How a Milwaukee Planned Parenthood clinic is preparing for a post-Roe reality

In early May, a leaked draft opinion from the U.S. Supreme Court suggested that it may be poised to overturn Roe v. Wade in the coming weeks. If that happens, a Wisconsin law from the 1800s that is still on the books could ban nearly all abortions in the state immediately.

Although state Attorney General Josh Kaul said the state Department of Justice would not enforce the ban, the state’s abortion providers are planning for a post-Roe reality and the prospect of halting virtually all legal abortion services in the state.

Dr. Allie Linton works at Planned Parenthood’s Water Street Health Center in Milwaukee four days a week, providing both medication and surgical abortions. Since last December’s oral arguments at the Supreme Court, Linton and other Planned Parenthood of Wisconsin staff have been preparing for the potential end of Roe vs. Wade.

Still, the leaked draft opinion took her by surprise.

“I was watching RuPaul’s Drag Race, because that is how I decompress at home,” she said. “And I got a text from another abortion provider here in Milwaukee, saying, ‘Is this real?’”

Now, the planning has kicked into hyperdrive, Linton said. They don’t know exactly when the decision will come down, but they expect it to be in the next few weeks. While they wait, they’re making sure to let patients know that some of the options they have now may not always be on the table.

“We are telling patients we don’t know how much longer we can provide abortions here, and that includes treatment for a failed procedure as long as the pregnancy is ongoing,” she said.

‘If I waited too long, then it’s too late’

In the clinic’s recovery room — a pastel-painted area with dim lighting and calm music — Ariel Moulton waits to begin a surgical abortion procedure. Moulton, who’s in recovery from substance abuse, said her pregnancy wasn’t planned. She was already considering having an abortion well before the leaked draft opinion, but hearing the news made her even more sure of her decision.

“I knew what I wanted to do,” she said. “It’s almost like I couldn’t even consider not doing it, because if I waited too long, then it’s too late.“

Moulton is alarmed at the potential of losing legal access to abortion in the state, and wonders what someone in her situation would do if Roe vs. Wade was overturned.

“Nobody wants to get an abortion,” she said, “But sometimes that’s a better option than having another life in this world that just can’t be provided for normally … I wouldn’t want somebody else to go through that.”

Later in the afternoon, another patient who preferred not to use her name waited for a procedure in one of the room’s curtained areas. Her feelings were more complicated — even though she was choosing to end her own pregnancy, she doesn’t support abortion.

“If they ban abortion, I wouldn’t really be upset,” she said. “People just need to be more careful.”

Contingency planning

If Roe vs. Wade is overturned, Planned Parenthood of Wisconsin would cease abortion services immediately, Linton said.

“The day of the ruling, the minute that ruling comes out, we have to suspend all abortion procedures, and that is regardless of indication,” she said.

In that case, one option for Wisconsin abortion seekers could be to travel to a state where it would still be legal, like Illinois. Planned Parenthood is making plans to help patients do just that, hiring patient navigators, whose main jobs would be to help people get across the border.

Zoie Hawpetoss currently works as a reproductive health care assistant for Planned Parenthood of Wisconsin, but will be taking over as a patient navigator in June. It will be a largely logistical job, she said, modeled after similar roles in Texas, which passed a restrictive abortion law last year.

“Getting our connections with hotels, and figuring out where the flights are, and how we can get them to different states,” she said. “And what Illinois’ laws are, and what Minnesota’s laws are, and how you can get financial assistance in those states.”

Additionally, many Water Street Clinic staffers are planning to get licensed to practice in Illinois themselves, including nurse Susan Hedges. The idea is that they could commute to Planned Parenthood’s clinic in Waukegan, Illinois, to help handle potential surges of patients from states like Wisconsin where legal abortion access could be going away.

“I’m in the phase of my life where my children are grown,” Hedges said. “So I could go down there for an entire week and come back, potentially, I could rent an apartment down there, or I could move there.”

The process of obtaining a license is daunting for Hedges and others. They say it’s time-consuming and bureaucratic and, for some, will involve tracking down nursing transcripts from decades ago.

For Linton, preparing to practice in Illinois was somewhat simpler. Since she trained in Chicago, she only needed to restore her Illinois license, a process which took about six weeks.

Clinic doctors are now prescribing all medication abortion patients an additional dose of misoprostol, the drug that causes the uterus to contract and empty. This is something they’ve always done for patients past nine weeks gestation, Linton said, because it’s sometimes needed to help the pregnancy pass and control bleeding. Now, she wants to make sure all patients have the extra dose if they need it, in case the ruling comes after patients have already begun their medication abortions.

Clinic staff is also trying to schedule procedures around the days when they think it’s most likely the ruling will be released.

“We don’t want a patient coming thinking that they’re going to get health care that day, and then we have to tell them, ‘No, based on a ruling that just came down, we have to turn you away,’” Linton said.

Planned Parenthood has made it clear that no staff members will lose their jobs if abortion is outlawed in the state, but operations at the Water Street clinic would look very different. Naomi Jackson is the center manager, and handles a number of things including scheduling. As she made the schedules for the next few weeks, she said it felt like preparing to close the doors.

“We won’t lose our jobs at Planned Parenthood, but we do lose our passion for what we come here to do every day,” she said.

For now, staff at the Water Street clinic are in a state of limbo, trying to see as many patients as they can before the ruling. Still, Linton said no amount of planning can prepare for the changes that may be on the horizon.

“I’m terrified for what that looks like for every single one of my patients, every single one of my staff,” she said. “It’s going to be a really hard day.”