The new abortion landscape means clinics in Minnesota are already seeing more patients — and trying hard to recruit more staff.
Whole Woman's Health (WWH), which runs an abortion clinic in Bloomington, had four facilities in Texas that abruptly shut down after the U.S. Supreme Court overturned Roe v. Wade last month. Sixty workers were displaced.
Now the Bloomington clinic is scurrying to relocate several of its Texas doctors to Minnesota. One physician flew in Wednesday to check out the Twin Cities. Another arrives next week.
If all goes well, the extra help — from already highly trained staff — can't come soon enough.
"Our biggest issue right now is the physician shortage," said Amy Hagstrom Miller, executive director. "Now that Roe has fallen, people [are] coming here from Wisconsin, Oklahoma, and Missouri and Louisiana and Mississippi."
But Minnesota only has eight abortion clinics. Already, staffing shortages have caused appointment cancellations and waiting lists and forced more patients to travel greater distances to get timely abortions, clinic providers said.
In some cases, delays pushed women into their second trimester, leaving fewer options.
"It's scary," said Laurie Casey, executive director of WE Health, a Duluth clinic that performed 462 medication and surgical abortions last year. Demand is now expected to rise 25%. "It's heartbreaking. Some of the women who call us are in tears."
WE Health usually sees patients one day a week, but with rising calls for help, it added half a day, Casey said.
"There is an 80 percent chance that we will add another day," provided she can find new doctors, Casey said. WE Health now uses three doctors who work on their days off from other jobs. Casey worries they'll burn out.
More of the patients are calling from the Twin Cities, where clinics are overbooked because of the new surge of out-of-state patients.
The Red River Women's Clinic in Fargo, which is soon moving to Moorhead, Minn., also has seen an increase of patients from the Twin Cities.
Planned Parenthood North Central States, Minnesota's largest abortion provider, said it too is seeing a surge, said spokeswoman Emily Bisek.
"We need all hands on deck," she said.
Planned Parenthood performed 7,144 procedures in Minnesota last year and expects cases to jump 25% as "trigger law" abortion bans take hold in Wisconsin, North Dakota, Texas and elsewhere.
The demand from out-of-state patients puts clinics here in a bind.
"It can take years to hire a full-time physician who is willing and able and located in the state where we need to hire," Bisek said. "It has been historically very difficult to hire abortion doctors in our region. The biggest need is in the health centers."
WWH in Bloomington predicts demand could reach 4,000 requests a year, up from 1,026 last year, Miller said. To handle the load, the nonprofit would need at least 10 more staffers, two more full-time doctors. The budget would need to increase by $500,000.
The situation "drives me crazy," Miller said. "I don't have the time or space to engage my emotions because I have 200 staff and thousands of patents to think about."
Red River, North Dakota's only abortion clinic, will relocate across state lines to Moorhead in two weeks. The Roe repeal triggered a statewide abortion ban in North Dakota that while being challenged in court is scheduled to go into effect on July 28.
A GoFundMe campaign raised more than $880,000 for the move, and the clinic took out a bank loan to cover a down payment for a new building, said Executive Director Tammi Kromenaker.
At Red River, seven nurses and three part-time physicians currently perform 28 abortions each week, up from 20. Red River might double services to two days a week — if it can recruit more doctors.
In the meantime, Red River plans to offer virtual telehealth appointments for the first time for abortions using medication, which do not require a clinic visit. The service is banned in North Dakota.
That would "take some of the pressure off," Kromenaker said.
Dr. Julie Amaon, executive director of the two-year-old telehealth abortion clinic Just the Pill, recently hired three clinicians in addition to herself.
Now the four of them can write prescriptions and mail pills to patients who either live in — or can get to — Minnesota, Montana and Wyoming.
"In less than four days following the Roe decision, Just the Pill had over 260 appointment requests made online. That's up from the usual 20 to 25 per day," she said. "In Minnesota, there is a big need for more facilities — hospitals, doctors offices, clinics — that can provide care."
There are doctors who want to provide abortion care, but can't because their employers don't allow it, or they work in select clinics that can't perform the procedure because of state laws, she said.
Minnesota law only allows physicians to conduct abortions (including prescribing abortion pills). The Maryland Legislature recently changed its law to now allow nurse practitioners also to perform abortions. In 2019, the nonprofit group Our Justice, which helps low-income women pay for abortion costs, and its attorneys at Gender Justice sued Minnesota in Ramsey County District Court to force it to erase practitioner restrictions. A decision is expected by December.