Once inside, an Indianapolis-area patient who was six weeks pregnant opted for a surgical abortion, nervous that the medication might not work.
Others traveled from Ohio and Tennessee, which had already banned abortion (an Ohio judge temporarily suspended the state ban Wednesday).
Another patient canceled her appointment, most likely because she was headed to Illinois, where clinics are expanding abortion services, said OB/GYN Katie McHugh.
“It is just a little desperate feeling right now, both from a patient and a provider standpoint,” said McHugh, who has provided 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 were bracing for the impact of the latest abortion ban since the Supreme Court overturned Roe v. Wade in June. Indiana’s legislature was the first to ban abortion last month, followed by West Virginia, but the Indiana law didn’t take effect until this week.
Indiana passes near-total abortion ban, the first state to do so post-Roe
Another 13 states had pre-Roe abortion bans or trigger bans that kicked in after the ruling, including several surrounding 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 varied recently from several days to weeks. Planned Parenthood of Illinois announced Thursday that it had added abortion services at its clinic in Champaign, just across the Indiana border, to help with the expected influx of patients.
“Indiana’s draconian abortion ban does not stop people from having abortions, it only makes it more difficult for people to access abortion in a safe and timely manner,” said Jennifer Welch, president and CEO of Planned Parenthood of Illinois.
The Indiana law bans nearly all abortions except in the case of rape or incest; to protect the life and physical health of the patient; or if a fetus is diagnosed with a lethal anomaly. A doctor who performs an illegal abortion or who fails to file required reports would lose their medical license, face a potential criminal penalty of up to six years imprisonment and a fine of $10,000.
“We view this as a major moment for life in Indiana,” said Mike Fichter, CEO of the nonprofit Indianapolis-based Indiana Right to Life.
Fichter said his group worked to remove rape, incest and fetal anomaly exceptions from the law. But, he added, “We’ll take the gains we have now but we’re committed to moving forward to ensure 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 were preparing to serve more women and that her group plans to rally at local courthouses 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 brought a sign in the shape of a headstone dated 1973 – 2022, the years abortion was federally protected, that said, “So tired of old white men telling me what to do.”
Starks, 73, a former public school teacher, said she knew many female students whose lives changed when they got pregnant.
“It was always about the girls,” she said. “Even though it takes two.”
Abortion rights supporters filed two lawsuits to block the ban, but 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 runs clinics in several states.
As the new law took effect, their clinic in South Bend — which has served 1,100 patients since opening in 2019 — stopped performing abortions. But it won’t close, Hagstrom-Miller said. Like Planned Parenthood’s four Indiana abortion clinics, she said, it will continue to provide patients with other services, including referrals to states where abortion is legal.
While people cannot get a medication abortion in Indiana via telemedicine, they can if they travel to Illinois or Minnesota, where Whole Woman’s Health operates.
“There is still a lot we can do to help people in Indiana get abortions even if we cannot offer them ourselves,” Hagstrom-Miller said.
The South Bend clinic performed its last abortion Saturday, but was still receiving calls seeking appointments days later, said Sharon Lau, Midwest advocacy director for Whole Woman’s Health.
“It was ringing off the hook this morning. Some people don’t know the law is taking effect,” Lau said.
Clinic staff referred people to Illinois and Michigan, she 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-worst in the nation for maternal mortality, after Georgia and Louisiana, both of which have enacted abortion bans since Roe was overturned.
“The abortion ban states are also the states that have not supported the health-care safety net, meaning that access to pregnancy care was limited or nonexistent for many people,” said Elizabeth Nash, principal policy associate for state issues at the Guttmacher Institute, a nonprofit research center that supports abortion rights.
Nash predicted more states will enact abortion bans in the coming months, up to 26 total.
“We are seeing a collapse of abortion access across the country,” she said, noting South Carolina lawmakers are still considering a ban after efforts failed last week.
Indiana University Health, the state’s largest hospital system, created a 24/7 “reproductive rapid response health team”: a clinician, ethicist and lawyer whom providers can phone to evaluate the impact of the law in emergencies, said Caroline Rouse, medical director of maternity services at Riley Maternity Tower in Indianapolis.
Rouse said the state health department provided guidance to hospitals on how they can still provide abortions under the new law, including septic abortions, ectopic and molar pregnancies, “or any pregnancy where the fetus has died in utero.”
But there’s no guidance for what qualifies under the law as risking the life of the pregnant person, she said. The state defines a “fatal fetal anomaly” as something expected to result in death within three months of birth, she said, but it’s not clear what conditions qualify. Even if doctors diagnose a fetus with anencephaly, a condition where the skull doesn’t form above the brow line, or bilateral renal agenesis, where neither kidney forms, they will likely have to call the new hotline for help, Rouse said.
“It’s really hard to reconcile what the law would have me do with the practical reality,” she said.
Pro-abortion protests were planned at the Indiana capital Thursday, including a march and rally outside the governor’s mansion that Jamie Harrell, a suburban Indianapolis lawyer, helped organize and planned to attend.
Harrell, 43, said she testified against the law because she had an abortion at age 25.
“It allowed me to finish college. It allowed me to go to law school. It allowed me to have an amazing relationship with my husband of 16 years and to bring our daughter into the world when we were ready for her,” she said.
Now her daughter is 6 years old, and Harrell worries she could be raped and not receive an exemption under the law, like the 10-year-old girl 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 Kansas abortion protections defeated this summer, and sees a similar uptick in activism among Indiana women.
“The reason I am fighting is not just because of the 10-year-olds who get raped or the women forced to carry the dead babies because of fetal anomalies. It’s about my rights,” Harrell said. “Women are pissed off. Kansas was just the beginning.”
As the last day at Women’s Med clinic wore on, reality began to sink in for the staff.
When a deliveryman arrived with lunch and asked, “Can I get you anything else?” a passing nurse quipped, “Tequila.”
He laughed, 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, tacking a sign on her walker that said, “Unborn lives matter. Abolish abortion.” As patients arrived, she asked for their names so she could pray for them.
“As long as babies are dying, we are here,” she said.
Clinic staff performed their last abortion at 2:18 p.m. Wednesday. By then, they had completed 27 abortions. Outside, protesters had disappeared.
OB/GYN Jeanne Corwin prepared to lock up. As she gazed inside, she began to cry. Corwin has worked at Women’s Med since 2018.
“We saved a lot of lives back there,” she said.
And then she closed the door.