The Final Days of Mississippi’s Last Abortion Clinic

JACKSON, Miss. — A young woman entered the parking lot of the only abortion clinic in Mississippi, her shoulders hunched. She was accompanied by an older woman and a stone-faced young man with a handgun on his hip. She appeared terrified.

All around them, the noise was deafening. It was early Saturday morning, and a man with a powerful P.A. system was preaching about Jezebel being eaten by dogs. Dozens of evangelical Christians had come to pray. Volunteer clinic escorts, sweating in the summer heat, directed patients’ cars through the throng and blasted music they thought the evangelicals would hate: At the moment, it was the cheeky alt-rock song “Stacy’s Mom.” Posters of aborted fetuses lined the street.

A pastor named Doug Lane huddled with the older woman and encouraged her to persuade the younger woman not to go through with the procedure. “I wanted her to have the baby,” the woman said, her voice unsteady.

Soon all of this — the preaching, the frightened patients, the rock music, the bloody posters — will disappear. But before it does, there are guaranteed to be a few more days of roaring, passionate crescendo, as the Jackson Women’s Health Organization, the pink-painted clinic at the heart of the Supreme Court decision overturning Roe v. Wade, tries to see as many patients as possible before it is forced to close.

There is already much talk about what will come next. Outside the clinic, abortion opponents discussed how their churches might do a better job spreading the message of abstinence in a state with the nation’s highest teen pregnancy rate. Supporters of abortion access, meanwhile, are working to create a network of donors, volunteers, educators and even pilots to help women in the nation’s poorest state travel to places where the procedure will remain legal. Similar efforts are underway across much of the country, in states where abortion will now be forbidden and in places hoping to accommodate out-of-state women in need.

“Abortion is our business, and that’s what we’re going to do — to make sure women have access,” said Diane Derzis, the owner of the Jackson clinic. “We’re not going away.”

Abortion bans have already gone into effect in nine states since Friday’s ruling in Dobbs v. Jackson Women’s Health Organization, with at least 12 more bans or restrictions, including in Mississippi, expected to take effect soon. Though it was a Mississippi law that sought to restrict abortion at 15 weeks that was at issue in Dobbs, the state also has a so-called trigger law, passed in 2007, that fully bans abortion, except in cases of rape or risk to the mother’s life.

That law cannot go into effect until 10 days after the state’s attorney general, Lynn Fitch, certifies the Supreme Court decision. As of Sunday, Ms. Fitch appeared not to have yet done so, although there is little doubt that she soon will. Ms. Fitch, a Republican, filed the brief before the Supreme Court defending Mississippi abortion restrictions; on Twitter, she hailed the decision as “a victory, not only for women and children, but for the court itself.”

And so the battle outside the pink clinic continued, much as it has for years. The protesters have long been a fixture in Jackson’s Fondren neighborhood, coexisting uneasily among its hip shops and cafes. They have been the subject of City Council ordinances, police consent decrees and incessant complaints from business owners. And they have been just one of the complications that have made operating the only abortion clinic in Mississippi exceedingly difficult.

The intimidation factor, the social climate and numerous legal hurdles — including a requirement that abortion providers give scientifically dubious health warnings to women — have forced the clinic to turn to a rotation of out-of-state doctors who have flown in and out of Jackson for years.

On Saturday, Mr. Lane, the pastor, said it was “galling” that the clinic was continuing to see clients even after the Supreme Court ruling. He was not in the mood to celebrate the fall of Roe. Rather, he said, he would protest the clinic the same way he had since the 1990s.

“This is going to be the hardest nine days of my life,” said Mr. Lane, who, like others, erroneously assumed that the clock had already begun ticking for the clinic. “Because they shouldn’t be doing abortions. All these other states closed their clinics down.”

A day earlier, Ms. Derzis, who lives in Birmingham, Ala., and owns a number of abortion clinics, came to the Jackson clinic and held a defiant news conference outside, her face partly obscured by big Jackie Onassis-style sunglasses. She spoke of a new clinic she was opening in Las Cruces, N.M., roughly 1,100 miles away, and about fund-raising efforts to help women in Mississippi travel to New Mexico and other places where abortion will remain legal.

“The fact that we’re not here doesn’t mean that we’re not going to see Mississippi women, and whoever needs us,” she said.

In an interview, Ms. Derzis, 68, said she had an abortion in 1973, at age 20, in Birmingham, while she was in college and living with her first husband. A year later, she went to work at a Birmingham women’s clinic. Owning and operating such clinics, she said, has been her “dream job,” offering her the chance to help women in need. She also said that she felt obliged, at one point, to get a law degree given the obstacles her critics have thrown up over the years.

Ms. Derzis said she would probably keep the phone number listed for the Jackson clinic, and might have the calls roll over to the New Mexico facility.

Cheryl Hamlin, a Massachusetts doctor who has been flying to work at the Jackson clinic, said in an interview that she was working on getting licensed in New Mexico so she could eventually fly there for work. She was also researching ways that Mississippi women might be able to obtain abortion pills “online or in the mail or whatever.”

Dr. Hamlin said she was heartened by the new burst of enthusiasm around fund-raising to help women travel. But she also worried that it might not be a long-term solution.

“You know, that goes away,” she said.

On Friday, Ms. Fitch, the attorney general, posted a tweet saying that after the decision, government should strive to pass “laws that empower women,” including an overhaul of child support, child care and workplace policies.

That same day, the three dissenting justices in the Dobbs case — Stephen Breyer, Sonia Sotomayor and Elena Kagan — enumerated the many ways in which Mississippi has fallen short, with the highest infant mortality rate in the country, and some of the highest rates of preterm birth, low birth weight, cesarean section and maternal death. They noted that while 62 percent of Mississippi pregnancies are unplanned, “Mississippi does not require insurance to cover contraceptives and prohibits educators from demonstrating proper contraceptive use.”

In recent years, Republican lawmakers in firm control of the state have declined to expand Medicaid under the Affordable Care Act, a major reason critics say the state’s health outcomes are so poor. In April, however, Gov. Tate Reeves signed a law granting tax credits to supporters of “pregnancy resource centers,” which are usually aligned with faith groups and counsel women against having abortions. Terri Herring, president of the group Choose Life Mississippi, was optimistic that the strengthened centers would help poor women understand their options in the post-Roe landscape.

“These pregnancy resource centers are going to provide that compassionate person to lead these people through their pregnancies,” she said. “A lot of women just need to know how to access what is already available to them.”

As the temperature headed toward 100 degrees on Saturday, the frustration of the clinic escorts was palpable. The street was narrow, and the escorts endeavored to shield the patients from the protesters as much as possible and assure that no pedestrians got hit.

At one point, Dale Gibson, 53, a merchant sailor who volunteered as an escort, began screaming and cursing at a protester named Zach Boyd, who had been holding a small rubber fetus doll aloft every time a patient drove in, then shouting to patients through the fence, imploring them to repent and keep their baby.

Mr. Boyd had moved Mr. Gibson’s folding camp chair. Mr. Gibson objected and accused Mr. Boyd, who was standing at the border of the clinic driveway, of trespassing. An armed security guard intervened, trying to bring down the temperature.

Mr. Gibson said he had had enough of Mississippi and was planning to move to California with Kim Gibson, his wife and a fellow escort. “We’re living in a theocracy, OK?” Mr. Gibson said, adding, “If they think it’s going to end with abortion, people are kidding themselves.”

Ms. Derzis said that the day had been particularly busy, with 35 abortions performed and 25 counseling sessions for women who intend to have the procedure soon.

As the last of the patients rolled in, Ms. Gibson, who stood in the entrance to the parking lot, was sweat-drenched and exhausted. An anti-abortion protester, Madison Gass, 21, asked if she wanted a bottle of water.

“All I want,” Ms. Gibson said, “is for y’all to vamoose.”

Mr. Boyd overheard her. “We will in nine days,” he said. “Praise the Lord.”