mily Mohrbacher spent all morning working through the queue, but by early afternoon, the list of people needing her assistance had climbed back up to 43.
Laptop open, earbuds in, Mohrbacher snacked on a fig newton in her Minneapolis kitchen and got back to work. She used an encrypted app to send a few questions to a woman in another state who had an abortion scheduled the next day but no way of getting to her appointment. As she waited for a response, Mohrbacher checked in with another client from Nebraska who needed to get to St. Paul for her procedure.
Someone from Texas was trying to get to an appointment in Wichita, and another to an appointment in Illinois. It's enough to keep her busy, but nowhere near as many people as last year, right after a leaked draft foreshadowed the Supreme Court's eventual reversal of Roe v. Wade, when the number of people waiting to hear from her hit 173.
"For some reason that number is seared into my memory," she said.
Mohrbacher is director of client services at abortion fund Midwest Access Coalition, and she plays a critical role in a movement in Minnesota and around the country to aid people in navigating the confusing, sometimes overwhelming post-Roe landscape. The navigation part is literal: case managers find rides, bus tickets, flights and hotel rooms for people who need an abortion but live hours — or sometimes several states — away from a clinic with an open appointment. Many clients end up in Minnesota, which is surrounded by states that have restricted or limited abortion access.
"The demand just really took off after that decision," said Emily Bisek, vice president for strategic communications at Planned Parenthood North Central States, which has hired a full-time abortion patient navigator in Minnesota and expects to hire another soon.
Their jobs are in the middle of a fight over how post-Roe America will operate. In states such as Texas and Oklahoma, people who do similar work can be sued. Earlier this month, Idaho's governor signed a law that makes helping a pregnant minor get an abortion in another state without parental consent punishable by two to five years in prison. Minnesota's DFL-led Legislature is considering a proposal to protect patients and those who help them get to Minnesota for an abortion from legal repercussions, but Republicans argue that legislation flies in the face of a constitutional provision to respect laws in other states.
"We're prioritizing an extreme position on one particular policy issue — the most extreme abortion policy possible — and we're saying that is so important that we're striking a blow against the constitutional order," said attorney and state Rep. Harry Niska, R-Ramsey. "We're telling other states that even if you get a judgment in your other state, if we in the state of Minnesota don't agree with it, we're not enforcing it."
Those restrictions and penalties have had a huge effect on the landscape, said Bisek, sending confused and nervous patients to their abortion navigators, unsure about what's legal and what's not.
And the need isn't leveling off, she said. Planned Parenthood's navigator in Minnesota has worked with more than 1,100 people to get to their appointments since Roe was overturned, nearly 80% of those cases in the Midwest. As they get better systems in place to do the work, they're taking on more cases each month.
"If this was a graph," said Bisek, "it would be a diagonal line."
A tight-knit community
Before the Roe ruling in 1973 — the last time abortion was illegal in parts of America — women looking for abortions relied on word of mouth to find clandestine clinics and try to cobble together enough money to travel across state lines.
Women still travel long distances and can face daunting costs, but five decades later, technology has made it simpler to book clinic appointments, hotel rooms and flights.
Shayla Walker spends part of her day bouncing between a spreadsheet and a dozen or more open tabs on her computer as executive director of Our Justice, a Minnesota-based abortion fund.
Walker's spreadsheet is automatically populated by a form on the group's website for people seeking funds to cover the costs of their abortion, which can range from $50 for someone getting a medication abortion to thousands of dollars for someone later in gestation. Her nonprofit raises hundreds of thousands of dollars each year through grants and individual donors to cover those costs.
There's an additional cost if someone also needs support for travel and lodging for their procedure. Walker also helps lead Spiral Collective, which gives people rides to their appointments. She knows doctors who work at the clinics and which hotels are nearby and respectful to people traveling for procedures.
"The abortion community is very, very small," Walker said.
The job requires them to use their connections. Walker was working with someone a few weeks earlier who was trying to get to the Twin Cities for an appointment. The woman was fearful of taking the bus into the city, so the Spiral Collective paid $400 for her to get a cab.
Once she got to her appointment, she realized she was 18 weeks into her pregnancy and the clinic offered abortions only up to 15 weeks. Walker got her an appointment at a different clinic the same day.
"If it wasn't for me being on the phone with her and reaching out to doctors I know, she probably wouldn't have been seen that day," she said.
Even with all that planning, things can fall through: the client might not get time off work, buses don't show up and snowstorms snarl traffic. Their appointments get pushed to later in a pregnancy, and there are a limited number available.
"It's squeezing access states even more, because we didn't get a massive explosion of providers here," said Megumi Rierson, communications director for Our Justice. "We're handling a much larger volume, and we've got banned states on almost all sides."
'Mutual aid'
Mohrbacher is always handling cases for the Chicago-based abortion fund she works for, which assists people in getting to, from and within the Midwest for appointments. The nonprofit has grown, raising hundreds of thousands of dollars in recent years from donors to support their work.
MORE FROM THIS SERIES
Sometimes, there's a lot more to that work than just booking travel accommodations. Mohrbacher recently helped a woman in an isolated area of Wisconsin travel to another state for her procedure. She also reserved a parking spot, secured an escort to help her move around protesters and made sure a translator was on site. During the appointment, Mohrbacher found a restaurant for her travel companion to decompress and bought her lunch.
"It's mutual aid in its purest form," said Mohrbacher, who did the work as a volunteer before starting full time last year. "Just to hear the sighs of relief on the other side of the phone, the deep inhale and the deep exhale. There's a plan in place."
Case managers are often among the first people clients tell they're pregnant. That was the case for Miranda, whose last name is not being used because she fled an abusive relationship. She was staying at a women's shelter in a state where abortion is banned when she got a positive pregnancy test. Panicked, she started calling Planned Parenthood locations. A navigator called her back.
The navigator arranged for her travel to a different state to get an abortion. Miranda's car started making strange noises when she got into the parking lot for her appointment, so her navigator contacted a body shop and got her an appointment for repairs.
Afterward, Miranda's navigator found her a hotel for a few days to keep distance from her ex. Since then, the navigator has been checking in regularly as Miranda starts a new job in a new city.
"She's kept me positive and kept me going," said Miranda. "You're putting your life in someone else's hands, and they've basically got your back the whole time."