Post-Roe, Illinois clinics call for more help
Providers say additional staff urgently needed to meet out-of-state demand
With Roe v. Wade overturned, Illinois abortion providers are trying to shore up enough medical staff to handle the anticipated influx of patients traveling for the procedure from other states — without disrupting or delaying care for Illinois residents.
Some solutions that reproductive rights advocates have raised include allowing advanced practice clinicians to perform abortions, as well as bringing physicians and medical providers from other states to practice in Illinois.
A new abortion clinic in Carbondale expected to open later this summer could also help offset the predicted spike in demand.
Gov. J.B. Pritzker has called for lawmakers to return to Springfield for a special legislative session on reproductive rights this summer, though a start date hasn’t been set.
“If there isn’t capacity, we could see Illinois patients have longer wait times to get the care they need,” said Brigid Leahy, vice president of public policy at Planned Parenthood of Illinois, during a phone interview. “And abortion is a timely health care procedure you can’t delay. We’re doing our best to avoid that, but that is a possibility.”
The U.S. Supreme Court’s June 24 decision to rescind federal abortion protections had immediate repercussions in the Midwest, with several states immediately ceasing to offer abortion services; other states nearby are expected to either ban the procedure or significantly curtail access in the coming weeks.
An additional 20,000 to 30,000 patients are expected to cross state lines to have an abortion annually in Illinois — a state long considered a haven for those seeking to terminate a pregnancy in the Midwest.
Abortion providers have urged the state to allow nurse practitioners and physician assistants to perform abortion procedures, in part to help serve the predicted wave of additional patients. Illinois law now permits these medical providers to prescribe and administer medication abortions, but they can’t perform surgical abortions.
“Southern Illinois abortion providers and advocates are working with the Pritzker administration to ensure nurse practitioners and physician assistants can practice to the full extent of their training including providing aspiration abortions, commonly known as in-clinic abortions,” said Yamelsie Rodríguez, president and CEO of Reproductive Health Services of Planned Parenthood of the St. Louis Region, in a news conference just after the Supreme Court ruling came down.
Roughly a dozen states already allow advance practice clinicians to provide procedural abortions, according to the Guttmacher Institute, a research group that supports abortion rights.
Dr. Nisha Verma of the American College of Obstetricians and Gynecologists said strong data shows that patient satisfaction is just as high when advanced practice clinicians provide first trimester aspiration abortion, as well as medication abortion.
“Allowing advanced practice clinicians to provide abortion care will help increase access to safe, effective abortions,” Verma said in an email. “People are already having to leave their communities to access care, because access is already limited for many people, and we expect that this is going to get worse. Overturning Roe will even more heavily restrict abortion for people across the country, especially our most marginalized populations, so it will be critical that we expand the group of clinicians who provide safe and effective abortion care.”
Abortion opponents denounced the prospect of expanding the role of advanced practice clinicians, questioning the safety of doing so.
“Now Pritzker is considering allowing non-physicians to perform surgical abortions, at the bidding of abortion providers,” said Eric Scheidler, executive director of the Pro-Life Action League, in an email. “These policies have nothing to do with keeping Illinois women safe, and everything to do with maximizing abortion provider profits. … Allowing non-physicians to perform abortions is dangerous for women and serves only the interests of the Illinois abortion industry.”
During a Friday meeting on abortion rights with President Joe Biden and other Democratic governors, Pritzker urged the federal government to support physicians in every state who provide telehealth and mail services. He also called for more federal funding for reproductive health care in Illinois and other states with strong abortion rights protections.
Illinois Attorney General Kwame Raoul said he’s been working with Wisconsin Attorney General Josh Kaul, who faces an uphill battle challenging an 1849 law that almost entirely bans abortion in Wisconsin but had been unenforceable under Roe.
“He and I also spoke about beefing up capacity to deal with the flow of patients who will be coming into the state,” Raoul said Thursday at a roundtable session on reproductive rights held at the Center on Halsted.
This could include streamlining the process of bringing Wisconsin abortion providers to Illinois so they can quickly help handle the increased demand here, Raoul added.
Abortion providers throughout Illinois have been planning for Roe’s demise for years. Planned Parenthood of Illinois recently began offering abortion pills by mail to state residents who qualify, potentially eliminating the need for some patients to ever leave home to terminate a pregnancy.
Since 2018, several new Planned Parenthood clinics have opened near state boundary lines, including one in south suburban Flossmoor near Indiana and one in north suburban Waukegan close to Wisconsin. The Planned Parenthood affiliate in southern Illinois also opened an abortion clinic in late 2019 in Fairview Heights, just a few miles from the Missouri border.
A new abortion clinic is expected to open around mid-August in Carbondale, which currently has no abortion provider.
While Illinois has strong reproductive rights protections, many parts of the state — particularly in the west and south — lack easy or close access to an abortion clinic. There are about two dozen abortion clinics statewide, but the vast majority are north of Springfield.
Eleven of 102 counties in Illinois have at least one abortion provider, according to Planned Parenthood of Illinois. In five of those counties, only medication abortions are available, which is restricted up to 11 weeks in pregnancy.
Choices Memphis Center for Reproductive Health recently announced plans to establish the Carbondale clinic, facing the decimation of abortion rights in Tennessee, where a six-week ban went into effect a few days ago. The Carbondale location was chosen in part to provide abortion access to Tennessee patients who can no longer find care in their state. The clinic will be about three hours from Memphis and Nashville, and accessible by train or bus.
“We expect a total ban to go into effect early to mid-August, where there will be no abortion allowed in the state of Tennessee except for a very narrow exemption for the life of the pregnant person,” said Jennifer Pepper, president and CEO of Choices. “It’s pretty heartbreaking.”
Pepper said Choices provided 3,800 abortions last year. The Carbondale clinic is expected to initially offer medication abortions and a second phase will add surgical abortions, once staffing and property upgrades are in place; in a third phase, the clinic plans to include midwifery services and potentially building a birthing center “so that it is a full-spectrum sexual and reproductive health care center,” she said.
After the fall of Roe, the matter of abortion rights is now determined by individual states. Terminating a pregnancy is legal in Illinois, where the 2019 Reproductive Health Act established abortion as a “fundamental right” statewide. But roughly half the states in the nation, including nearly every state in the Midwest, is expected to ban or nearly outlaw abortion in the coming weeks.
Even under the federal protections of Roe, many Midwest states restricted access to abortion with waiting periods, gestational limits and strict regulations on clinics and providers.
In 2020, nearly 10,000 out-of-state patients traveled to Illinois to terminate a pregnancy, according to the latest data available from the Illinois Department of Public Health. The number of patients crossing state lines to come here for an abortion has risen every year since 2014.
“Lives are now at stake,” said Illinois U.S. Rep. Jan Schakowsky at Thursday’s roundtable session, arguing that access to abortion should be considered potentially lifesaving care. “This is 2022 in the United States of America and we are not going back.”