Roe’s Final Hours in One of America’s Largest Abortion Clinics and the Shift to Border State Care
At seven o’clock on Friday morning, Ivy turned on the lights of the Houston Women’s Clinic, the largest abortion provider in the state, where she has worked as a supervisor for nearly two decades. Since May, when the draft of a Supreme Court decision leaked, revealing its conservative majority’s intention to overturn Roe v. Wade, Ivy went to work each day knowing that it might be her last.
The Day of the Decision in Houston
Friday, patients began arriving at eight o’clock, having negotiated picketers who were working the parking lot. A ruling on Roe v. Wade was imminent and the procedure could be banned at any time, Ivy would warn the pregnant women who approached the front desk, after the perfunctory good mornings. The dominant concern was whether the ultrasound would determine that they were more than six weeks pregnant or had electrical activity in fetal cells—eventualities that, following the passage of a state law last September, would mean they’d be barred from receiving an abortion in Texas and need to seek care in a different state.
Despite the tension, for the next hour, the workers tried to focus on their particular responsibilities, including answering the phone, which rang constantly. But at 9:11 A.M., before the doctor had walked through the door and any abortions had commenced, Sheila heard from an A.C.L.U. lawyer. “Roe, overturned,” she said flatly. Moments after learning that the Supreme Court had overturned Roe v. Wade, Ivy, the supervisor at the Houston Women’s Clinic, walked to a nearby room and pressed her fingers to her eyes, fighting back tears.
Relocating Abortion Services to Border States
In the weeks since the Supreme Court overturned Roe and dismantled federal abortion protections, conservative states have begun enforcing bans on the procedure. Now, reproductive health providers have started leaving those states, working to open new outposts for abortion on the borders in nearby states that appear likely to maintain access. Providers hope the new clinics can help serve the surge of patients now expected to travel for abortions.
Relocation Plans of Major Providers
The following table details how providers are moving to maintain access to care:
| Organization | Original Location | New / Planned Location |
|---|---|---|
| Whole Woman’s Health | Texas | New Mexico |
| CHOICES | Memphis, Tennessee | Carbondale, Illinois |
| Red River Women’s Clinic | North Dakota | Minnesota |
| Jackson Women’s Health Organization | Jackson, Mississippi | Las Cruces, New Mexico |
| Planned Parenthood | Neighboring Idaho | Ontario, Oregon |
The Challenge of Capacity and Access
The pattern reflects a growing reality: About a dozen states will soon be tasked with providing the majority of the nation’s abortions, per an analysis by the Guttmacher Institute. But in those states, there aren’t enough clinics to provide care for everyone in need. Wait times for abortion appointments have increased to two to three weeks from one to two days, according to staff at Hope Medical Clinic in Granite City, Illinois.
Jennifer Pepper, the CHOICES executive director, expects to get to capacity very quickly. “There will be people who have the ability and resources [to travel for an abortion] and are going to have a very hard time finding an appointment because the clinics are already at capacity,” Pepper said. Furthermore, Whole Woman’s Health is opening only one clinic in New Mexico—not enough to account for all the Texans who have now lost access to abortions in their home state, and the journey will be expensive.