Inside the Mississippi last abortion clinic

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JACKSON, Mississippi – Patients that morning included a teenage girl with her mother, a nearby hospital worker wearing scrubs, a student in a sorority T-shirt, and a woman who had left the house long before sunrise. sun for the seven-hour drive from Texas.

They had all come to get an abortion at the last clinic in Mississippi.

Expecting Massachusetts obstetrician-gynecologist Dr Cheryl Hamlin is part of a rotation of out-of-state doctors doing work that local doctors won’t.

“I am obligated by the state of Mississippi to tell you,” Dr. Hamlin said, “that abortion will increase your risk for breast cancer. “

“It is not,” she added without hesitation. “Nobody thinks so. The American College of OB-GYNs does not believe this to be the case.

The clinic, Jackson Women’s Health Organization, has long negotiated measures intended by the legislature to discourage women from having abortions and to make it difficult for providers to function. They include the requirement that doctors warn patients of a link between breast cancer and abortion, although the American Cancer Society says “The scientific evidence does not support the notion. “

Today, the culmination of those legislative efforts – a state law banning abortion after 15 weeks of pregnancy – has pushed the clinic to the center of a case that could lead to one of the most important decisions. on the right to abortion for decades.

The Jackson Women’s Health Organization has sued Mississippi over the new restrictions, and lawyers will argue the case in the Supreme Court on Wednesday. The implications will most likely be felt far beyond Jackson. The law was intended as a direct challenge to Roe v. Wade, who established a constitutional right to abortion and prevents states from banning the procedure before fetal viability, which most experts estimate at around 23 or 24 weeks.

The law, which includes exceptions for medical emergencies or serious fetal abnormalities, reflected efforts by state leaders to make Mississippi “the safest place in America for an unborn child,” said Phil Bryant. , the former republican governor, by signing the legislation. in 2018.

If the judges overturn Roe completely, the ruling will trigger laws in a dozen states – including Mississippi – that will make abortion illegal almost immediately. Even if Roe isn’t completely overturned, the court could give states more leeway to limit how and when abortions are performed.

While the survival of the Jackson Clinic is at stake, it has never been so busy. In recent months, it has extended its hours of operation from three to five days a week. The phones are constantly ringing with people trying to make appointments, calling from all over Mississippi and increasingly Texas – an influx attributed to the new law, which is the most restrictive in the country. The clinic now sees around 300 women per month.

“Our number of patients has almost doubled,” said Shannon Brewer, clinic director. “We are adapting,” she added. “We just know it needs to be done.”

The weight of the implications of the decision was inevitable. In recent weeks, film crews have crowded into Ms Brewer’s office. A Time magazine cover featured a photograph of her staring sadly into the distance.

But taking the time to ruminate on it all feels like a luxury. “By the time I get home and find myself, I’m going to sleep,” Ms. Brewer said. “I’m not sitting there thinking about it.”

Dr Hamlin, who travels to Mississippi about once a month, arrived at the clinic around 8 a.m. on a recent Monday with two and a half busy days ahead of her.

The morning began with state-mandated counseling sessions that begin a 24-hour countdown before patients are allowed to complete the abortion process. About half a dozen women at a time sat in a back room as Dr. Hamlin gave an overview that vividly illustrated the conflict between Mississippi’s legal requirements and his professional opinion.

“There are many laws restricting the care we can provide here,” said Dr. Hamlin. “I encourage all of you – if this is an important issue for you – to vote in the next election. “

The women then lined up to speak to him individually. They came from all walks of life, but primarily reflected the demographics of Jackson, which has a predominantly African-American population, and Mississippi, one of the poorest states in the country.

As a patient sat across from the desk, Dr Hamlin thumbed through a file containing a copy of her ultrasound and medical information. Her blood pressure was a little high, she noted.

“You might be just as nervous,” Dr Hamlin said.

The woman needed a surgical abortion. Dr. Hamlin looked at a calendar. Her only option was to come back the next day or wait another week, which would leave her with a narrow window. The 15-week restriction has been put on hold pending a court ruling, but the clinic, restricted by a host of other state laws, only performs abortions for up to 16 weeks.

“I would like to come tomorrow,” the woman replied, “but I want to make sure I have all the money. “

Surgical procedures range from $ 650 to $ 800. Medical abortions cost $ 600. Patients must pay in cash or by credit card, but financial assistance is available.

“Why don’t I put you on for tomorrow?” Dr Hamlin said. “And if for some reason you feel like you can’t make it, let us know.”

“Because clearly,” she added, “the sooner the better.”

The clinic, known as Maison Rose for the flamingo hue of its stucco exterior, is located in Jackson’s vibrant Fondren neighborhood, a small arts district with trendy shops, cafes, and restaurants.

It predates the takeover of the neighborhood and has made it a sometimes annoying neighbor. Protesters for and against abortion regularly clash outdoors, often at high volume.

The entrance to the clinic is blocked by a fence covered with black paneling to protect patient privacy. That day, a protester walked outside as the women walked inside: “You are already a mom and dad for the baby! she screamed. “Let us help you! You are paying someone to kill your baby!

Derenda Hancock, who heads the advocates of Pink House, as the volunteers who escort women in and out of the clinic are known, apologized to a patient on the other side of the fence .

“They are not going to block me,” replied the woman. “I have to live with it. They don’t have to live with it.

Just outside the fence, Pam Miller, an anti-abortion protester, waved cars back and forth, trying to hand women gift bags with Cheez-It crackers, sachets of applesauce and a pamphlet on reversing the effects of the first part of a medical abortion, a practice touted by anti-abortion groups but considered by many researchers to be based on questionable science.

“To me it’s a Bible question,” Ms. Miller said, “because God created people in his own image and that means we are special, we have intrinsic worth just to be.”

Dr Hamlin had planned to become a veterinarian, but a college guidance counselor pushed her to medical school. In her first year, she followed a doctor who let her watch a woman give birth.

“I just thought it was the most miraculous thing I have ever seen in my life,” she recalls. “I cried.”

She decided to become OB-GYN. “I felt like the doctors were so paternalistic,” said Dr. Hamlin, who completed his residency in 1992.

In the fall of 2016, Dr. Hamlin, a hospital doctor in the Boston area, found himself destabilized by the election of Donald J. Trump. She realized that there was a large part of the country that she did not understand. She signed up to work at the Jackson clinic and another in Alabama.

On a typical day in Jackson, she sees over a dozen patients and most of her counseling sessions last only a few minutes.

“Is this your first pregnancy?” Dr. Hamlin asked a patient while scanning her chart. “Looks like you’re healthy. Your blood pressure is good. The blood count is good. All right, something else? “

Afternoons are devoted to surgeries and group sessions in which she distributes medical abortion pills and educates women on the process.

From her desk, Mrs. Brewer, the clinic director, watches a screen showing the view of security cameras posted around the clinic, alerting signs of a problem. There were threats and clashes broke out outside.

“I’m a very careful person because of this place,” said Ms Brewer, manager for 11 years and employee for 20 years.

Jackson is a town of about 154,000 people that can feel like a small town, which is especially true for the people who work at the clinic. Ms Brewer lived across the street from a regular protester. Sometimes she sees others at the grocery store. “They generally seem more surprised when they see me away from this place,” she said.

After the last patient left that day, Dr Hamlin went through a stack of files on his desk, reviewing the files and signing the documents.

The clinic has not had a staff physician for over a decade. Local doctors, whether for moral opposition or security reasons, refused to do this work. Instead, the clinic maintains a home to accommodate doctors from out of state. Dr Hamlin keeps a pair of running shoes and clothes there, but his connection to the city is limited. Her job is not without risk, but unlike other women working at the clinic, she knows she can return to Massachusetts after every short trip.

“I come and I go,” she said, “and they continue. “

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