As soon as Roe vs Wade fell on June 24, abortion providers in Illinois were braced for what was coming next: a dramatic increase in demand for their services from women across the country.
“We’ve already seen our out-of-state patients double,” said Michelle K, a clinician at a downtown Chicago Planned Parenthood clinic that provides abortion services, referring to the effect of an earlier abortion ban enacted in Texas in October.
“It is a bit, at times, overwhelming to think that we’re really anticipating a twentyfold increase [in light of the Roe vs Wade decision],” added Michelle, who asked that her surname be withheld for safety reasons.
Illinois is one of a handful of states — including New York and Vermont — that have been thrust into the role of providing safe abortion havens for women after the Supreme Court overturned the constitutional right to the procedure, with many swiftly enacting bans.
As a liberal island surrounded by a vast sea of more conservative states, “Illinois is in a unique position”, said Planned Parenthood of Illinois chief strategy and operations officer Kristen Schultz.
All six bordering states — Wisconsin, Iowa, Missouri, Kentucky, Indiana and Michigan — have either banned abortion or are expected to soon, leading to a growing rush of inquiries to Illinois clinics from women looking to end their pregnancies.
“We’re all just really anticipating a very large surge,” said Michelle K.
Illinois’ role as a haven long predates the recent Supreme Court decision, as other Midwestern states have steadily restricted abortion access in recent decades.
The number of people seeking the procedure from out of state has increased each year since 2014, according to the Illinois Department of Public Health.
Meanwhile in 2020, approximately 21 per cent of the 46,243 abortions performed in Illinois were for people living in another state, up from 16 per cent the previous year. Most came from Missouri and Indiana.
Now that Roe has been overturned, Planned Parenthood of Illinois, which operates 17 of the state’s 29 abortion-providing clinics, anticipates an influx of 20,000 to 30,000 out-of-state patients annually.
“On an average day, we were seeing about 250 calls. Now it’s upwards of 500,” said Melissa Grant, chief operations officer of Carafem, which runs an abortion clinic in the Chicago suburb of Skokie. “We’re already seeing more Wisconsin patients.”
Generally, about 20 per cent of Carafem’s patients come from out of state, though that number increased to 30 per cent last month and is expected to jump further.
Many abortion providers believe the increase in demand is only the beginning, as women become more aware of the options available to them and further state bans elsewhere begin to take effect. There is “a lot of confusion” among patients over what is legal in their states, said Michelle K.
Lee Hasselbacher, interim executive director of Ci3, a sexual and reproductive health research centre at the University of Chicago, warned that “it’s going to be difficult” for Illinois clinics to scale up to handle the patient surge.
“Obviously time is of the essence when you’re considering abortion care,” she said.
Planned Parenthood of Illinois has been preparing for the fall of Roe and the tightening of restrictions in neighbouring states for years. Since 2018, two strategically positioned clinics, one each on the borders of Indiana and Wisconsin, have been opened.
Clinics throughout the state are now planning to expand various services to support increased demand, including telehealth offerings, abortion navigation, call centres and emotional support counselling.
Northwestern Medicine, the hospital system of Northwestern University that offers abortion services through its family planning centre, said it would take a similar approach to reallocating resources as it did during the early days of the coronavirus pandemic, should patient volumes increase.
Political leaders in Illinois have reaffirmed their commitments to protecting abortion rights and access in the state. Governor JB Pritzker, a Democrat, plans to call a special session of the state legislature to strengthen further Illinois’ abortion rights laws.
The state, which has voted for a Democratic presidential nominee every cycle since 1992, has passed several abortion access bills over the past decade, the most significant being the Illinois Reproductive Health Act in 2019, said Hasselbacher.
The law removed all language about abortion bans from state statutes and explicitly protected the right to abortion, laying out a spectrum of reproductive rights that Illinois residents would have, including access to contraception. The state no longer requires parental notification for minors who obtain abortions.
Illinois also required Medicaid to cover abortion care, the effects of which Hasselbacher has been studying. “The Medicaid coverage has been working very well, and people are very relieved when they find out they have that coverage,” she said.
Other haven states such as New York, New Jersey, Vermont and Connecticut have also taken steps to expand abortion rights, making it easier for out-of-state patients to gain access to the procedure.
Abortion-rights activists argue that more can still be done legislatively in Illinois, such as protecting providers from civil or criminal liability for performing abortions on patients from states that ban the procedure, and making it easier for physicians licensed in other states to move along with their clinics to Illinois.
In a June 27 letter signed by Chicago mayor Lori Lightfoot, World Business Chicago, a public-private economic development entity, encouraged 335 US chief executives to bring their companies to the city because it would be more welcoming for employees who might otherwise “suffer” in states with abortion bans.