To fortify access to abortion throughout the Midwest and in Missouri, where the procedure is almost entirely banned, Planned Parenthood is launching a mobile clinic across the state line in southern Illinois.
The mobile clinic will be part of Planned Parenthood of the St. Louis Region and Southwest Missouri, providing medication abortions up to 11 weeks gestation. It’s expected to launch later this year.
Abortion clinics on wheels have begun to get off the ground across the country, and this mobile unit will be the first throughout the Planned Parenthood network, said Yamelsie Rodríguez, president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri.
In the coming weeks, Planned Parenthood will also be taking over the location of Tri-Rivers Family Planning, a Title X health center in Rolla that closed its doors Friday and provided contraceptives, pregnancy tests, and additional reproductive health services to residents across central Missouri.
The dual initiatives are two prongs in Planned Parenthood’s strategic plan to bolster access to abortion and reproductive health care in the wake of the U.S. Supreme Court decision overturning Roe v. Wade.
“We are doubling down on our commitment to expanding access to family planning in the state of Missouri,” Rodríguez said, “while we continue to work nonstop to rebuild access to abortion in the state.”
The mobile clinic will have two fully functional exam rooms, a lab, and ultrasound machines. The unit will be built with the ability also to offer procedural abortions, which may be offered at a later date, Rodríguez said.
While exact routes for the mobile unit have not been finalized, the 37-foot long, 8-foot wide RV will reduce the miles patients are traveling for care while relieving pressure on Planned Parenthood’s abortion clinic in Fairview Heights, Illinois across the Missouri border.
The surge in patients traveling to what has become an abortion safe haven in southern Illinois “happened practically overnight” after Roe v. Wade was overturned in late June, Rodríguez said.
Calls for assistance for transportation, accommodations, and monetary aid received by the Regional Logistics Center in Fairview Heights more than doubled in the first two months following the Supreme Court’s decision, Rodríguez said, and have come from practically every state where abortion has been restricted.
In Missouri, the state’s trigger law banned nearly all abortions the day Roe v. Wade was overturned, and Planned Parenthood — previously the state’s last abortion provider — ceased all abortion services. According to The New York Times, most abortions are outlawed in at least 14 states, with bans blocked by the courts in nine states.
Planned Parenthood has extended its hours at its Fairview Heights clinic to 10 hours a day, six days a week, with appointments also being offered one to two Sundays a month. Having appointments seven days a week is the next goal.
The crush of demand and longer distances patients are now forced to travel to access the procedure means Planned Parenthood is seeing a rise in demand for an abortion later in pregnancy, said Colleen McNicholas, Planned Parenthood of the St. Louis Region and Southwest Missouri’s chief medical officer.
“So as the numbers and demand for procedural abortion, particularly in the second-trimester increase,” McNicholas said, “it’s going to be really critical for us to be able to redistribute some of the demand for medication abortion — a service that we know is completely safe to offer outside brick and mortar either via telehealth or via mobile care.”
Planned Parenthood ceased offering medication abortions, typically induced by a two-pill regimen, in Missouri in 2019 after the state-mandated pelvic exams on patients McNicholas said were “really truly a violation of our medical ethics to continue to provide that service under those conditions.”
In Illinois, Planned Parenthood has provided medication abortions through telehealth — an avenue that is banned in Missouri — and can mail the pills to patients. Before Roe v. Wade being overturned, over 60% of those seeking an abortion nationwide across Planned Parenthood health centers sought a medication abortion, Rodríguez said.
‘We’re going to continue to show up’
In the wake of Roe v. Wade being overturned, confusion has swirled.
A hospital system in Kansas City temporarily ceased providing emergency contraception, citing ambiguity in the state’s trigger law. Missouri physicians shared fears of potentially fatal delays in care due to doctors’ fears of prosecution under the law.
That’s when Tri-Rivers Family Planning in Rolla began receiving calls from patients worried they would have to remove their intrauterine devices and seeking guidance to cut through the misinformation on whether their birth control was now illegal.
“We’re still having people that tell us that that’s why they’re getting those longer-acting methods,” of birth control, said Hailey Kramer, Tri-River’s lead nurse practitioner. “Because they don’t want to get pregnant in this day and age.”
Tri-Rivers does not offer abortions. But residents have still turned to the provider to help manage its impacts, like when a grandmother called to ask where her granddaughter, who was having a miscarriage, could go to receive help after being turned away from more than one provider’s office. An emergency room, said Lisa Ecsi Davis, Tri-River’s director of operations.
“The ripple effects of that are brutal,” Ecsi Davis said.
In Rolla, a city of roughly 20,000, Tri-Rivers has been the only provider in the area for 51 years that was dedicated to reproductive health services. The clinic offered birth control, testing for sexually transmitted diseases, and pap smears, among other services.
The clinic shut its doors Friday as it weathered the pandemic, labor shortages, and rising costs amid stagnant federal funding for family planning services. But soon, Planned Parenthood will be launching in the same location with many of the same staff.
Patients will be seen again starting the first week of November.
Ecsi Davis said Planned Parenthood will be able to build on the services offered, like initiating gender-affirming care and vasectomy services.
Many of Tri-River’s patients are low-income and lack health insurance. The clinic will be the Planned Parenthood affiliate’s first rural location in the state, where access to health care — and reproductive health care in particular — can be especially difficult to attain in the face of long distances, cost barriers, stigma, and more.
Rodríguez said it’s part of Planned Parenthood’s commitment to expanding into communities needing greater reproductive health care and continuing to make abortion accessible — even as it faces losses of over $600,000 a year from restricted Medicaid payments from the state. Planned Parenthood’s lawsuit against the state over the restricted payments is ongoing.
“We’re going to continue to show up,” McNicholas said. “And whether it takes a month, a year, or 10 years, we will fight our way back to having equitable access to all reproductive health care, including abortion in the state of Missouri.”