When Supreme Court justice Ruth Bader Ginsburg died in September, many began to lament the potential undoing of a host of human rights milestones. High among them was the federal decision on abortion access.
In 1973, via the landmark Roe v. Wade decision, the Supreme Court ruled that a woman's right to choose an abortion is protected by the Constitution. Earlier this year, in an amicus brief, more than 200 Republican Congress members urged the Supreme Court to reconsider Roe v. Wade. Anti-abortion activists have been setting up legal cases in states such as Louisiana and Mississippi in an effort to have them heard by the Supreme Court. Meanwhile, Illinois lawmakers have promised the state will continue to provide this necessary medical procedure, regardless of any potential decisions that would undo the precedent set by Roe v. Wade.
Before Ginsburg's death, Brigid Leahy, director of public policy for Planned Parenthood of Illinois, and others were already hard at work solidifying protections. "We have been seeing a steady drumbeat of attacks on access to reproductive health care, and attacks on abortion access in particular. These are state-level attacks and they are part of a national strategy to cut off access to abortion," said Leahy.
As part of an effort to combat those attacks, in 2019 Illinois passed the Reproductive Health Act. The point was to ensure any federal decision would not undermine the ability for people to access abortions in Illinois. Now "access to reproductive health care is a fundamental right under Illinois law," Leahy said. The measure affirmed that the state should handle reproductive procedures the same as all other forms of health care. It also required private medical insurance providers that cover maternal health costs to also cover abortion. The state had decided in 2017 abortion would be covered by Medicaid.
The road to care
According to the Illinois Department of Public Health, the number of nonresidents coming to the state for abortions has risen in recent years. Between 2014 and 2018, the percentage grew by more than 90%, up to 5,669 cases in 2018.
Hope Clinic for Women, in Granite City, is near the state's border with Missouri – where there is a single abortion clinic left. Hope Clinic is one of the oldest clinics of its kind in the country, founded in 1974. Many early practitioners there were motivated by the desire to prevent the deaths of women, who had limited options for safe abortion before Roe v. Wade, said Alison Dreith, the clinic's current deputy director.
Missouri is one of the states that has passed sweeping restrictions in recent years. As more states make it harder for people to access care, Hope Clinic has provided an increasing number of abortions, Dreith said. In 2017 and the decade prior, the clinic was seeing about 3,000 patients a year, she said. In 2019, the same year the Reproductive Health Act passed, that number was above 5,000. Dreith said the increase was due to the "proactive legislation in Illinois" as well as "restrictive laws also being passed in our neighboring state."
Along with the increase of clients has come an increase of opposition. "We've seen an insurgence of new protesters coming to our clinic" and the Trump administration has seemingly emboldened them, said Dreith. She said the protesters have physically blocked clients from getting into the clinic. This form of antagonism, while on the rise, is not new. In 1982 a Hope Clinic doctor and his wife were kidnapped by members of an extremist group called the "Army of God."
Dreith said about 65% of patients come from out of state, largely from Missouri. Last year, The New Yorker wrote about Illinois as an "abortion-rights haven." As the article states, it was long before Ginsburg's death that advocates began the fight to codify abortion rights through additional avenues. "Staff from Planned Parenthood offices across the country were holding a strategy session in Chicago on June 27, 2018, when Supreme Court Justice Anthony Kennedy announced his retirement, clearing the way for Trump to appoint Kavanaugh," the article read. One of those people was Brigid Leahy, who told the magazine, "We started looking state by state and asking, where do we need to shore things up." The goal was to ensure "Illinois was as strong on reproductive rights as we could possibly make it," she had said.
Before Roe v. Wade
Abortion is literally ancient history, with evidence of the practice dating back into the pre-modern era. Miscarriages are quite common. One in eight pregnancies end with one, according to some statistics. Some women need an abortion to assist their miscarriage, a medical intervention for a natural process. Regardless of the reason, without legal and safe abortion, women have taken matters into their own hands, using risky self-induced methods or patronizing unregulated and unsanitary providers. "Almost every abortion death and disability could be prevented through sexuality education, use of effective contraception, provision of safe, legal induced abortion and timely care for complications," according to the World Health Organization.
It took an evolution of thought for LuAnn Atkins to see abortion as a human rights issue. Five decades ago, she was one of the first students at Sangamon State University (SSU) – now University of Illinois Springfield. Married with two children, she had moved to Springfield in 1966. While at SSU, she earned a degree in "justice and the social order." During that time she was introduced to the women's liberation movement.
Previously, Atkins had earned a college degree in Texas, and had attended the University of Oklahoma where she had been active in campus ministry. While at SSU she took a human sexuality course and read the book Our Bodies, Ourselves. A touchstone of the second wave of feminism and the women's health movement, the book was created "by and for women." First published in 1970, the book was born of cooperative effort. At a women's liberation conference in Boston in 1969, women shared their accounts related to sexuality, pregnancy, childbirth, menopause and other topics largely considered taboo at the time. Some continued to meet and research, and together they published the book which was then distributed at women's centers and regularly taught on liberal college campuses.
"It freed me up to think more about my body and how that relates to my total life. And slowly, my values began to evolve," said Atkins. Atkins found out about an organization based in New York City called the Religious Coalition for Abortion Rights (RCAR). The organization – still active and now called the Religious Coalition for Reproductive Care – began as an "underground network of ministers and rabbis called the Clergy Consultation Service (CCS), formed in 1967, six years before the Roe v. Wade Supreme Court decision legalized abortion in the United States," according to the group's website. RCAR helped women find safe pathways to abortion. Many of those involved were also participants in the civil rights movement. They saw their work for racial justice to be connected to the fight for reproductive health access.
A Methodist, Atkins felt called toward the intersection of faith and women's health. In 1971, she started a chapter of RCAR in Springfield. There were four clergy people who agreed to help counsel women and two volunteers, including herself. Atkins said two OB-GYN doctors in Springfield agreed to refer women to the local RCAR chapter.
At the time, abortion was legal in Kansas City, so women could be referred to seek assistance there. There were also doctors in Chicago who would perform abortions illegally. For later term abortions, some women would fly to New York City. Atkins said there was a couple in western Illinois, a doctor and a nurse practitioner, who would also perform abortions. She said RCAR members would visit providers they referred women to see. "We wanted to make sure that the places we told people about were safe." She would tell the women she counseled, "I'm not here to question you. I'm not here to make sure you're making the right decision. It's up to you. I just want to help you."
In Springfield, local women had founded the city's first birth control center in 1938. According to the Sangamon County Historical Society, the dominating presence of what is now St. John's Hospital meant doctors were largely averse to assisting the effort, as the Catholic health provider opposed all forms of "unnatural" birth control. Volunteers largely ran the clinic, and it went through a series of iterations and names before becoming officially affiliated with Planned Parenthood in the '70s.
Atkins became the executive director in 1973 and held the post until 1980. Her leadership came on the heels of the Roe v. Wade decision. Atkins went on to work in public health before retiring from St. John's hospice program as a social worker in 1997.
While religious leaders and people of faith, such as Atkins, have long been a part of the battle for women's health care access, it's the so-called religious right that is often given the biggest spotlight in the enduring national debate. Organizations such as the Eagle Forum and the Illinois Family Institute continue to lobby against abortion access, arguing that life begins at conception and embryos and fetuses should be protected by the state.
In 2017, at the age of 85, Atkins joined others in Springfield as they rallied to defend funding for Planned Parenthood, squaring off against protesters on the other side of the argument. Dressed in pink, her curly white hair under a floral visor, she held a sign that read, "I will not go quietly back to the 1950s."
"I have been very upset, frankly, over the last 15 or 20 years, that there's been a blurring of the lines between how church and state are separated," she said. "We are not a religious state. We are secular." Abortion access means lower mortality rates for women and bodily autonomy, said Atkins. She said of her ideological opponents, "I don't think it's about saving the fetus. It's about controlling women."
Jenna Gordon is a social worker with Planned Parenthood of Illinois who works downstate. Like Atkins, she said her role is not to tell clients what to do, but to let them know their options, and support their decisions. She counsels clients from a variety of backgrounds. "I'm typically able to help them with some things such as intimate partner violence, sexual assault or financial and familial strain." When it comes to the decision of how to handle a pregnancy, the approach is that the decision must be up to the patient, "in consultation with their health care provider," she said.
"No matter their reason, we want to be there to help and support them, and we always trust our patients to be making their own fully informed sexual and reproductive health care decisions." Planned Parenthood provides sexually transmitted infection screening and treatment, contraception, gender affirming hormone treatment and other services.
When it comes to abortion, many clients still feel the harmful effects of stigma, said Gordon. "Plenty of my patients tell me about the fact that their family or their partner is going to ostracize them or leave them because of their decision to have an abortion," she said. "It is definitely a misconception that people making decisions regarding their abortions do so in a flippant manner. The reality is that most people are putting deep thought and consideration into their decision." She said even though it can be a heavy choice to make, the most common reaction she hears from clients after the procedures is that of relief.
Planned Parenthood of Illinois continues to push for better access and education throughout the state. While Illinois has become a beacon of access, Brigid Leahy said the work of expanding education and access goes on.
One measure the state chapter is lobbying for would repeal the Parental Notice of Abortion Act which requires health care providers to notify the guardian of anyone under the age of 18 prior to performing an abortion. Another proposal aims to ensure more comprehensive sexual education throughout the state. "There is so much more work to do, we are not done. Holding the line and keeping the status quo is not enough," said Leahy.
Contact Rachel Otwell at [email protected].