in hopes of terminating a pregnancy that was the result of rape or abuse.
“What you used to see was maybe one or two 10-year-olds and 11-year-olds a year,” she said. “Now you meet a couple every month because they are from all over the country. Just sitting there knowing that so many people are going through so much trauma… There are times when it’s really hard.”
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The Associated Press receives support from the Robert Wood Johnson Foundation for public health reporting. The AP is solely responsible for all content.
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