More likely than not, you’ll find Sarah Traxler in an airport terminal, looking at her watch and wondering “When is this plane getting here? » Traxler, an abortion provider, flies from her home state of Minnesota to South Dakota twice a month to provide care at the state’s newest abortion clinic, Planned’s Sioux Falls Health Center Parenthood.
The center has provided abortion care to South Dakotans for more than 20 years, but in all that time the clinic has never had an in-state abortion provider. State hospital systems do not allow doctors to work for them if they are also providing Planned Parenthood care. So Traxler, along with four other doctors, works on a rotating schedule — each doctor takes one week a month, flying in twice a week to fit into the state’s 72-hour waiting period for patients.
And the movement of each doctor is scheduled to the minute. South Dakota law requires patients seeking an abortion to undergo an initial in-person consultation, then wait 72 hours before you can come back for the procedure. Although many states have waiting periods, South Dakota is one of the few to impose such a long wait, and it is the only state that does not include weekends or holidays during this period. The added hurdle here is that South Dakota law also requires the patient to see the same doctor for both visits.
That’s why Traxler’s timing is so critical. “Nothing can really start with the patients until I arrive, which is why I’m so anxious. They’re all waiting for me,” Traxler told HuffPost in a post. conversation earlier this week.
Although South Dakota prohibits abortion after 20 weeks, the Sioux Falls clinic offers the procedure for up to 13 weeks and six days due to a law requiring outpatient procedures to have access to a blood bank, a rule that does not apply to hospitals. There are doctors who can provide abortion care later than in the hospital system, but these procedures are performed rarely and only in specific cases when the mother’s life is in danger or in cases of fatal fetal abnormalities. , and the whole process must go through a hospital ethics committee.
Traxler and his four other colleagues are essentially the South Dakotans’ only option. A flight delay or winter storm could cost someone their short window to get an abortion.
Abortion access is already so limited in South Dakota that many people facing unwanted pregnancies are “already living in a post-Roe word,” Traxler said. South Dakota’s long history of a Republican majority in its legislature has allowed it to consistently pass anti-abortion measures that have slowly but surely hijacked access.
Abortion care is threatened at the national level by a Mississippi law of 2018 prohibiting abortion at 15 weeks and which is in direct violation of Roe vs. Wade, the landmark 1973 Supreme Court decision that protects the right to abortion. Experts and lawyers agreed that the court’s conservative majority reported he would likely uphold Mississippi law by outright banning abortion or changing the definition of fetal viability after the December pleadings. The experience of so many South Dakotans is about to become a reality for people across the country.
A logistical nightmare
Traxler’s schedule is time-stamped: Typically, she can travel from Minnesota in time to arrive at the clinic at 11 a.m. Monday and see 12 to 15 patients. The same day, she flew to Minnesota and, three days later, started the whole process again. If she arrives at the clinic before 11 a.m. on the second day, she cannot start seeing patients until those 72 hours between visits are up.
This causes a logistical nightmare for Traxler: if she misses her flight on the first day, her entire week is shot; if her flight is delayed on the second day, she may not reach all of her patients, forcing her to repeat the process for those not seen.
“It has a ripple effect where all these patients who couldn’t be seen that week have to be rescheduled and start the whole process over again because the consent procedures that I do with them on day one are not valid. for the next doctor,” Traxler said.
“There are times when I feel personally responsible. Even though I’m sitting at the airport and the airline tells me my flight will be three hours late, I wonder if I can get in a car, I text the clinic manager and we try to solving problems… solving,” she said. “It’s really tough. It’s kind of devastating when we end up not being able to do it.
The burden on patients is even worse. They have very little flexibility in appointment times, and the costs to get to the clinic are doubled due to the requirement for two in-person visits (the governor is currently trying to requires a third visit). Sioux Falls is in the southeast corner of the state, which means many patients drive up to five hours to get to the clinic.
There were several times when patients couldn’t make it to that second visit, recalls Traxler, who has worked at the Sioux Falls center since 2015. Sometimes it’s because a big snowstorm blocked roads or because a patient has used up all his money on the first trip.
“I’ve had patients look at me and say, ‘You mean I can’t have an abortion today? I used all my money. I don’t know how I’m going to get back here on Thursday,” Traxler said, noting that the clinic can usually rely on private abortion funds that help pay for the procedure.
There is a patient experience that has stayed with Traxler all these years. A teenager, Traxler recalls, had been circumvented ― no small feat – get an abortion.
“She came to me on the first day, we went through everything, she was determined she wanted to have an abortion,” Traxler said. “She did the 72 hours, then the day she was due back at the health center for her abortion, her school principal found out and refused to let her leave school. And she couldn’t make it to her appointment that day.
Traxler says it was deeply upsetting for her, the young woman and the clinic staff. They were able to work with the teenager to get her back a week later. “But, again, she had to go through the whole process from the beginning,” Traxler said.
Worse and worse
Like many GOP-controlled state legislatures, South Dakota is gearing up for Roe’s fall this spring. Ahead of the impending trial, South Dakota Governor Kristi Noem, a Republican opposed to reproductive rights, introduced a copy of the most extreme abortion ban in US history: Texas’ six-week ban that delegates private citizens to enforce it by filing civil suits. Noem is also preparing to finalize a September Executive Order block telemedicine abortions, meaning in-person visits would be required to receive care.
If Roe falls, South Dakota has a so-called trigger law on the books, which would immediately ban all abortions. North Dakota also has a trigger ban ready, and other surrounding states including Nebraska and Iowa are set to introduce similar laws this legislative session.
“It is already very difficult in the region, but according to the evolution of the legislation and [the Supreme Court decision] will ― we are looking at a very difficult map in the Midwest when it comes to access to abortion,” said Emily Bisek, regional director of strategic communications at Planned Parenthood North Central States.
Traxler tried to be optimistic, but she’s also realistic. She knows that soon her days as a traveling abortion care provider may be over: Patients in South Dakota will have to come see her instead. But not everyone can do that.
“It’s going to be pretty dark in South Dakota,” Traxler said. “We’re going to see an increase in the number of unwanted pregnancies that are carried to term, and we’re going to see more people self-managing their abortions.”