On a recent weekday afternoon, Ezra Figueroa is giving a tour of Planned Parenthood of Illinois’ clinic in Waukegan, about 20 minutes from the Wisconsin border.
The space is big and quiet, except for Michael Jackson tunes and other hits playing in the background. There are hardwood floors throughout, and exam rooms typical of a doctor’s office.
There’s also this — a shiny silver vault in the break room that Figueroa, the assistant health center manager, is unsuccessfully trying to open.
“Can’t get inside of it. I really wish we could,” Figueroa said. “But it’s really cool to just have here.”
The vault is a reminder of what this health center used to be — a big bank on a busy retail strip — and what Planned Parenthood of Illinois saw in its future. This clinic opened two years ago with Wisconsin in mind, with the knowledge that if Roe v. Wade was overturned — as it was in June — a state law would largely strip away access to abortion in that state. Indeed, that happened immediately.
So recently, Planned Parenthood organizations in Illinois and Wisconsin announced a deal. More than a dozen employees from Wisconsin — including doctors, nurses and medical assistants — are commuting to Waukegan. Some come a few times a week; some a few times a month.
“It really required this perfect pairing of supply and demand,” Kristen Schultz, Planned Parenthood of Illinois’ chief strategy and operations officer, said of the partnership. “They had capacity without local demand, and we had the opposite.”
The idea is to preserve access to abortion for Wisconsin residents, while helping staff at the Waukegan clinic as Illinois becomes an even more vital oasis for abortion care. In the month since Roe v. Wade was overturned, dozens of abortion clinics have closed across the nation as 11 states across the South and Midwest implemented bans, according to the Guttmacher Institute, a nonprofit that supports abortion rights and tracks the issue.
The influx of patients into Illinois has had another impact. For years, abortion providers have been traveling to other states like Mississippi and Oklahoma, where their help has been needed more. They would fly in once or twice a month to perform abortions, then return home.
Chicago OB-GYN Dr. Laura Laursen was one of them.
“Now the script is totally flipped,” said Laursen, a fellow with Physicians for Reproductive Health. “This is where you are needed more than anywhere else.”
Outside the Waukegan clinic along busy Lewis Avenue, two people demonstrated silently as cars zoomed. They were shielded by bushes that essentially blocked them from the health center’s view. They said they drove from the Milwaukee area, and plan to do so a few times a week now that they’re not needed as much in Wisconsin.
“These babies deserve to be protected,” said Anne, one of the demonstrators. She did not want to give her full name. “We’re hoping some women change their minds.”
Anti-abortion groups are opposing the Planned Parenthood partnership and are preparing for a marathon-long fight if necessary to attempt to restrict abortion rights in Illinois. In a statement after the organizations’ announcement, Amy Gehrke, executive director of Illinois Right to Life, called it “particularly tragic.”
The long commute
Natalee Hartwig is a nurse midwife and associate director of clinical services at Planned Parenthood of Wisconsin. She drives on average two days a week to Illinois, working in Waukegan or training in Aurora to provide medication abortion.
As she prepared to head to Illinois recently, she described how her day-to-day routine has changed.
“I’m going to leave way before he wakes up — my son — so I’ll leave at 5:30 in the morning,” Hartwig said. “Luckily it’s summer. For now he can sleep in. But any getting ready that has to happen will be on my spouse.”
The drive takes at least two hours from her home in Madison. On the long rides, she distracts herself with audiobooks and podcasts that are not about abortion. The journey, she said, is worth it.
“This was really just what I was always supposed to do,” Hartwig said. “There’s nothing that’s going to keep me from helping our patients.”
From her perspective, providing abortions should be part of her scope of practice since she already delivers babies and otherwise takes care of pregnant patients.
But Wisconsin doesn’t allow nurses like Hartwig with advanced degrees to perform abortions. Illinois does allow them to perform medication abortion, according to the state Department of Financial and Professional Regulation. And so now she’s traveling to the state, working toward that.
Dr. Kathy King, Planned Parenthood of Wisconsin’s medical director, said while her staff is dedicated to providing these services, it comes at a cost.
“It is a burden on our clinicians and nurses and medical assistants who have young children at home,” King said. “It sounds great. Sure, we’ll all just travel down to Waukegan five days a week. But the logistics of that and the sacrifice of doing that on just people’s day-to-day lives takes a toll.”
This sacrifice has helped. With staff from Wisconsin, the Waukegan clinic now has doubled the number of abortion appointments available, and they’re still ramping up. This also frees up other staff to treat patients who come for other needs, like birth control and cancer screenings.
There has been a burst of patients from Wisconsin for abortion appointments at all Planned Parenthood of Illinois clinics — a tenfold increase since Roe overturned, from about 35 patients a month to 350, King said. That doesn’t include Wisconsin residents who might have sought abortions with other providers.
The Waukegan clinic sees more out-of-state patients for abortions than any other Planned Parenthood of Illinois health center, said Schultz, the organization’s chief strategy and operations officer.
A potential model
The Waukegan clinic has ignited interest from abortion providers in other nearby states. Planned Parenthood of Illinois is fielding calls from those in Indiana, Kentucky and Ohio, for example, Schultz said.
What Illinois needs is more staff to treat more patients. But where will those additional employees come from? The commute from Wisconsin to Waukegan is relatively short compared to providers in Ohio who’d have to cross Indiana to get here.
Across the nation there are other conversations happening among providers. The National Abortion Federation, which has about 500 facility members including independent abortion clinics and hospitals, has become a matchmaker of sorts. The organization is pairing up people who are looking for jobs at abortion clinics with those that need workers, from doctors to staffers who answer phones, said Melissa Fowler, chief program officer at the federation.
Still, she acknowledged moving isn’t a realistic option for everyone. Some couldn’t afford to leave.
“People have lives,” Fowler said. “They have families. They’re deeply rooted in their communities and they’ve chosen to live there on purpose. And so a situation like you’re seeing in Illinois and Wisconsin is great because people are able to stay connected to their community, not have to move their family and still be able to provide care.”
In the southwestern pocket of Illinois, many people who work in a clinic in Fairview Heights live across the border in St. Louis. It’s a roughly 30-minute commute for Dr. Colleen McNicholas, chief medical officer of Planned Parenthood of the St. Louis Region and Southwest Missouri.
Early in her career, she frequently traveled to Kansas to provide abortions, and later to Oklahoma. Now she’s seeing whose expertise she can bring to Fairview Heights, such as doctors and clinic managers in Arkansas who in a post-Roe world now work in a state that has banned nearly all abortions. There’s been a big uptick in patients seeking abortions in Fairview Heights recently from Arkansas, Tennessee and Mississippi.
“The volume of patients that we are now going to be seeing does demand that we are going to not only ramp up our offerings or services, but also who’s going to provide those services?” McNicholas asked.
In the days before Roe was overturned, patients typically waited three days for an appointment to get an abortion. Now that wait time has climbed to around three weeks — at a clinic that provides abortions six days a week, eight hours a day.
Within the year, if projections for the crush of expected out-of-state patients pan out, Fairview Heights might open its doors for abortion care seven days a week, 12 hours a day.
“Even that might not be enough to give (patients) as quick of access as we would like to,” McNicholas said.
Kristen Schorsch covers public health and Cook County on WBEZ’s government and politics desk. Follow her @kschorsch.