The day was jampacked at a Planned Parenthood clinic in southern Illinois when a woman who had just driven over 12 hours from Louisiana for an abortion procedure erupted into tears during her health intake.

Kawanna, the surgical services director at Planned Parenthood’s St. Louis Region, gave up her duties and took the woman to a private area for a conversation. She said that she was panicking as she had used her rent money for child care, to rent a car, to buy gas, and to drive to Fairview Heights. In the days before and after Texas’ restrictive abortion law was implemented, clinics in neighboring states became overwhelmed, diverting patients further away. Shannon stated that this patient had only one day off work to complete the procedure. She said that Illinois was the only option for her, but it would have cost her her rent.

Kawanna Shannon. Reproductive Health Services of Planned Parenthood

“No one is thinking about these hardships when they put these bans on. Shannon stated that people have children, have health problems, and are willing to spend every penny just so they can go to another state because the basic need isn’t available in their home state. They need to know that there are people who will fight for them, regardless of the laws or restrictions. We are doing our best to serve these patients. They should know that we will continue to fight to protect them The Illinois clinic is a symbol of a state that considers itself to be a safe haven for abortion. It has seen dozens of women travel hundreds of miles to get an appointment. The Illinois clinic stated that it is ready to accept any woman who requires medical care, despite facing its own problems, such as staff shortages and similar legislation being considered across the Missouri border. According to Yamelsie Rod, the president and CEO at Reproductive Health Services, Planned Parenthood’s St. Louis Region which manages Fairview Heights, the clinic has been working for “the writing on Wall”. “This is the reality that we have been seeing for a long time, and we’ve been preparing for a post-Roe world with a plan to ensure abortion services remain accessible with this clinic.”

The Texas law bans abortions at around six weeks of pregnancy, before most women know they are pregnant, without any exceptions for rape and incest. Rodriguez stated that the access problem is not limited to Texas. When it is lost in one country, it creates a ripple effect that reaches Fairview Heights. Appointments are filling quickly.

The clinic has seen patients from Texas, Arkansas, Louisiana, Kentucky and Tennessee over the past week. Rodriguez stated that no one will be turned down.

The clinic, a $10 million investment by Planned Parenthood and Hope Clinic, sits on the southwest border of the state just 15 minutes from St. Louis, and was built in preparation for abortion bans and restrictions in neighboring states. It has the capacity to handle up to 15,000 patients per year.

Illinois is a refuge in the Midwest that provides unencumbered abortion access. The Reproductive Health Act also guarantees access to birth control and pregnancy care.

Sponsors stressed in legislative sessions the importance and necessity of the act’s protections in the event of the historic Roe v. Wade decision being overturned. The Supreme Court said in May that it would consider the legality of Mississippi’s abortion ban on most abortions after 15 weeks of pregnancy in its upcoming fall term. Jennifer Welch is the president and CEO of Planned Parenthood of Illinois. She stated that regardless of Roe v. Wade’s outcome, the law will still protect the right of choice. “As other states put more barriers into place for people to access this health care, we know that patients will turn to Illinois and we could see tens of thousands of patients if other states follow Texas’ example or if the Supreme court further erodes abortion protection in their upcoming case.”

Inside the busy clinic, Dr. Colleen McNicholas, one of six physicians who work at the facility, has spent a fair share of days staying late to care for patients, but more often than not that goes beyond just medical care, she said.

After completing a late procedure for a patient last week, she had to help the woman, who drove over 300 miles from Tennessee, figure out how to get her car fixed. McNicholas was forced to assist the patient in finding a hotel for the night, while she waited for her car to be repaired. It was an additional financial burden this patient wasn’t prepared for, she said.

Dr. Colleen McNicholas. Reproductive Health Services of Planned Parenthood

Most of these patients are existing in the intersections of marginalization with financial insecurity and housing insecurity, she said. She said that life is hard enough for these patients. Then, having to go through additional hoops to get care can make it very difficult.

Half of all women in the U.S. who got an abortion in 2014 lived in poverty, according to a 2016 study by the Guttmacher Institute, a reproductive health research group.

Kencia Page is the call center director for the clinic in Fairview Heights, which fields more than 350 calls a day. She said that many of these calls are from patients outside the state, particularly with Texas placing emphasis on the whole system of abortion providers.

“We have received calls from Texas patients frantic about the Texas abortion ban, and eager to find out their options,” she stated. These patients are overwhelmed. One Texas patient called us to ask how she would access abortion. They didn’t have the financial support of their family or enough money to travel to Texas.

Page stated that it was “heartbreaking” for patients to share such stories, but it helps to understand the importance of their work and the need to continue if other states do the same.

But, while the clinic deals with the aftermath of Texas’s disaster, Missouri is a battleground for reproductive rights. A full appellate court will next week take up the eight-week ban that was enacted in Texas. Fairview Heights could be able to receive more patients if the law is passed.

While the clinic is ready for an influx of new patients, it also has its own problems, such as staff shortages caused by the pandemic, which have led to creative scheduling and longer work hours. McNicholas stated that the staff is also responsible for carrying the burden of patient’s struggles.

“It isn’t just that we’re there to take care of patients’ procedural needs. We are oftentimes with them, holding their hand, trying to figure out how to help them manage the financial insecurities of those 72 hours,” she said. “There’s a number of things that we certainly will have to navigate, and staff morale and meeting the complex needs of the patients are one of the challenges.”

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