Even with Roe v. Wade intact, many states have aggressively restricted abortion access

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• Judy Woodruff:

  Judge Brett Kavanaugh's nomination to the Supreme Court has many abortion rights advocates worried that the Roe vs. Wade Supreme Court ruling is in peril.

  But, in many states, the rollback of abortion access is already steadily progressing.

  Amna Nawaz recently traveled to South Dakota, one of four states with a law on the books that would immediately ban all abortions if Roe were overturned.

• Amna Nawaz:

  Every few weeks, Dr. Sarah Traxler flies from her home in Minneapolis to Sioux Falls, South Dakota, to work her shift at Planned Parenthood, the only abortion clinic in this sprawling state of 850,000 people.

• Dr. Sarah Traxler:

  I have about 20 patients on the schedule today that I will see. Hopefully, most of them will come.

• Amna Nawaz:

  Is that about average?

• Dr. Sarah Traxler:

  That's about — that's about the average we have on our schedule.

• Amna Nawaz:

  Traxler is the medical director for Planned Parenthood in Minnesota, North Dakota, and here in South Dakota.

  The organization has been flying in physicians since the 1990s after the last remaining abortion doctor in the state retired.

  Dr. Traxler is one of four doctors who rotate in and out of the Sioux Falls clinic. She says that about a third of her patients travel more than 150 miles to get to her.

• Dr. Sarah Traxler:

  There's no typical abortion patient. I see women from all over and from all walks of life come through these doors.

• Amna Nawaz:

  Planned Parenthood says about 17 percent of all their patients in South Dakota are here for abortion-related services. Under state law, they provide abortions up until the gestational age of 13 weeks and six days.

  Last year, the clinic performed 525 abortions in all.

  Planned Parenthood requested that we not show the inside layout of their clinic, nor the outside of Dr. Traxler's car, nor the security that she travels with here in South Dakota. Their concerns, they say, are rooted in the recognition that they are working in hostile territory.

  That's because, in recent years, South Dakota's abortion laws have become some of the most restrictive in the nation.

• Elizabeth Nash:

  South Dakota is really a microcosm for what's happening around the rest of the country.

• Amna Nawaz:

  Elizabeth Nash is the senior state issues manager for the Guttmacher Institute, a research group that supports abortion rights.

• Elizabeth Nash:

  There's a whole host of restrictions in South Dakota. And then it's compounded by really the lack of access, with only one clinic in the state.

• Amna Nawaz:

  In 2006, South Dakota's legislature passed a law banning nearly all abortions. That law was later overturned by voters. A 2011 law requiring women to first visit a state-regulated pregnancy health center where abortions are discouraged is currently in litigation.

  Likewise, a law passed earlier this year requiring the reading of a state-mandated script to patients that abortions terminate the life of a — quote — "whole, separate, unique living human being" is also being fought by Planned Parenthood.

  South Dakota was also the first date to introduce a mandatory 72-hour waiting period, the longest in the nation, meaning a woman seeking an abortion must meet with a doctor in person for her first visit, then return 72 hours later to meet with the same doctor for the actual procedure.

  Holidays and weekends don't count. To comply with the law, Dr. Traxler flies in and out on one day for patient consultations. After the mandatory waiting period, she repeats the trip to see those same patients for their abortion procedures.

  Caitlin Anderson was a patient at the Sioux Falls clinic last year. Already a mother of three, Anderson became unexpectedly pregnant. She says she and her husband discussed their options and decided to abort the pregnancy.

• Caitlin Anderson:

  We knew immediately that was the best choice. I said…

• Amna Nawaz:

  You say immediately. You mean, you found out you were pregnant, and you knew?

• Caitlin Anderson:

  Yes, I knew. I took a couple days to sort of emotionally come to terms with it. I was sad. I didn't like that I had to do it.

  My youngest was a-year-old, I mean, just turned 1. Financially, we were still kind of struggling. Our marriage was sort of still recovering from pregnancy and childbirth and all of that goes along with it. And it just was not a good time. It was knowing that it would strain the limited resources we already had and make things even more difficult.

• Amna Nawaz:

  In South Dakota, a little more than half of all women who have abortions are already mothers of at least one child. Nationwide, that number is about 60 percent.

  Anderson, a Sioux Falls resident, says she's willing to speak publicly about her decision to help fight the stigma she says many women in her conservative home state face.

• Caitlin Anderson:

  I want to talk about it, so I can be like, I'm a stay-at-home mom. I have three kids. I'm not a dumb teenager. It's not just these imaginary immoral people that some people like to make up. So it's every type of person.

• Amna Nawaz:

  But Anderson said it was the 72-hour waiting period that was the hardest part of the process for her.

  At any point in those 72 hours, did you think, maybe I don't want to do this?

• Caitlin Anderson:

  No.

• Amna Nawaz:

  Not once? Did that surprise you?

• Caitlin Anderson:

  No.

• Amna Nawaz:

  Did you think, maybe I will use this time to mull my decision over?

• Caitlin Anderson:

  No. I mean, that's — supposedly, that's the intention of it. But, again, I feel like, why would you assume a woman hasn't thought about those things before making that call?

• Dr. Sarah Traxler:

  I truly believe that, for most women, once that pregnancy test turns positive, they're already starting that decision-making process. The 72-hour waiting period is simply a delay and women being able to access safe, legal health care, and that it is a part of the decision-making process that's unnecessary.

• Fred Deutsch:

  I would say that I support a woman's right to choose, but not to choose to murder her own unborn child. That's a — that's a horrific choice. It's a choice too far.

• Amna Nawaz:

  Fred Deutsch is the president of South Dakota Right to Life. He says the state's current restrictions have helped prevent abortions, and he's hopeful that Supreme Court nominee Judge Brett Kavanaugh will be the justice to help reverse Roe v. Wade.

• Fred Deutsch:

  Obviously, I would like to see the Supreme Court revisit Roe. You know, if Roe is potentially overturned, I hope that the decision-making can come back to the states, so each state can make their own decision.

• Elizabeth Nash:

  States started limiting access to abortion as soon as the ink was try on Roe.

• Amna Nawaz:

  Elizabeth Nash says that, while she's worried Roe might one day be overturned, her bigger concern is that abortion access is already being restricted aggressively in many states across the nation.

• Elizabeth Nash:

  Since January 2011, we have seen 423 abortion restrictions enacted in 33 states, from, you know, Virginia, to Arizona, South Dakota, to Georgia. It's everywhere.

• Amna Nawaz:

  South Dakota is one of just six dates with only one abortion clinic currently open, and women are often traveling to nearby states in these areas to have abortions, according to Nash.

• Elizabeth Nash:

  If Roe is further undermined her overturned, then issues around travel will just grow, because you will be talking about more states that will either ban abortion or all but ban abortion.

• Amna Nawaz:

  In Minnesota, state figures suggests that non-residents comprise about 10 percent of all abortion patients, traveling mainly from Wisconsin, Iowa, and North and South Dakota, states that have all moved to restrict abortion access in recent years.

  We watched Dr. Traxler meet with patients here at Planned Parenthood's St. Paul clinic. A 24-hour waiting period has been on the books here since 2003. The patients are allowed to conduct their first consultations over the phone.

• Dr. Sarah Traxler:

  The state of Minnesota requires that I give you certain information at least 24 hours before you have an abortion.

• Amna Nawaz:

  Since the 1980s, Minnesota has seen a steady decline in the total number of abortions. But over the last two years, the state had its first consecutive uptick in abortions since 2000.

• Brian Gibson:

  If you're going in for an abortion, demand to see your ultrasound. You have a right to see it. They want to hide it from you.

• Amna Nawaz:

  The increase has caused concern among anti-abortion activists here, like Brian Gibson, who stands sentry with his colleagues from Pro-Life Ministries every week outside Planned Parenthood.

  Gibson says he's been advocating for a total ban on abortions since 1981. And even though he's been disappointed in the past by the Supreme Court, he says he's now cautiously optimistic that his movement is closer than ever to overturning Roe.

• Brian Gibson:

  It feels like it in may be really happening. And part of that is just, you know, the whole political climate across the United States for the past five or six years has — has shifted dramatically. A lot of states have passed pro-life legislation in large numbers.

• Amna Nawaz:

  Seventy-two hours after first seeing her patients, Dr. Traxler returns to South Dakota.

  Of the 10 patients scheduled to have an abortion on this day, all but one showed up for the procedure.

  There's been a lot of conversation about whether or not Roe v. Wade could be overturned.

• Dr. Sarah Traxler:

  Yes.

• Amna Nawaz:

  What do you think about that? Is that something you worry about?

• Dr. Sarah Traxler:

  It is something I worry about. And I truly worry about women living in a world without Roe.

  My fear, when Roe — if Roe were ever to be overturned, is that women would turn to unsafe places.

• Amna Nawaz:

  Dr. Traxler says that's why she will continue making this trip for as long as she is legally allowed.

  For the "PBS NewsHour," I'm Amna Nawaz in Sioux Falls, South Dakota.