Renee Chelian had expected it.
Like so many other people who work in abortion clinics across the country, Chelian had long ago realized that Roe v. Wade’s chances of surviving 2022 were slim. But on Friday, when the majority-conservative Supreme Court overturned Roe, Chelian, who runs three abortion clinics in Michigan, felt her heart break.
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“I’ve got grief, so today I’m going to try to take some time,” Chelian said. “Everybody is not going to be able to travel to another state. Funds are not going to last for years and years, and we’re going to see a public health crisis.”
The future of abortion access is murky in Michigan. Chelian, who had an illegal abortion at 16 in the days before Roe, is now working on a ballot initiative to protect abortion in the state.
“This isn’t about me and it’s not about my clinics,” Chelian said. “I’m 71 years old. I could have retired already. I’m fighting for the safety and protection and health of everyone who loves someone who may need an abortion.”
Her voice choked with tears.
Hanz Dismer, who works as a licensed clinical social worker at an Illinois abortion clinic, immediately thought they were going to throw up when they heard the news.
“I got a text from my boss that we were having a meeting for 9:30 and I knew that the decision had been revealed and was in effect,” said Dismer, whose pronouns are they/them. When they read the decision, they said, “I felt my heart drop to my stomach.”
Across the country, abortion-rights activists and abortion providers reeled at the ruling in Dobbs v. Jackson Women’s Health Center, a case involving a 15-week abortion ban in Mississippi. Not only did the justices rule to let the 15-week ban go into effect, despite the fact that it flew in the face of Roe, but they ruled that the U.S. Constitution “does not confer a right to abortion.”
“The authority to regulate abortion must be returned to the people and their elected representatives,” read the opinion of the court, written by Justice Samuel Alito.
Without Roe’s protections, 26 states are certain or likely to ban abortion, according to an analysis by the Guttmacher Institute, which tracks abortion restrictions.
In a call with reporters, a Planned Parenthood official said the organization’s affiliates in states that are hostile to abortion are now deciding whether to stay open, weighing potential threats to staffers’ safety versus their patients’ potential needs.
Texas is one of the states expected to ban abortion. In a statement, Jeffrey Hons of Planned Parenthood South Texas, Melaney A. Linton of Planned Parenthood Gulf Coast, and Ken Lambrecht of Planned Parenthood of Greater Texas all condemned the Friday decision.
“Forcing someone to continue a pregnancy against their will is a grave violation of human rights and dignity. All Americans deserve to live under a rule of law that respects their bodily autonomy and reproductive decisions,” they said. “We know the impacts of this decision will fall hardest on the communities who already face discriminatory obstacles to healthcare—particularly Black, Latinx, and Indigenous communities, people with disabilities, people in rural areas, young people, LGBTQ+ people, undocumented people, and those having difficulty making ends meet.”
Although it can be medically safe to self-manage an abortion using pills, both Dismer and Chelian worry that people may injure themselves attempting to perform an abortion. Dismer has met a patient who threw themselves down the stairs to end a pregnancy, they said.
“Doctors in emergency rooms haven’t seen this for 50 years and they are going to start seeing this,” Chelian said.
Chelian is especially worried that if people need medical attention, they may not seek it for fear of legal or criminal reprisals. It’s a valid fear: Between 2000 and the present day, more than 60 people have been criminalized for either self-managing their abortion or helping someone else do it, according to a tally by If/When/How, which runs a legal defense outfit helping people who are facing criminal probes for inducing their own abortions.
Dismer and Chelian weren’t the only people having physical reactions to the news.
“Shoutout to all the reporters who called me just now as I was throwing up: yes, that’s my in real time reaction,” tweeted Renee Bracey Sherman, who runs We Testify, a group dedicated to amplifying the voices of people who’ve had abortions.
Just hours after the ruling, Missouri became the first state to officially ban abortion, according to Missouri Attorney General Eric Schmitt. In total, at least 13 states have so-called “trigger laws” that would ban abortion more or less automatically once Roe was overturned. Those states will presumably start moving through the process of enacting those laws.
Relatively few abortions are now performed in Missouri anyway, thanks to efforts by government officials to gut the last remaining abortion clinic. Instead, many patients travel to Granite City, Illinois, which is just minutes away from Missouri and home to the abortion clinic where Dismer works.
Last year, the clinic saw patients from 19 states. They are bracing to see even more, as Illinois is set to become one of the few Midwestern states where people can still get abortions. But abortion providers in liberal states know that relative to the people who ultimately make it to their clinic for the procedure, there will likely be many more who do not.
“We know that there are gonna be people who are not able to access care, and that is devastating,” Dismer said. After the decision came down, Dismer said they went and hugged a fellow staffer for comfort.
“I haven’t cried yet, but I feel like I’m about to,” they said. “Even just seeing the reactions that my team are having and how hard this is for them is taking a toll on me. It’s taking a toll on all of us. These are young professionals who are eager and excited and have all this knowledge and training, and they’re being told that what they’re doing is wrong and what they’re doing should be criminalized in some states. I really admire my team and the folks that, knowing this climate, have decided to work here and decided to dedicate a large portion of their life and mental space to helping people get access to safe abortions and safe information about abortions post-Roe.”
Although Roe’s end may now be official, many abortion providers have long said that much of the United States has already been living in a post-Roe world. In Oklahoma, abortions have been effectively shut down for weeks, after the state enacted a law that banned almost all abortions.
In a statement, Trust Women, a group that runs clinics in Oklahoma City and Wichita, Kansas, insisted that their clinics will remain open.
“After fifty years of essential but inadequate protections afforded by Roe,” the group said in a statement, “our society is at a pivotal moment: Will we let the rising tide of white supremacy and authoritarianism overwhelm our institutions and make us less free, or will we stand together and demand no less than full agency over our own lives and communities?”
