DETROIT — A mad scramble for abortion services nationwide has spiked demand for abortions in Michigan as other states have shuttered their clinics in the wake of the U.S. Supreme Court's rollback of Roe v. Wade.
Michigan is among the majority of states that still allow abortion since state Court of Claims Judge Elizabeth Gleicher issued a preliminary injunction barring enforcement of a 1931 state law that bans abortion except in cases where the mother's health is endangered.
The court in Dobbs v. Jackson Women's Health Organization ruled there is no constitutional right to an abortion and handed regulatory power over abortion policy back to the states, disrupting access to abortion across the country that had been available for nearly a half-century since the Roe v. Wade decision.
In Ohio, on Michigan's southern border, Republican Attorney General Dave Yost moved swiftly on the day of the Dobbs ruling to remove an injunction that had kept that state's "heartbeat" law on hold for three years. Within hours, a law was in force that prohibits abortion from the first heartbeat of the fetus, usually at about six weeks of gestation.
The impact on Michigan abortion providers was immediate. Here, abortion is legal until fetal viability, the point at which a fetus can possibly survive outside the womb, or about 24 weeks.
“There’s been a flood of Ohio patients. We’re doing our best to take care of as many patients as we can,” said Renee Chelian, founder and president of Northland Family Planning Centers, Michigan's largest abortion providers with clinics in Southfield, Westland and Sterling Heights.
At Scotsdale Women's Center in Detroit, the owner was caught off guard by the speed with which Ohio's heartbeat law was brought back following the Supreme Court ruling.
"We really thought we'd have four or five weeks to prepare for this ... and then everything went crazy," said the owner, who spoke on the condition her name be withheld due to safety concerns.
Not only are more people scheduling abortions, but fewer people also are canceling their appointments, she added. Before Dobbs, the clinic would overbook, expecting about 50% of patients would cancel. Not anymore.
"The people from Ohio are scheduling and showing up because they have no choice," the Scotsdale owner said. "And the local people are scheduling and showing up because they're scared" that abortions soon will be banned in Michigan.
Legislation has been introduced in Ohio to ban abortions from conception, which could mean even more Ohioans seeking abortions in Michigan if it is passed and signed into law.
"For the time being, Michigan’s 1931 law that would make abortion illegal from fertilization is being blocked by Judge Gleicher’s rogue injunction," said Anna Visser, spokeswoman for Right to Life of Michigan.
"So we’re working on getting that injunction removed so that actually Michigan can join Ohio and the other life-affirming states."
Michigan has 150 pregnancy resource centers and adoption centers that assist pregnant women with child care, counseling, housing or other resources to meet their needs, Visser said.
"I think it's interesting that we have an influx of women coming from other states," she said. "And it's at a very interesting time when Gov. (Gretchen) Whitmer's only goal appears to be to increase abortions in our state, to make sure that we're an abortion 'mecca' of the Great Lakes states."
Traffic on the website abortionfinder.org, which provides information on the abortion laws in every state — and where visitors can type in a ZIP code to find the nearest clinic where they can qualify for an abortion — has increased 1,300% since the June 24 ruling, a site spokeswoman Rachel Fey said.
"The laws are changing daily and sometimes hourly in different states and people are scrambling to find care," said Fey, vice president of policy and strategic partnership with Power to Decide, which runs the abortionfinder.com website.
Fey said visits by Michigan residents to the site a couple weeks ago were up 268% compared with June 23 — the day prior to the Supreme Court decision. Clinic searches by Michigan residents were up 553% in that time period.
"What I think is happening in Michigan is the states where abortion is legal, they're seeing a huge influx of patients seeking abortion care," Fey said. "This decision doesn't just affect states where abortion is banned, it affects all of us because it puts a strain on the capacity of providers in states where abortion remains legal to meet the needs."
Where patients are coming from
Planned Parenthood of Michigan, which has 14 clinics in the state, has hired "abortion care navigators" to help connect women with providers and sources of financial assistance to help with travel costs, spokeswoman Ashlea Phenicie said.
"Patients traveling out of state face additional barriers to abortion access," Phenicie said. "Planned Parenthood of Michigan anticipated that this scenario was coming and created a plan."
Patients are coming from Kentucky, where abortions are now banned altogether, and West Virginia, where the state's only abortion provider has paused services due to uncertainty about that state's law.
They're coming from Wisconsin, where a legal war is being waged over which law should take effect now that Roe has fallen: An 1847 statute that bans nearly all abortions or a 1985 law that allows abortions until 22 weeks. Until the matter is settled, all four of Wisconsin's remaining abortion providers have paused operations.
Chelian of the Northland clinics said patients are coming from as far as New Jersey, Oklahoma and Texas — as the list of states that ban or severely restrict abortion expands by the day.
Abortion is currently legal in Pennsylvania, but the state's Republican Legislature could move to ban or severely restrict the service. The state's Democratic governor would likely veto such a law, but the governor is term-limited.
Across the Great Lakes region, abortion rights appear safest in Illinois, where Michigan residents would be most likely to seek services if abortion becomes illegal in the Mitten State.
Illinois' Reproductive Health Act, signed into state law in 2019, codifies access to abortion as a "fundamental right" and says a "fertilized egg, embryo, or fetus does not have independent rights."
"When it gets to a point that half the U.S. is serving all of the U.S., I don’t know what’s going to happen," Chelian said. "I think we’re going to see a health care crisis the likes of which we have never seen."
Ohio's impact on Michigan
Connecting patients with far-away abortion services has become a routine part of the job for abortion doctors in states that suddenly banned or narrowly limited abortions.
"One of the challenges in Ohio is keeping up not only with our own laws, but the laws in other states — it's moving pieces everywhere," said Dr. Catherine Romanos, a family practice physician who performs abortions throughout Ohio.
Some states have been closed to abortions, then re-opened and then closed again — sometimes in a matter of days or hours, Romanos noted.
"Michigan has been fairly stable, which is helpful," she said.
Romanos said she typically refers patients to clinics in Indiana, but that state restricts abortions beyond the first trimester to hospitals or ambulatory surgery centers, an impediment to most women beyond about 13 weeks and six days of pregnancy.
"For all intents and purposes, you can't go to Indiana if you're beyond the first trimester," she said. "For patients that are further along in pregnancy, Michigan is a good option for them."
Asked what she thinks of Ohio's ban on abortions after the first fetal heartbeat, Romanos said she believes the law has had unintended consequences for some patients — resulting in abortions that might not otherwise have occurred.
"I have had more than one patient say that they felt they were being rushed into a decision," she said.
Romanos noted many women feel compelled to abort after Ohio's mandatory 24-hour waiting period.
"We have to do the ultrasound, see if there's cardiac activity, and then make them wait for 24 hours to have the abortion — ostensibly to give them time to think about it," she said. "But then they have to come back and get their abortion before cardiac activity develops."
Michigan's abortion numbers
A total of 30,074 induced abortions were reported in Michigan in 2021, a 1.4% increase from the 29,669 procedures reported in 2020, when abortions hit their then highest level in three decades, according to the Michigan Department of Health and Human Service's annual report.
The over 30,000 abortions were the state's highest mark since 1996, while the rate of 16 abortions per 1,000 women of child-bearing age in 2021 was the highest since 1990.
Abortion providers said fears about pregnancy outcomes or financial insecurity led to increased demand for abortion services during the COVID-19 pandemic. But they also pointed to an influx of patients from other states, such as Ohio, that deemed abortion a nonessential service, shuttering clinics during pandemic-related shutdowns. About 5.7% of Michigan abortions in 2020 involved out-of-state patients.
An executive order in March 2020 by Whitmer required hospitals, freestanding surgical outpatient facilities, dental facilities and all state-operated outpatient facilities to postpone nonessential procedures. But the order made an exception for “pregnancy-related visits and procedures.”
The move proved controversial with Right to Life of Michigan, the Michigan Catholic Conference and pandemic restriction order critics, especially after Whitmer called it "life-sustaining." Right to Life argued that most abortions are done for economic and social reasons, not health.
“If a lack of enough personal protective equipment is the reason that many surgeries remain postponed or canceled, then it’s heinous that Gov. Whitmer is allowing abortion facilities to continue using up these precious supplies in surgical abortions and ultrasound examinations prior to medication abortions,” Right to Life of Michigan President Barbara Listing said at the time.
Michigan clinics provided 1,664 abortions for out-of-state patients in 2021, about 5.5% of the 30,074 abortions conducted in Michigan last year, according to the state health department.
The out-of-state patients came to Michigan from 36 other states — including 1,212 women from Ohio, 276 from Indiana, 37 from Texas, 19 from Wisconsin, 16 from Illinois and 14 from Kentucky, according to state data.
Michigan health officials said they were unable to provide data on the number of abortions performed in Michigan so far in 2022. But industry insiders said they're seeing more patients, from both inside and outside the state.
Advocates worry that the rush for services combined with narrowing access will result in wait times so long that some women will no longer qualify for an abortion.
Historically until Dobbs, the vast majority of abortions have occurred in the first trimester of pregnancy; only about 1 in 10 have been performed later than 12 weeks, Fey said. And while about 54% have been medication abortions, performed before the 10th or 11th week of gestation, some states are seeking to outlaw abortion pills.
"I’m not a lawyer, but one thing I can say is that this is chaos," Fey said. "Right now in Michigan abortion is accessible, and wow, are people going for it.
"The real question is what happens after this, when people are forced later into their pregnancies while they’re looking for abortions in other states."
———
