On a recent Monday afternoon, all abortion appointments at Planned Parenthood-Imperial Valley Health Center were already full for the week.
Vivian Perez, an office manager at the center, had already logged a 12-hour day, but she stayed in the office tinkering with the schedule. She had received a desperate call from the San Diego call center, which helps with scheduling.
“Could you please add one more patient”? asked the programmer.
Knowing that the patient was probably coming from afar, Perez managed to get her in.
It wasn’t like this before.
The El Centro clinic was always busy. Now he is overwhelmed as he finds himself on the front lines of drastic changes brought about by the United States Supreme Court’s recent Dobbs decision, which in overturning Roe v. Wade eliminated 50 years of federal protections for abortion care.
Almost instantly, many abortion clinics across the country stopped providing services, positioning states like California, where the procedure is still legal, as something of a haven for people seeking abortions.
A recent report from the Center on Reproductive Health, Law, and Policy at the UCLA School of Law estimates that between 8,000 and 16,100 more people will come to California each year for abortion care, and that at least half of them will depart from Arizona due to the long border it shares with California.
Since the Dobbs decision, the number of out-of-state patients has increased at the 19 clinics in San Diego, Riverside and Imperial counties affiliated with Planned Parenthood of the Pacific Southwest.
As of last week, out-of-state patients accounted for 21% of abortion visits at clinics in those three counties, a 513% increase from two weeks before the Dobbs ruling. Arizona patients are the highest demographic of out-of-state patient visits for abortion care — an 847% increase from two weeks before the Dobbs decision, Sandra Duran said , spokesperson for Planned Parenthood of the Pacific Southwest.
In the Imperial Valley, the Planned Parenthood center in El Centro is one of the hardest hit because it is closest to Arizona, where legal abortion care vanished overnight. Roe’s fall against Wade has caused confusion because Arizona laws do not specify whether abortions are prohibited.
The Grand Canyon State had a ban dating back to 1901 that had been blocked by the courts since the 1973 Roe decision. Some legal scholars have argued that the courts should lift the block for it to take effect.
In March, the Arizona legislature passed a ban on all abortions after 15 weeks of pregnancy without exception for rape or incest. But the law did not specify when it would be implemented. As a result, abortion providers, including Planned Parenthood, have stopped all abortions in the state out of an abundance of caution.
In El Centro, Perez, 60, who lives near Holtville, had long prepared for an increase in patient visits.
In late May, she was in the process of looking for more staff, including an additional registered nurse and a medical assistant, to bolster the clinic’s 20-person staff. She said she wanted to ensure there was sufficient capacity for abortion care while continuing to provide preventive health care, contraceptives, pregnancy tests and other health services for women. .
At the time, the clinic offered surgical abortions once a week and medical abortions about twice a week. Perez planned to offer an extra day of surgical abortions.
Last week, Perez was so inundated with appointments for abortion care that she had to ask the Planned Parenthood medical team for additional abortion providers.
“We were preparing, anticipating it would be busy,” Perez said after the Dobbs decision. “But it’s more than I expected. Absolutely.”
Last week, Perez booked more than 100 surgical and medical abortions for Tuesday and Thursday and the rest of the week was booked with more than 50 medical abortions. The clinic would normally have an abortion provider during the week. Now he has two to three.
One day a few weeks ago, the clinic in El Centro saw 17 patients for medical abortions. All but one were from Arizona.
Out-of-state patients — especially Arizonans — are nothing new to the El Centro center. Since its opening seven years ago, it was clear that Planned Parenthood-Imperial Valley Health Center would not just serve El Centro.
Located a 20-minute drive from the Mexican border and an hour from Yuma, Arizona, the center has long served as a haven, especially for Mexicans and Arizonans seeking abortion care.
“In Arizona you have to go through a process,” Perez said weeks before the Dobbs decision. “There is a waiting period. There are barriers. It’s much easier for them to come here. It’s not far from Yuma, Phoenix, Tucson.”
Patients came from all over the country, Perez said.
A few months ago, an Oklahoma woman, her husband and young children piled into a small recreational vehicle and drove more than 1,200 miles to get an abortion in this conservative farming frontier town.
Exhausted from the trip, the family looked relieved when they arrived at the health center, Perez said.
The mother was eventually able to get an abortion — something Oklahoman leaders had made nearly impossible to obtain in her state.
Oklahoma banned abortion in May with a law enforced through private citizen lawsuits. State officials also criminalized abortion the day Roe v. Wade was overturned, except to save a mother’s life.
Tucked away in a strip mall next to a Thai restaurant, the center looks unassuming — a beige and brown building with a blue sign that reads “Planned Parenthood.” It is a short walk from the Imperial Valley Life Center, a pregnancy center, one of many that have sprung up in recent years and are aimed at persuading people to reconsider abortion and providing support for those who continue their pregnancy. A rolling door usually separates the two in El Centro.
Inside the health center, a modern reception hall resembling that of a three-star hotel welcomes patients. The building has a mid-century new style with neutral tones and a turquoise wall accent.
It was once a health clinic that served the Spanish-speaking population before Planned Parenthood took over and renovated it. It houses six examination rooms. A security room in the back is full of screens with footage from cameras stationed throughout the facility.
The clinic may attract one protester a day.
Anticipating that Arizona could be one of those states to scrap abortion if Roe fell, Planned Parenthood officials in California and Arizona created a system to provide coordinated abortion care and help channel Arizonans to service providers in California. Planned Parenthood staff members in Arizona confirm each case of pregnancy and then refer patients to clinics in California.
If a patient decides to have an abortion, care coordinators in California help her. That could mean helping pay for gas, a plane ticket or rental car, providing childcare, providing a hotel voucher or lowering the cost of the abortion procedure, said Tessa Hemmi, manager of the care coordination program at Planned Parenthood of the Pacific Southwest.
On June 24, the day U.S. Supreme Court justices cleared Roe, Hemmi and three other members of his team already had five patients waiting on the phone when they started their day at 9 a.m.
They answered 50 calls that day. It has been constantly busy and everyone is on deck. The need was so great that first week that the team had to work over the weekend, guiding patients to California.
Some callers cry. Others thank her. Most are panicked.
Their stories are overwhelming, Hemmi said.
“I have my two kids. What to do with my two kids? I don’t have daycare,” one caller said.
“Do you have a Sunday available so I don’t have to miss work?” another questioned.
“Is it legal for me to come to California? others asked.
“Abortion is safe and legal in the state of California,” Hemmi and her team members responded.
One of the biggest concerns for out-of-state callers is California gas prices.
“People gasp when we tell them it’s over $6 a gallon,” Hemmi said.
A woman called to say her car had broken down. Between sobs, she said she had to spend all the money she had for the abortion procedure in a rental car.
Hemmi sent the woman gift cards for gas and helped lower the cost of the abortion.
The call center team can help you with just about anything except a complicated question.
“Can I get in trouble getting an abortion here when I get home?” some ask.
Hemmi and her team tell callers they can’t really answer that question because they don’t want to provide false information.
“We’re not legal professionals, and the laws are constantly changing,” Hemmi said.
Perez said she was happy to see that many foreign patients arriving at the El Centro center received some kind of support to get them there. Some have gas cards. Other hotel vouchers. Many of those who come for abortions are women who already have children.
The center was not used to performing medical and surgical abortions on the same day, but some travelers are too far away to qualify for medical intervention. When that happens, Perez can sometimes easily rush them for a same-day surgery appointment.
Some days, Perez feels the pressure. But, she says, she thinks it has nothing to do with the pressure patients on the move must feel.
“We can do it,” she told herself. “That’s what we have to do, and that’s what we’re going to do.”
Los Angeles Times