Maggie Olivia of St. Louis took a 20-minute drive across the Mississippi River in March 2020 for an abortion.
Olivia was 24 at the time and had only been with her partner for a couple months when she found out her birth control had failed. She was working at a catering company as COVID-19 pandemic restrictions began forcing businesses to close.
She wasn’t ready to be a parent.
“I can’t imagine what my life would look like having not had access to abortion,” said Olivia, who now works for abortion activist organization Pro-Choice Missouri. “My abortion changed my life and it changed the path of life that I’m taking.”
Thousands more people will begin seeking abortions in the metro-east after the U.S. Supreme Court struck down Americans’ constitutional right to end a pregnancy Friday.
Abortion will still be legal in Illinois and other states that choose not to outlaw it.
“Abortion remains legal in Illinois. If you have an appointment, keep it. If you were thinking about making an appointment, make it,” said state Rep. Kelly Cassidy, a Democrat from Chicago. “We are protecting choice in Illinois.”
But abortion will become illegal in Missouri, Kentucky, Arkansas, Tennessee, and Oklahoma, sending upwards of 14,000 additional people to southern Illinois from those states, according to estimates from Planned Parenthood.
Missouri’s “trigger law” went into effect Friday. It was designed to prohibit nearly all abortions immediately after the Supreme Court overturned Roe v. Wade, the landmark case that legalized abortion in 1973.
People seeking abortions will not yet be prosecuted for getting an abortion, according to a news release from Missouri Gov. Mike Parson’s office, but there could be criminal charges for doctors who perform an abortion “unless there is a medical emergency.”
Abortions were only available at one location in Missouri: the Planned Parenthood clinic in St. Louis. The clinic performed their last abortion on Wednesday.
Planned Parenthood will instead direct patients across the river to clinics in Illinois. People were already seeking abortions in Illinois before the overturn of Roe v. Wade.
Missouri law already made it difficult if not impossible to get an abortion. Patients have to first listen in-person to anti-abortion information and then wait 72 hours before the procedure. Olivia, who survived sexual violence in her past, said she wasn’t willing to go through that.
“Doctors appointments are really uncomfortable but especially any kind of gynecological setting. So, it was really important to me that I was fully in control of what that appointment would look like,” Olivia said.
Getting an abortion in Illinois was easy, and the state plans have made it even easier as people flee their home states for care.
Yamelsie Rodríguez, president and CEO of Planned Parenthood in the St. Louis region, said 36 million people of reproductive age “will live in a state poised to ban abortion.”
“This public health emergency requires all of us in public service to do everything we can to ensure those 36 million people are cared for,” Rodríguez said at a news conference in St. Louis Friday.
Illinois plays a central role in providing abortions to people from surrounding states.
To serve those patients, abortion clinics will operate the Regional Logistics Center located in the Planned Parenthood’s center in Fairview Heights. Planned Parenthood of the St. Louis region and Hope Clinic for Women in Granite City bill it as a “travel agency” for patients. They can seek assistance in paying for travel and lodging from the center, and there are no income limits.
Planned Parenthood will focus on coordinating logistical support for those seeking abortions in Illinois, said Dr. Colleen McNicholas, the organization’s chief medical officer in St. Louis.
“There is no infrastructure that is capable of managing the mass mobilization of millions of people,” McNicholas said. “We don’t have to guess what’s going to happen in the days and weeks to come.”
As Texas and Oklahoma further restricted abortion access, St. Louis region abortion clinics saw numbers of patients seeking care more than double.
“Now we’re helping folks navigate how you’re going to get here,” McNicholas said. “Who’s going to watch your kids? ... Where are you going to stay? How are you going to eat when you’re here?”
What happens legally in Illinois and Missouri?
As Missouri and other states took steps to limit abortion Friday, Illinois planned to expand protections.
Gov. J.B. Pritzker announced he was calling the General Assembly into special session to “to further enshrine our commitment to reproductive health care rights and protections.” He did not say when the session would take place or what specific legislation would be addressed.
Illinois expanded state law to provide extra protections for abortion. In 2019, Gov. J.B. Pritzker signed the Illinois Reproductive Health Act into law, making access to abortions a fundamental right. The governor also repealed a parental notification law that required minors to involve a parent or guardian in their abortion decision.
In 2020, roughly 21% of people who had abortions in Illinois came from out-of-state, according to data from the Illinois Department of Public Health. Most of them came from Missouri.
Missouri lawmakers could take it a step further. Some lawmakers want to stop residents from seeking abortion in other states. A proposal before lawmakers would allow citizens to sue anyone who helps a Missourian seek an abortion out-of-state.
There are still avenues for abortion rights activists to challenge Missouri’s outlawing abortion. A statewide ballot initiative in Missouri could force a vote on legalizing abortion, the Kansas City Star reported. The courts could also see a lawsuit arguing the Missouri Constitution guarantees the right to an abortion.
Anti-abortion states may also attempt to restrict access to abortion pills by mail. The pills can be taken at home and are safe and effective, according to the Kaiser Family Foundation, a health care research nonprofit.
Pritzker talked about “women who were nearly dead” from botched illegal abortion attempts. They were treated at Ward 41, the “Septic Obstetrics Ward” in the Cook County hospital pre-Roe v. Wade. From 1961 to 1965, Ward 41 treated the health ramifications from more than 20,000 illegal abortions, Pritzker said.
“They treated women who burned their insides with bleach and peroxide, women whose uteruses were perforated with paintbrushes, cocktail stirrers, knitting needles and wire coathangers. ... They risked their lives out of desperation,” Pritzker said. “We cannot go back to Ward 41.”
Olivia said she believes mailed abortion pills will prevent people from seeking or trying illegal or medically unsafe procedures. In the 1970s, an underground network of providers helped those in need of abortion.
“Medicine is so much more advanced than in the 1970s,” Olivia said.