Physicians in Illinois have said they are already preparing for a surge in patients seeking abortions and possible legal battles after neighboring Missouri's trigger laws immediately restricted legal abortion access after the Supreme Court overturned Roe v. Wade.
Dr. Colleen McNicholas, the chief medical officer with Planned Parenthood of the St. Louis Region, told ABC News the staff at the clinic at Fairview Heights, Illinois, plans to add two to four hours a day to their schedules, and probably operate seven days a week to handle the increased demand. Planned Parenthood built the Fairview Heights clinic, which is roughly 15 miles away from St. Louis, in 2019 in anticipation of tightened restrictions on abortions in nearby states, according to McNicholas.
Under Missouri's trigger law, physicians are prohibited from performing an abortion unless the life of the mother is at risk. There is no exception for rape or incest.
"We said this is ground zero and we're bracing for impact for sure," McNicholas told ABC News. "We've been expecting this, but it's still felt soul crushing to know that this country that is supposed to be leading the free world has just allowed at least half of the people in our country to lose access to such basic reproductive health care," she said.
McNicholas' preparation comes in the midst of anti-abortion rights lawmakers in some states looking to crack down on out-of-state abortions.
Missouri Republican State Rep. Mary Elizabeth Coleman, who helped draft the state's trigger law, told ABC News that she wants to prevent Missouri abortion providers from helping patients get abortions in other states. Coleman, a mother of six, contended that if a facility in Missouri is arranging for an abortion in another state, it is violating the new Missouri law.
McNicholas said the Fairview Heights facility has recently been fielding calls as far away as Mississippi as states began restricting legal abortion access this year. The doctor recalled one patient who drove nine hours from Houston shortly after Texas enacted its ban.
"She just went down the list and called clinic after clinic...next clinic, next clinic. So she got all the way to us before she was able to get that care. Twenty minutes later, she had her abortion medication, got back in the car to drive another nine hours back to Houston," McNicholas said.
McNicholas estimated that Illinois will see up to 30,000 additional patients who seek abortions this year and half of those patients will come to southern Illinois. She said she's working to shore up more funding and resources to take on the influx of patients heading to the Illinois facility.
But she and other abortion providers offering services to out-of-state residents, particularly from Missouri, may face another obstacle.
"I don't want to see commercial activity in the state of Missouri that is aimed and designed to avoid the laws of the state of Missouri," Coleman ABC News.
Coleman said her proposal would exempt the patient from prosecution and only targets providers and other private groups that arrange for a procedure out of state.
Coleman wouldn't go into specifics as to how her proposed law would be enforced or more specifics on who would be liable for prosecution.
"What I would like to see happen is people's activity in the state of Missouri follow the law in the state of Missouri. And if people are going to choose not to do that and to violate the laws of our state, then they will be liable under the penalties in our code for that activity," she said.
Coleman added that there needs to be "a culture that supports women," and for more resources to pregnant women. She acknowledged Missouri's high maternal mortality rates and said she has petitioned the federal government for more funding for programs and resources for mothers.
"We've focused on making sure that our foster care system gets reform and the resources that it's needed," she said.
McNicholas contended that the support systems for women in these situations is already weak and underfunded in many states, in addition to the rising costs of child care.
"We weren't prepared before Roe to take care of birthing people and their families, and we certainly aren't going to be ready to do it when those numbers increase," she said.
McNicholas warned that if more states continue to prohibit abortions and force more people to seek care in farther parts of the country, there will be a major health crisis.
"The abortion care infrastructure in this country is so fragile already. It is not sustainable and is not going to be able to withstand what is going to be the mass mobilization of millions of people for this basic health care," she said.