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A river and a 20-minute drive separate two galaxies in access to abortion. On one shore, Missouri Conservatives try to close the last clinic open. In the other, Democrats soften the law and treat poor women for free

Written on a yellow page: “We knew this decision was difficult, but it is the best for us and our families. I am 28 years old; I am already the mother of a child of six. My best friend and I had a drunken night and we don’t need this son. ” Written on pink paper: “Lord, I know that you are with every woman who is in this situation.” Again, with a yellow background: “Do what is best for you and don’t let anyone make you feel bad about it.”

Women who abort at the last clinic open in Missouri, in the city of St. Louis, leave letters for God and also for the next patient in a guest book in the waiting room. To get there they have had to circumvent a line of pious women who pray and have found a girl in a multicolored vest who acts as a companion in case they are harassed. There are usually few pious women; also few patients. On a Wednesday in October, the only day that week they will perform abortions, there have only been two interventions. Two, in a State of 6.2 million inhabitants.

Dr Colleen McNicholas, 39, ends the day early, without too much fatigue, and explains: “Abortion has been around for as long as pregnancy has been. When they get into difficulties, women look for a way out, and usually they go out of here. When I was born, there were 30 clinics, when I entered university there were 10 and now that I am already practicing there is only one left ”.

It remains, miraculously, or, rather, by a judge. Over the years, the authorities of the conservative state were implementing more and more requirements to the centers so that they can operate and last year they were about to close the last one, managed by the great family planning association Planned Parenthood, by not renewing the license due to a conflict with the latest demands. The pulse came in the midst of a major offensive by conservative states against abortion, with new limitations in Iowa, Mississippi, Alabama or Louisiana bordering on a total ban. In parallel, Democratic territories such as Illinois, New York, Vermont and Rhode Island reacted in the opposite direction and have passed new laws and regulations that facilitate the termination of pregnancy and try to protect the right to abortion for the future.

Nowhere like the Mississippi River Bridge, those 20 minutes that separate Missouri and Illinois, to see a broken society. In St. Louis, before having an abortion, women should listen to the same doctor who is going to have it – Dr. McNicholas – warning them that they are ending a life. Required by regulation. Also a last pelvic exam. The authorities also require a 72-hour wait between a first visit before the service and the intervention. Those three days for “reflection” hardly change the decision of the patients, but they do create problems for many of them, because if they live in locations far from the only center they need to ask for several days off from work. And health insurance only covers the cost of the intervention in case of risk to life.

Across the river in Fairview Heights, Illinois, a brand new Planned Parenthood clinic opened just over a year ago. It has the capacity to serve some 11,000 patients, the vast majority of whom are Missouri women. In Illinois, women do not spend those 72 hours of reflection and those who are in a more vulnerable economic situation have expenses covered by Medicaid (the public health program for disadvantaged people). Governor JB Pritzker signed a law that enshrines it as a “fundamental right” and relaxed restrictions on cases of advanced pregnancy. An organization, the Chicago Abortion Fund, also collects funds to defray the travel expenses of low-income women.

In the waiting room in downtown Fairway, instead of letters, there are pictures of young, beautiful and cheerful people on the beach, or passing through the city, as if they were advertisements from a fashion catalog.

“We are already living here now a reality of what the United States can be in the future, if the Supreme Court changes its mind. Women who cannot have an abortion in their state and must travel to others, ”explains Jamelsie Rodríguez, president of Planned Parenthood for the St. Louis and Southwest Missouri region.

All the great social debates in the United States end up being resolved in the Supreme Court: racial segregation, abortion, or the right to burn the flag. Rodríguez refers to the Supreme Court ruling in the 1973 Roe v. Wade case, which legalized the voluntary interruption of pregnancy throughout the country. It did so under the argument of the right of women to “privacy”, which forever left an open door that the new times are trying to reopen. Several of the most restrictive laws on abortion, stopped in the lower courts, seek to end the legal battle in the high court, now with a reinforced conservative majority, in order that it must return to pronounce itself. The Senate is currently debating the confirmation of Judge Amy Coney Barrett, who has been against it on other occasions, as a new member, which will leave progressives in a minority of six to three.

At Planned Parenthood they think about what a “post-Roe” world will be like. If Missouri closed the only one that remains open, it would already have, de facto, abortion prohibited. There are five States where only one clinic remains. National Right to Life, an anti-abortion league that believes that life begins at the very moment of conception, has high hopes for the future Supreme Court judge. According to the president, Carol Tobias, Amy Coney Barrett “has demonstrated her commitment by defending the text and the history of the Constitution”, that is, she belongs to that current of literalist interpreters of the Magna Carta with a more conservative tendency.

The president and Republican candidate Donald Trump, married three times, accused of abuse by several women, and who has admitted having paid two to silence extramarital affairs, has become something of a hero of the anti-abortion movement. Few aspects of his life would make him the ideal leader of the conservative voter, but no one can doubt the pragmatism of the religious right and his Administration has favored their interests: he recovered a law that prohibits NGOs and healthcare providers abroad from using government funds American for pro-abortion counseling; it struck down a law that required employers to include contraception in the health plan offered to their employees, and announced a reform of a federally funded family planning program for low-income patients.

Patty Rule, one of the women praying in front of the new Illinois abortion clinic, which is also frequented by pro-life activists, sees a change: “The fight against abortion lost some steam 10 years ago. It became easier and safer, so the number increased. But for some time now, more people realize how important life is. ” Following the historic 1973 ruling, the number of abortion clinics soared across the country. Planned Parenthood and other feminist organizations warn of a reverse process that may culminate next year in the Supreme Court. In Missouri they have already had a look at the crystal ball.


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