MEMPHIS, Tenn. — These days, the nation’s first nonprofit clinic that includes a birthing center and provides abortions is half empty.
The clinic, CHOICES – Memphis Center for Reproduction Health, opened in 1974 in response to the Supreme Court’s Roe v. Wade decision.
But now abortion patients’ clinics and recovery areas are being used as storage areas. The call center room remains unused. Many staff members were laid off and others had to take new career paths.
More than two-and-a-half years after the Supreme Court overturned the constitutional right to abortion in Dobbs v. Jackson Women’s Health Organization, the decision has had a major impact.
For reproductive health professionals, this is a daunting situation. Health care workers, concerned about medical education and job security in an ever-changing landscape, are struggling to determine what is permissible under state law. This complexity causes some people to avoid a career in reproductive health.
Lily Picard is one of the first people to have had to take a new career path since Dobbs.
Picard was originally hired three years ago as an abortion doula to support patients during and after surgery at CHOICES. Since the ban took effect, she has been transferred to another department.
Now she helps patients with their appointments.
CHOICES still has a birthing center and provides birth control. Patients in need of abortion care are referred to the clinic’s branch in Carbondale, Illinois.
“I’m still struggling, but I always really miss doing that job,” said Pickard, who volunteers as a virtual abortion doula in addition to her job. “I still have people calling me just to talk about it.”
That’s not ideal. But she’s grateful there was still a place for her to participate.
“I don’t think there was room for me in midwifery,” Pickard said. Picard is also a certified doula in birth, death, and postpartum care.
In September, a federal judge suspended a portion of a 2024 Tennessee law that restricts adults from helping minors travel out of state for abortions. On October 17, a state court suspended a portion of another Tennessee law that prohibits providers from performing most abortion procedures. The law specifically excluded mental health emergencies as a justification for emergency abortion.
Uncertainty weighs heavily on Picard.
“If it wasn’t for my son, who is now 5 years old, I definitely would have moved somewhere else,” Pickard said. “I would like to do this in the future, when my son is older and less dependent on his family.”
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At the anti-abortion center across town, things haven’t changed as dramatically.
“We’re still doing the same thing because they (abortion patients) are being sent out of state,” said Susie Lovato, director of advocacy and development for the Memphis Life Coalition, which opposes abortion. Ta. The group’s office is across the street from Planned Parenthood – Memphis Health Center in Midtown, but abortions can no longer be performed there.
Lovato said the coalition uses a continuum of care model common in substance use treatment to connect pregnant women with broader social support resources, which are primarily faith-based. That might mean connecting them with mental health counseling, mentoring, parenting resources, nutrition classes, transportation, and even housing.
“What happens is a crisis happens,” Lovato said. “And what we’re trying to do is say, ‘Hey, Mom, what do you need to do to stay out of crisis?’ Let us help you find a new trajectory for your life.” Can you please?’ Because in many cases, the crisis is not the pregnancy; the life is already in danger.”
Lovato said the majority of the organization’s funding comes from individuals and, to a lesser extent, churches.
“There’s no help from the government at all, but we’re OK. You know, we’ve been OK for five years,” she said.
However, data provided by the Tennessee Department of Finance and Administration shows that 41 organizations received $20 million in Tennessee Strong Families Grant Program funds. The program provides resources to nonprofit organizations and pregnancy centers that work with crisis pregnancies, including Confidential Care Mobile Ministries Inc. He is a member of the six-member Memphis Life Coalition.
In Congress, lawmakers have also begun supporting what anti-abortion groups call crisis pregnancy centers. At least four measures introduced this year will support such centres. Although not yet adopted, two resolutions recognize the role of pregnancy centers, and two bills would provide tax credits for donations to pregnancy centers.
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The broader national question of what is legally required of health care providers and facilities in obstetric emergencies remains unclear, and its complexity appears to have implications for future health care workers. .
The Supreme Court said in June that Idaho should allow emergency abortions for now, but left the larger issue unresolved. And in October, the court declined to hear the Biden administration’s appeal in a similar case in Texas, leaving the lower court’s ruling in place.
If former President Donald Trump is re-elected, the executive branch’s interpretation of whether abortion can be classified as a medical emergency could change.
This uncertainty is worrying providers.
Jeff Gardere, a board-certified clinical psychologist, associate professor and course director at Touro College of Osteopathic Medicine in New York City, said that since Dobbs, fewer medical students are discussing obstetrics and gynecology residency programs and asking for recommendations.
“I don’t really feel that enthusiasm anymore,” he says.
In an October survey of Texas obstetrics and gynecology employees conducted by Manatt Health, 29% of respondents said they were confused about abortion laws, and 60% said they were unsure about the legal requirements for their practice. It turned out that they were afraid of the repercussions.
Pratima Gupta, assistant professor of obstetrics, gynecology and reproductive sciences at the University of California, San Diego Health, said the emotional distress is not limited to health care providers in states that have outlawed abortion.
“I don’t think anyone in this day and age can be as blunt about it, no matter where they are, no matter what state they live in, no matter what state they provide care to,” Gupta said. She checked off a list of safety measures she’s taking to protect herself and her family.
Her program also trains Utah residents to travel to California seeking abortion-related experience for litigation over Utah’s ban.
She said the moral pain of complying with vague laws goes against the medical ethics doctors are taught.
“How sick is enough? How close do we have to get this patient to become septic?” Gupta said. “This is really stressful for us and very morally challenging for those who provide abortion care.”
