They came with friends or sisters or alone in Ubers. Before reaching the doors of the clinic, they were confronted by a range of protesters, some shouting, “Murderers!” and “Don’t kill your baby!” Once in, a patient in the Indianapolis area who was six weeks pregnant opted to have a surgical abortion, worried that the drug might not work. Others traveled from Ohio and Tennessee, which had already banned abortions (an Ohio judge temporarily suspended the state’s ban on Wednesday). Another patient canceled her appointment, likely because she was headed to Illinois, where clinics are expanding abortion services, OB/GYN Katie McHugh said. “It’s a little bit of a desperate feeling right now, both on the patient and provider side,” said McHugh, who performed abortions at this clinic and another in Bloomington, Ind. “It’s exhausting to provide this level of access knowing the end is so close.” Indiana and surrounding states brace for impact of latest abortion ban since Supreme Court overturned Roe v. Wade in June. Indiana’s legislature was the first to ban abortions last month, followed by West Virginia, but Indiana’s law didn’t go into effect until this week. Indiana passed a near-total abortion ban, the first state to do so since Roe Another 13 states had pre-Roe abortion bans or activation bans that began after the decision, including several around Indiana: Kentucky, Tennessee and Missouri; Those bans led patients to initially travel to Indiana’s seven clinics. Now patients will likely head to Ohio or Illinois, where they will face waits that have recently varied from several days to weeks. Planned Parenthood of Illinois announced Thursday that it has added abortion services at its clinic in Champaign, just across the Indiana border, to help with an expected influx of patients. “Indiana’s draconian abortion ban doesn’t stop people from getting abortions, it just makes it harder for people to access abortion in a safe and timely manner,” said Jennifer Welch, president and CEO of Planned Parenthood of Illinois. Indiana law prohibits almost all abortions except in cases of rape or incest. to protect the patient’s life and physical health; or if a fetus has been diagnosed with a fatal abnormality. A doctor who performs an illegal abortion or fails to file the required reports will lose his medical license, face a possible criminal sentence of up to six years in prison and a $10,000 fine. “We think this is an important moment for life in Indiana,” said Mike Fichter, CEO of the Indianapolis-based nonprofit Indiana Right to Life. Fichter said his group worked to remove the rape, incest and fetal malformation exemptions from the law. But, he added, “We’ll take the gains we have now, but we’re committed to moving forward to make sure all life is protected.” Abigail Lorenzen, education coordinator for the nonprofit Right to Life of Northeast Indiana, said the state’s more than 100 pregnancy resource centers are gearing up to serve more women and that her group plans to gather at local courthouses on Sept. 24. Just after noon Thursday, about 20 protesters gathered in front of the Indiana governor’s mansion, with more protests and a march expected later in the day. Karen Starks carried a tombstone-shaped sign dated 1973 – 2022, the years abortion was federally protected, that read, “So tired of old white men telling me what to do.” Starks, 73, a former public school teacher, said she knew many students whose lives changed when they became pregnant. “It was always about the girls,” she said. “Though it takes two.” Abortion rights advocates have filed two lawsuits to block the ban, but the courts have yet to rule on them. “This fight is far from over,” said Amy Hagstrom-Miller, founder and CEO of Whole Woman’s Health, which operates clinics in several states. As the new law went into effect, their South Bend clinic — which has served 1,100 patients since it opened in 2019 — stopped performing abortions. But it won’t close, Hagstrom-Miller said. Like Planned Parenthood’s four Indiana abortion clinics, he said, it will continue to provide patients with other services, including referrals to states where abortion is legal. Although people cannot get a medical abortion in Indiana via telemedicine, they can if they travel to Illinois or Minnesota, where Whole Woman’s Health operates. “There’s still a lot we can do to help people in Indiana get abortions, even if we can’t provide them ourselves,” Hagstrom-Miller said. The South Bend clinic performed its last abortion on Saturday, but was still getting calls asking for appointments days later, said Sharon Lau, Midwest director of advocacy for Whole Woman’s Health. “Heard off the hook this morning. Some people don’t know that the law is coming into effect,” Lau said. Clinic staff referred people in Illinois and Michigan, he said, which each have more than two dozen abortion clinics (a Michigan abortion ban was struck down by a judge last week). Indiana ranks third in the nation for maternal mortality, behind Georgia and Louisiana, both of which have since enacted abortion bans. Roe overturned. “The abortion ban states are also the states that have not supported the health care safety net, meaning that access to pregnancy care has been limited or non-existent for many people,” said Elizabeth Nash, senior policy fellow for State issues at the Guttmacher Institute. a nonprofit research center that supports abortion rights. Nash predicted that more states will enact abortion bans in the coming months, up to 26 in total. “We’re seeing a collapse of abortion access across the country,” he said, noting that South Carolina lawmakers are still considering the ban after efforts failed last week. Indiana University Health, the state’s largest hospital system, has created a 24-hour “reproductive health rapid response team”: a clinician, an ethicist and a lawyer that providers can call to assess the law’s impact on situations emergency, said Caroline Rouse, medical director of maternity services at Riley Maternity Tower in Indianapolis. Rose said the state health department has provided guidance to hospitals on how they can still provide abortions under the new law, including septic abortions, ectopic and molecular pregnancies “or any pregnancy where the fetus has died in the womb.” However, there are no guidelines for what qualifies under the law as a risk to a pregnant woman’s life, he said. The state defines a “fatal fetal abnormality” as something expected to result in death within three months of birth, he said, but it’s unclear what conditions qualify. Even if doctors diagnose a fetus with anencephaly, a condition where the skull does not form above the brow line, or bilateral renal agenesis, where no kidney forms, they should probably call the new hotline for help, said the Rouse. “It’s really hard to reconcile what the law will compel me to do with the practical reality,” he said. Pro-abortion protests were planned in Indiana’s capital on Thursday, including a march and rally outside the governor’s mansion that Jamie Harrell, a suburban Indianapolis attorney, helped and planned to attend. Harrell, 43, said she testified against the law because she had an abortion at 25. “It allowed me to finish college. He allowed me to go to law school. It allowed me to have an amazing relationship with my husband of 16 years and bring our daughter into the world when we were ready for her,” she said. Now her daughter is 6, Harrell worries she could be rushed and not get an exemption under the law, like the 10-year-old girl who was raped in Ohio who had to travel to Indiana this summer to get an abortion. Harrell was encouraged to see a ballot measure that would have set aside abortion protections in Kansas defeated this summer, and he sees a similar uptick in activism among Indiana women. “The reason I’m fighting isn’t just because of 10-year-olds being raped or women being forced to carry dead babies because of fetal abnormalities. It’s about my rights,” Harrell said. “Women are outraged. Kansas was just the beginning.” As the final day at the Women’s Med clinic wore on, reality began to sink in for the staff. When a delivery boy arrived with lunch and asked, “Can I get you anything else?” a passing nurse said, “Tequila.” He laughed and then turned serious. “Good luck,” he said, “God bless.” Outside, a dozen protesters gathered, including Debi Nackenhorst. Nackenhorst, 70, has been protesting weekly at the clinic for the past year, taping a sign to her walker that read: “Unborn lives matter. Abolition of abortion”. As the sick arrived, he asked for their names so he could pray for them. “As long as babies die, we’re here,” he said. Clinic staff performed his last abortion at 2.18pm on Wednesday. By then, they had completed 27 abortions. Outside the protesters had disappeared. OB/GYN Jeanne Corwin ready to lock down. As she looked inside, she began to cry. Corwin has been with Women’s Med since 2018. “We saved a lot of lives back there,” he said. And then he closed the door.
