One year ago, the U.S. Supreme Court overturned Roe vs. Wade, which for five decades legalized the right to abortions nationwide. Within minutes of the high court’s decision, Missouri officials banned the procedure, and several states in the South and Midwest soon followed suit.
Since the high court’s ruling last June, clinics in the Metro East that offer abortions have become a destination for thousands of patients seeking the procedure. In the months after the decision, a report found the number of abortions performed in Illinois increased more than 30%.
Planned Parenthood’s Fairview Heights clinic has increased its workforce and hours to try to keep up with increased patient loads. St. Louis Public Radio’s Sarah Fentem asked Kawanna Shannon, Planned Parenthood's director of patient access, and Dr. Colleen McNicholas, its chief medical officer, what the organization's Fairview Heights clinic has seen in the past year.
Sarah Fentem: We spoke last summer about the surge in patients coming to the Metro East. And since we talked, another abortion clinic has opened in Southern Illinois, in Carbondale. Are patients still coming to the Fairview Heights clinic in the same numbers from states that have banned or restricted abortions in the past year?
Colleen McNicholas: What we have seen over the last year, especially as additional states have gone down, is that there is still far more demand than our health center, HOPE Clinic [in Granite City] or even the new clinic, Choices, in Carbondale, can accommodate.
Kawanna Shannon: There has been a surge after Roe, and it's actually constantly increasing. So we haven't seen any type of slowdown of patients coming; we've only seen an increase due to more restrictions in others in other states and more bans.
Fentem: In the last year, we've seen legal efforts to ban the use of the abortion pill mifepristone. Do you envision other attempts to restrict reproductive health care access in the region now that Roe has been overturned?
McNicholas: Look, we've always known that overturning the federal right to abortion was never the end game for anti-abortion extremists. And they have now gone after the abortion pill. Probably and most likely because it is a method of abortion that people can control in their own home, that they don't need to have a clinic space to go to in order to successfully complete an abortion.
But we've also seen year after year in Missouri [there have been] attacks on birth control. There's some recent data out that suggests that Missourians don't even know if birth control is available to them and legal in the state. And we expect that those attacks on reproductive and sexual health care more broadly will continue.
Fentem: I was going to mention that survey. How much do patients know about this rapidly changing policy landscape?
Shannon: We have a lot of patients who call, who are really shocked by the fact that they even had to leave their state to get an abortion. We are grateful that we are in Illinois, where we're able to serve and help people traveling all over the United States. They don’t have the knowledge, they’re very confused.
McNicholas: You know, every day I see patients who are traveling from other states here in Illinois, who didn't know abortion was illegal in their state until they tried to schedule one. And so you know, people [have] busy lives. They don't live day-in and day-out, every minute of the day in the abortion landscape like we do.
Fentem: Speaking of birth control, I know Planned Parenthood mentioned a surge in interest in vasectomies after the Supreme Court overturned Roe last year. Has there been an increased demand for birth control among Planned Parenthood patients, even beyond vasectomies?
McNicholas: Absolutely. So one of the maybe more surprising trends that we've seen over the last year is the increased demand for sterilization across all genders, increases of more than 100% in our vasectomy care services. And we expect that to continue.
You know, some of the things we heard from our vasectomy patients, especially those who are coming in right after the the Dobbs decision, was that they felt threatened, going back to what I think is very reasonable fear from Missourians, and others, which is that abortion isn't the end, that they really felt like and still do feel like their access to pregnancy prevention and birth control is also on the table.
Fentem: Advocates said at the time, the decision would disproportionately affect Black women, what demographics are traveling to Illinois, the most to get abortions at this clinic.
Shannon: It is very clear that our poor communities, our Black communities, are being hit harder than any other communities. Our patients are already suffering with housing, the lack of access to food, other types of medical care, and this just puts another barrier on, and we hear those things when they are calling us. So definitely the other populations and poor populations are being affected by this.
Fentem: The Missouri legislature, spurred in part by last year's decision, has extended postpartum Medicaid coverage from 60 days to one year after someone gives birth. How does that decision affect Planned Parenthood patients?
McNicholas: Well, it is absolutely the right decision. You know, we know that the postpartum period is one of the most vulnerable times for new moms and for families. And so I absolutely applaud the legislature for getting that across the line.
But the truth is, despite the fact that Planned Parenthood is one of the largest safety net providers of sexual reproductive health care for Missourians, we are excluded from that right. We have continued year after year to be defunded by the legislature for the very services that we know help prevent pregnancy that help prevent abortion and help keep people healthy. We will continue to litigate that, while we also continue and commit to seeing Medicaid patients. You know, we are not getting reimbursed from the state for the care that we provide for folks for their cancer screenings and their birth control for their STD care.
Fentem: In the year ahead, what do you envision will happen?
Shannon: At this moment, we do see that [the legislative challenges are] going to increase, the patient volume is going to increase, and the help that the patients need is going to increase. We’re in here for the long haul.
