Perched on an exam table at the WE Health Clinic, Alice waited patiently as lab supervisor Paulina Briggs pressed an ultrasound wand to her abdomen. Alice believes she’s pregnant — she's had three positive tests — but the ultrasound wasn’t detecting a pregnancy.
Even with the next step — a vaginal ultrasound — Briggs saw nothing certain. The gestational sac that should show up as a black spot at the center of the image to indicate a pregnancy wasn’t present.
The technical term is “pregnancy of unknown location.” It could be that it’s too early to see anything, she told Alice. Or it could be a miscarriage. Or it could be something more serious, like an ectopic pregnancy, where a fetus grows outside of the uterus, a circumstance that won’t lead to a full-term pregnancy but could trigger internal bleeding and threaten the person’s life.
“An ectopic pregnancy is very treatable if it's caught early,” Briggs reassured Alice. “So, I'm glad that you're here, getting to the bottom of it.”
“I have a lot of anxiety right now,” said Alice, who’d come to WE Health seeking an abortion. MPR News agreed not to use her real name to protect her privacy. “But I'm glad that I'm here, and I'm figuring these things out.”
While the clinic’s offered reproductive and abortion services to people for more than 40 years, it’s become an island in a vast stretch of the Upper Midwest as the only abortion provider across northern Minnesota and northern Wisconsin.
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Its leaders are bracing now for an influx of patients and protesters from across the nation if the United States Supreme Court this year overturns Roe v. Wade and other states tighten or end legal abortion. Here, the current and coming challenges are clear.
‘Seeing that need grow and grow’
Minnesota is already seeing an increase in people traveling here from Texas and other states that have passed strict abortion laws anticipating the end of Roe v. Wade.
In February, Whole Woman’s Health reopened a clinic near the Minneapolis-St. Paul International Airport to close the distance for patients from out of state. The clinic says that as of early May about 30 percent of new patients were from outside Minnesota.
“We have seen that need even further beyond what we initially anticipated,” said Sean Mehl, the group’s associate director of clinical services. “Every week we're seeing that need grow and grow.”
In Duluth, WE Health has performed 201 abortions through April compared to 161 in the same period last year, said Laurie Casey, the clinic’s executive director.
“The past couple of months we’ve seen an increase in people traveling from the metro area to our clinic, because they're having a hard time getting into the clinics down in Minneapolis and St. Paul,” Casey said, noting that local patients are increasingly having trouble getting appointments.
“I just think with the influx of people traveling from out of state, it's just going to impact … the people in Minnesota who expect that they can get in for an abortion quickly,” she added. “I think the wait times will increase.”
Abortion has been a protected right in Minnesota since 1995, when the Minnesota Supreme Court concluded in Doe v. Gomez that abortion decisions fell under a constitutionally secure right of privacy. In the ruling, Chief Justice Sandy Keith wrote that there were “few decisions more intimate, personal and profound” than between childbirth and abortion.
“I don't know that right now I can safely say: ‘Oh, sure, if you need an abortion, there's not going to be an access problem in Minnesota,’” said Jess Braverman, legal director for the nonprofit advocacy group Gender Justice. “I think we need to continue to shore up our abortion infrastructure here.”
‘Used to be much more calm’
Right now, WE Health Clinic only performs abortions one day a week. But they’re looking to increase the frequency. Since the news leaked that the U.S. Supreme Court might overturn Roe v. Wade, the clinic’s seen a swift uptick in monetary donations, supplies and other support.
As patients and the need for services increase, Casey said there’s also a need to ramp up security around the clinic. They’re working with local officials and exploring investing in building upgrades and hiring private security.
CBS News reported in May that law enforcement agencies across the country are on high alert for possible threats.
Workers at WE Health expect that the number of protesters outside their building will rise if Roe falls. They’ve already seen an increase over the past few years.
On any given day outside the Duluth clinic there can be a few or dozens of anti-abortion demonstrators, said Cassidy Thompson, who helps run the clinic’s escort program, which walks patients in and out of the facility to ensure their safety.
Some wear light blue vests, emblazoned with the words “Choose Life” in large, yellow letters, and pass out pamphlets that encourage patients to look at their ultrasound. Others carry picket signs decrying abortion; some yell at people seeking care.
“It used to be much more calm outside of our building,” Thompson said.
On a recent day, Tom Schaer with Pro-Life Ministries of Duluth stood outside the clinic. In his view, there are no occasions where seeking an abortion is justified. But he doesn’t see the leak indicating the end of Roe v. Wade as anything to get excited about.
“It’s not something to get real responsive to, the fact is we don't know if that's the end or not,” he said.
On the same day, Carrie drove for hours to get an abortion at the Duluth clinic. Clinic workers, she said, had warned her about the demonstrators, but it was still frustrating to see.
“When I came into the building, you know, there were people yelling at me,” she said. “They don't know what I'm going through.” MPR News agreed not to use her real name to protect her privacy.
A week and a half earlier, Carrie said she found out she’d been diagnosed with an aggressive form of breast cancer. She’s a stay-at-home mom, taking care of two kids younger than six.
“By being pregnant, it will prolong my cancer treatments,” said Carrie. “Like, did I want to make this choice? No. But I'm going to because it's going to help me in the future — it's going to save my life.”
Correction: A previous version of this story misspelled Paulina Briggs' name. The above story is updated.