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The Strategy Behind Where to Build Abortion Clinics

Erin Heger

The bifurcation of abortion access in the United States means more clinics should be built on the border of states with onerous anti-choice restrictions, advocates say.

After 18 months of secret construction, Planned Parenthood will open one of the nation’s largest abortion clinics in southern Illinois this month, expanding access not just in the state but across the midwest.

The new health center in Fairview Heights, Illinois, will replace the city’s smaller Planned Parenthood clinic, which provided family planning and medication abortion services to more than 5,000 patients in 2018. The location of the new facility, just 13 miles from Missouri’s last remaining abortion clinic in St. Louis, was strategically chosen to reach as many patients in the region as possible, said Yamelsie Rodriguez, president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri.

The 18,000-square-foot facility, equipped to serve 11,000 patients a year, is the latest abortion clinic to be built near the border of a state where lawmakers have restricted access to abortion care at every turn. Reproductive rights advocates say it will be critically important to construct abortion-providing facilities near states where people are burdened by medically unnecessary anti-choice laws.

“We specifically chose Illinois because we know the policies in that state have made Illinois an oasis for access to the entire spectrum of reproductive health-care services,” Rodriguez told Rewire.News.

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Missouri is one of six states with only one abortion provider, and that provider’s state license has been in jeopardy this year as anti-choice politicians continue to adjust licensing requirements. Conversely, Democrats in Illinois have passed legislation to protect and expand abortion access, making it one of the least restrictive states in the country. An increasing number of patients from surrounding states are traveling to Illinois to receive abortion care.

“Planned Parenthood of the St. Louis Region and Southwest Missouri has been looking to expand and protect access to comprehensive reproductive health care not just in Missouri, where we know abortion access hangs on by a thread, but in the Midwest region, where we have states like Arkansas and Kentucky increasing restrictions to limit women’s access to these services,” Rodriguez said.

The divide between Illinois and Missouri illustrates an emerging trend across the country, as states with Republican-held legislatures, primarily in the South and Midwest, continue to make abortion care inaccessible, while states with Democratic-majority legislatures in the West and Northeast protect and expand access. In the first six months of 2019, state legislatures enacted 58 abortion restrictions, 26 of which would ban the procedure in all, most, or some cases, according to the Guttmacher Institute.

In Colorado, another state many people travel to for abortion care, the location of abortion clinics is strategically chosen to reach those needing services, said Laura Chapin, spokesperson for NARAL Pro-Choice Colorado. Colorado is one of seven states that doesn’t restrict abortion at any stage of pregnancy. Colorado clinics served women from 34 states in 2018, the Denver Post reported.

“There’s a Planned Parenthood facility on the eastern side of Denver off I-70. That’s not an accident,” Chapin told Rewire.News. “There should be a national standard of care across the country. That’s why you have constitutional rights that aren’t dependent on your geography.”

While 2019 has brought a surge of GOP-backed abortion bans, spurred by hopes that conservatives on the U.S. Supreme Court will overturn Roe v. Wade, Democratic-led state legislatures have passed a record number of bills meant to secure and expand abortion access, said Elizabeth Nash, senior state issues manager for the Guttmacher Institute. In the first six months of 2019, states have enacted 93 proactive provisions, including 29 that protect abortion rights, 11 that increase access to contraception, and 15 that seek to improve comprehensive sex education.

“The immediate catalyst is a more conservative Supreme Court, but these proactive bills are also a reaction to a longer trend of abortion restrictions,” Nash told Rewire.News. “And there isn’t a lot of overlap. States are either looking to ban abortion or protect it.”

Planned Parenthood built the new Fairview Heights facility using a shell company to avoid interference from protestors, CBS News reported. Other Planned Parenthood projects have been halted by protestors harassing contractors and putting pressure on other vendors The new clinic will begin serving patients in mid-October and will provide a broad spectrum of reproductive health-care services including medication and surgical abortions, cancer screenings, annual exams, family planning, HIV prevention, and STI testing.

Though the new Planned Parenthood facility in Illinois will be equipped to serve thousands of patients, many across the Midwest will still have to travel long distances to receive care. People in the middle or southern regions of Missouri will need to drive at least a couple hours to reach an abortion provider in either St. Louis or Illinois. People in western Missouri could seek care in eastern Kansas, but will still need to travel to get there.

“We know that increasing one access point doesn’t necessarily mean all people will be able to seek the care they need, but Planned Parenthood is committed to reducing as many barriers as we can,” Rodriguez said.

While the new Planned Parenthood facility will expand access in Missouri and Illinois, the same strategy may not be as effective in other parts of the country where neighboring states have onerous restrictions, Nash said.

“If we are looking at the current political environment, particularly in the South, you aren’t going to find many states where building a facility on a border will really increase access,” Nash said. “Certainly for Illinois, building capacity there is part of a solution, but if you’re in Alabama or Mississippi, where potentially could the next clinic be?”

As state legislatures continue to pass laws aimed at either restricting or expanding access to abortion care, more patients will be forced to travel or go without the care they need.

“I do think the existing divide in access will continue and be exacerbated, and that isn’t where we need to be,” Nash said. “We need to be looking at what patients need, and making sure they get the services they desire and deserve with respect and dignity.”

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