FAIRVIEW HEIGHTS — One year after the U.S. Supreme Court overturned Roe v. Wade, medical providers are uncertain about what services they can legally provide, and patients seeking abortions are traveling hundreds of miles to clinics that often can’t admit them right away, because of a steep increase in demand.
That’s the situation health care workers, patients and abortion-rights advocates described to U.S. Department of Health and Human Services Secretary Xavier Becerra, who visited ºüÀêÊÓƵ Friday to take stock of reproductive health care services in the region on the anniversary of the Supreme Court decision.
After the Supreme Court decided Dobbs v. Jackson, which overturned the landmark Roe v. Wade case that had established a constitutional right to abortion in 1973, Missouri banned abortion except in cases of medical emergencies that threaten the life of a pregnant woman.
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That shift has created an even greater divergence in the policies on the east and west sides of the state line that runs through the ºüÀêÊÓƵ region.
On Friday, Becerra and Rep. Cori Bush, a ºüÀêÊÓƵ Democrat, visited two Planned Parenthood clinics, 17 miles apart, on opposite sides of the Mississippi River. The first, in Fairview Heights, Illinois, has become one of the few abortion clinics in a wide swath of the Midwest. The second, in Missouri, was the last abortion clinic in the state. Becerra and Bush were both at the Missouri clinic one year earlier, for a panel discussion, when the Supreme Court issued the Dobbs decision.
Dr. Colleen McNicholas, Planned Parenthood’s regional chief medical officer, said people are now traveling farther, and waiting longer for appointments at the Fairview Heights clinic. Wait times have increased from two or three days, before the Supreme Court decision, to about two weeks.
In the past year, the clinic has seen patients from 29 states. Though the facility has increased its hours, McNicholas said, “The truth is, we are not going to meet all the needs.â€
Planned Parenthood said more than 40% of abortion patients come to the clinic from outside of Missouri and Illinois. McNicholas said that is compared to about 7% before the Supreme Court decision.
Vasectomy appointments have increased by 97 percent over the past 11 months, Planned Parenthood said.
For about an hour in Fairview Heights, Planned Parenthood employees told Becerra stories about the influx of patients traveling there. They said in some cases, patients had never left their home states before. Beyond helping patients arrange travel, organize childcare and figure out how to pay for the journey, at times clinic staff have to explain how to navigate airports, and how a layover works.
“Clearly, the stories are devastating,†Becerra said after visiting the Fairview Heights clinic. “We’re going to continue this fight.â€
One of the main topics of conversation during Becerra’s visit was the confusion felt by patients and medical providers over the new legal landscape for reproductive health in the U.S.
“Patients are scared. They’re confused. They don’t know who to trust for accurate information. Providers feel they’re on very shaky ground,†said Michelle Trupiano, of the nonprofit Missouri Family Health Council.
Trupiano referenced a survey released this week found that many Missouri residents are uncertain about whether birth control is legal in the state.
“Contraception is not abortion,†Becerra said. “Do not let anyone deceive you.â€
Earlier this year, Axios reported that HHS was considering a range of other possible actions on abortion access, potentially including a
At a press conference late Friday morning at the ºüÀêÊÓƵ clinic, Becerra said HHS has “never excluded any particular proposal.â€
“We continue to explore what we can do,†Becerra said. “We’re going to do our part. We will consider any proposal, and we will act wherever we can.â€
In April, HHS proposed rules that would prohibit the disclosure of reproductive health information for criminal, civil or administrative investigations.
In May, HHS announced investigations into two hospitals — one in Missouri, and one in Kansas — alleging they failed to provide care to a patient in an emergency.
The Associated Press reported that doctors at both hospitals told a patient that her fetus would not survive and that she was or losing her uterus, but they would not terminate the pregnancy because a fetal heartbeat was still detectable. the hospitals’ actions as violations of the Emergency Medical Treatment and Labor Act, or EMTALA.
On Friday, Melanie Fontes Rainer, director of the HHS Office for Civil Rights, said the situation is pending. Becerra said the agency doesn’t report on its investigative work.
But, he added, HHS will take action if hospitals violate EMTALA, “up to and including†removing facilities’ Medicaid reimbursements.
Staff at Planned Parenthood's clinic in southern Illinois say they will continue to provide medication abortions as usual, despite a federal appeals court decision late Wednesday restricting access.
The playbook in Jefferson City, where it has held considerable clout for decades, has shifted.
The Regional Logistics Center, launched in January 2022 by Planned Parenthood and Hope Clinic, helps patients cover costs for child care, travel and missing work.
Planned Parenthood of the ºüÀêÊÓƵ Region and Southwest Missouri performed 42 vasectomies in July, compared to 10 in the same month last year.
Before the Dobbs ruling, a patient could schedule an appointment to terminate a pregnancy in three or four days in the Metro East. Now it’s taking on average three weeks or more because of a massive influx of out-of-state patients.
Despite Illinois dropping parental notification requirements for teens, a similar law in Missouri can prevent teens from getting help to cross the state line for an abortion.
In the days following Missouri’s abortion ban, local women leaders scrambled to anticipate the fallout and what it might mean for their industries and organizations.
Officials on both sides of the abortion issue say the fight is not over.
The Supreme Court’s decision will almost certainly divide the ºüÀêÊÓƵ metro area, a center of abortion access and a region with deep Catholic roots.Â