By Randall K. O’Bannon, Ph.D., NRL Director of Education and Research
The legal details are still being worked out, but with Roe gone, America has ended up a patchwork of legal protections, with abortion being fully legal in some states and unborn babies being afforded a degree of legal protection in others.
For the most part, Planned Parenthood seems to be trying to comply with these laws, publicly (but perhaps only temporarily?) shutting down abortion operations in those states where new protections are in place. This does not necessarily imply an acceptance of the new reality so much as perhaps represent a strategic decision to try to keep the organization and its staff out of legal jeopardy while they plan their next moves.
To no one’s surprise, Planned Parenthood is actively challenging these protective bans in the courts.
In the meantime, however, Planned Parenthood has been working on ways to work around the new limitations, keeping their abortion business humming by relying on new mega-clinics in border states and now a new mobile abortion clinic.
Border Clinics
In October 2019, Planned Parenthood opened one of the organization’s largest abortion clinics in the country, an 18,000 square foot megaclinic, in Fairview Heights, Illinois, equipped to handle services to 11,000 patients a year. The new clinic was replacing an older Planned Parenthood clinic that had been much smaller and could only handle a fraction of the patients anticipated at the new facility (NBC News, 10/2/19).
Something else about that clinic, though. It was less than 15 miles from the border of Missouri, which was at that time involved in a long running dispute with Planned Parenthood regarding the licensing and operation of abortion clinics in that state.
Planned Parenthood openly admitted that one of the reasons for building the new clinic, for building it where it was and presumably for building it so big, was to be able to serve those who might be traveling from out of state to receive “reproductive health care.”
“The idea is that we are creating a regional abortion access hub,” Yamelsie Rodriguez, the president of Planned Parenthood of the St. Louis Region and Southwest Missouri told the New York Times. “In a post-Roe world, this is crucial to our mission” (NY Times, 10/22/19).
Just over the line
This is hardly the only new bordertown clinic that Planned Parenthood has erected in the past couple of years.
In July of 2020, Planned Parenthood of Illinois (PPIL) opened a large new abortion clinic in Waukegan, IL. PPIL said that the new center could handle overflow from North Chicago as well as any patients who might cross the state line from Wisconsin, which PPIL described as “a state that poses stringent legal barriers to abortion” (Daily Herald, 7/12/20).
In April of 2022, Planned Parenthood announced plans to lease space for an abortion clinic in Ontario, Oregon, a small town of less than 12,000 located in that state’s eastern high desert. Considering its size and its isolation from any other large population centers in the state, the opening of a new business appeared to make little economic sense. One wouldn’t expect to see enough STD, birth control, PAP smear, let alone abortion patients, to keep the business open.
But one other important detail puts the plan in perspective – Ontario was situated right on the border of Oregon and Idaho, only about an hour’s drive from Boise, Idaho’s most populous city. Boise, statistics tell us, was home to the women responsible for most of Idaho’s 1,680 abortions in 2020.
There is no way that the timing and placement of the new clinic was simply coincidental with a June 2022 announcement by Planned Parenthood that its Boise, Idaho clinic would be closing, anticipating the state’s actions in light of Roe’s impending overturn.
A national objective
Planned Parenthood’s national president, Alexis McGill Johnson, in an interview with CNBC shortly before the Supreme Court’s official Dobbs announcement, said that the group was focused on, in CNBC’s paraphrase, “boosting access to abortion in states where the procedure is expected to remain legal, especially states like Colorado and Illinois, which share borders with states ready to immediately ban abortion if Roe v. Wade is overturned.”
“We want to ensure that patients get the care that they need, even in states where abortion is banned or severely restricted,” McGill Johnson told CNBC (CNBC, 6/9/22).
Besides building the clinics mentioned above, McGill Johnson talked about increasing staff and funding at existing clinics in some of these states so that they could help schedule travel for patients coming from out of state and could handle the overflow.
Deadly Deals on Wheels
Many of the details are still a bit fuzzy, but the same folks who built the Fairview Heights megaclinic on the Illinois side of St. Louis are back at it again, now announcing what it says will be Planned Parenthood’s first mobile abortion clinic.
The idea is to have a 37 foot RV that will travel the roads along the southern border of Illinois offering abortions to women in neighboring states like Missouri, Kentucky, and Indiana where abortion has been limited or banned. The RV is set up to include a small waiting area, a lab, and a couple of exam rooms.
How this is supposed to work
Initially, the plan is for clinicians aboard the mobile clinic to give abortion pills to women up to 11 weeks gestation. The U.S. Food & Drug Administration (FDA) protocol limits this to 10 weeks, but Planned Parenthood ignores this limitation. It appears that women will call Planned Parenthood, be told about the mobile program, and if interested, will discuss their situation and the nature of the chemical abortion process and then arrange a time and place to meet. The mobile unit will then drive and meet them at that location when it is time for their appointment.
Once there at the mobile clinic, it sounds as if women may be given some sort of brief exam and counseling and, once cleared, will get and take mifepristone, the abortion pill. They will then be given the prostaglandin misoprostol, the second drug in the process, to take later on their own a day or so later.
Presumably the women drive home to endure the bloodiest and most difficult part of the abortion there. None of the stories mention any sort of in person or professional follow up to determine whether or not the abortion has been “successful” or is complete. A certain percentage of these abortions fail, and sometimes women require surgery to complete the process or just to stop the bleeding.
Unmarked roads
No specific route has been identified, other than somewhere “along the southern Illinois border.” Colleen McNicholas, the chief medical officer, says that with the mobile clinic is that patients “might only have to drive five hours instead of nine hours” (NPR, 10/3/22).
NPR says that “The organization is reviewing data to determine where patients are coming from and looking at healthcare facilities, churches, and other locations as potential stopping-off points.”
This may not turn out to be as simple as Planned Parenthood believes. Beyond the exurbs across the river from St. Louis, much of the southern Illinois area involved is rural and farmland, not the sort of communities who would be anxious to host a mobile abortion clinic.
Planned Parenthood is starting with the one truck and chemical abortions, but the plan is to add surgical abortions as early as next year and maybe add additional mobile clinics in the future.
Deadly competition
Sadly, while Planned Parenthood may get most of the media coverage and more of the customers, it is not the only organization going the mobile clinic route. In June of 2022, a new telemedical abortion group called “Just the Pill” announced plans to build a fleet of mobile abortion clinics that would travel the country, concentrating on states like Illinois and New Mexico where abortion was legal but less so in neighboring states (ABC News, 6/29/22).
“Just the Pill” was already operating two such mobile abortion clinics in Colorado at the time, performing an average of 16 surgical abortions a day and having 50 patients a day pick up abortion pills. The group hopes to expand its fleet to 30 vans, if sufficient funds can be obtained, adding mobile units to Illinois, New Mexico, and Pennsylvania in the near future.