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ST. LOUIS – In some parts of the Midwest, access to abortion can come down to which side of a state’s border you live on. While the procedure is now banned in Missouri, it’s legal across the Mississippi River in Illinois and across its western border in Kansas. And in all three states, health care providers are trying to ensure that all those who need care can get it.
In a first for Planned Parenthood, the national health provider will open a mobile clinic at the southern Illinois border later this year. The decision to launch the expansion was based on data that projected up to 14,000 patients, including from out of state, would seek care in their service area the first year after Roe fell, a number that Planned Parenthood says they are on track to reach. It was a possibility for which they had long been preparing.
“The mobile clinic didn’t just magically exist overnight – we had been planning for a post-Roe reality for many years, to be honest,” said Bonyen Lee-Gilmore, vice president of strategy and communications at Planned Parenthood of the St. Louis Region and Southwest Missouri.
Lee-Gilmore told the PBS NewsHour that the new mobile clinic will “roam the southern Illinois border to bring abortion care just a little bit closer to patients who were traveling further.” When it finally opens, it will start by providing medication abortion care first before later adding procedural abortion care as well.
“The mobile abortion clinic is a health care tool. It is also a symbol of our act of defiance in a post-Roe era,” she said.
In announcing the plan in October, Planned Parenthood of the St. Louis Region and Southwest Missouri said that its Fairview Heights health center saw a 340 percent increase in patients from outside of the Missouri and Illinois bi-state area after the Supreme Court overturned Roe v. Wade. Patient wait times at the center, located across the Mississippi River in Illinois, increased from four days to two weeks, furthering the need for expanded care that Lee-Gilmore noted had been a part of the planning for some time.
READ MORE: On 50th anniversary of Roe, women’s marches draw thousands across the U.S.
But the increase in overall reproductive care isn’t just happening across the border. In Rolla Missouri, a little more than a hundred miles from St. Louis, Planned Parenthood of the St. Louis Region and Southwest Missouri Planned Parenthood also launched its first rural health center in Rolla, which the provider officially took over in November.
Providers say the new mobile clinic will start with medication abortions before later providing procedural abortions. Photo by Planned Parenthood of the St. Louis Region and Southwest Missouri
Formerly the Tri-Rivers Family Planning Center, the new incarnation of the clinic provides almost all forms of reproductive care and sexual health care, except abortion services. While Planned Parenthood locations do provide abortions, they also provides STD testing, cancer screening and primary care, which providers say is scarce in many places.
“Rural communities in states like Missouri are experiencing a public health crisis that won’t go away, Lee-Gilmore told the NewsHour. “Rural communities are still experiencing the aftermath and the recovery from the height of the pandemic that, by the way, has not eased up in states like Missouri.”
READ MORE: Religious leaders file lawsuit to block Missouri’s abortion ban
However, data from the University of Kentucky’s Center for Economic Analysis of Rural Health found that some of these gaps in care existed even before the pandemic – in the United States between 2012 and 2019, out of the 148 counties that lost obstetric care, 113 were rural.
Lee-Gilmore noted that they’re “hoping to bring vasectomy services to that health center soon.” Last October, Planned Parenthood noted in a press release that providers had seen a 240 percent increase in vasectomy patients compared to that same time period in 2021.
Now that the Rolla location, a Title X provider, falls under Planned Parenthood’s operation, Lee-Gilmore said they have been working with staff to “do a more comprehensive scope” of sexual and reproductive health care, and that they are focused on being able to expand to include gender-affirming care. Title X providers provide access to low-income people and families who may not have access to health insurance or additional health care.
“At the end of the day, our patients, whether they are rural or city folk, whether they are Black, brown, white, Asian – everybody deserves access to health care, no matter their ZIP code,” Lee-Gilmore said.
Thirteen clergy members from six different faiths gathered in downtown St. Louis in January to announce a lawsuit challenging the state of Missouri over its abortion ban. Photo by Americans United
A new Missouri lawsuit argues, in part, the same idea, and that Missouri’s ban denies “equality and body autonomy” based on “one narrow religious doctrine.” The legal challenge comes from a coalition of 13 clergy members from six different religious backgrounds and is backed by both local and national organizations.
“Missouri’s abortion bans are a direct attack on the separation of church and state. Religious extremists and their lawmaker allies are forcing all Missourians to live by their narrow beliefs. Religious freedom promises each of us the freedom to make our own decisions about our own bodies based on our own beliefs,” Rachel Laser, president and CEO of Americans United said in a press release.
Similar lawsuits have challenged abortion restrictions in Florida and Kentucky, as well as in Indiana, where a judge in December issued a preliminary injunction on that state’s ban because it may interfere with religious freedom.
On the other side of Missouri, neighbor Kansas has also kept the right to abortion post-Roe, despite a ballot measure bid in 2022 to amend its state constitution, and patients have come from around the region to seek care.
“More and more, our parking lots are full of Texas license plates, Oklahoma, Arkansas, sometimes Louisiana, people are going a long way for care,” Emily Wells, CEO of Planned Parenthood Great Plains, said.
READ MORE: Maine Gov. Mills, legislative leaders move to expand abortion access
Her branch of the national organization serves patients in Kansas, Missouri, Arkansas, and Oklahoma.
In November, a district court judge blocked a Kansas state law that barred doctors from prescribing abortion pills via telemedicine, which connects people with medical-related services and resources by phone or computer. The decision, Wells told the NewsHour, “opened the door” for Kansas Planned Parenthood clinics to be able to expand their care, not just to Kansans but to those from out of state who can get to Kansas for a telemedicine appointment.
“The state’s law applies wherever you’re sitting. So patients in Kansas have the rights of people who live in Kansas,” Wells said. But providers can’t use telemedicine to serve patients who are physically in states with abortion bans. “We can’t increase access in states where there are already bans in effect, which is a pretty devastating thing.”
People from out of state still call, however, hoping to get help. It can be a difficult conversation.
“The patients are still shocked every day when they find out there is not an exception that applies to them, and not a way for us to help them in their home states,” Wells said. “We just feel like we’re living the same nightmare when we have that conversation again and again.”
Gabrielle Hays is a Communities Correspondent for the PBS NewsHour out of St. Louis.
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