Inside a Michigan clinic, patients talk about abortion — and a looming statewide vote Abortion rights are on the ballot in Michigan, which has already become a regional abortion haven. Kate Wells spent weeks observing procedures and talking to patients inside a clinic outside Detroit.

Inside a Michigan clinic, patients talk about abortion — and a looming statewide vote

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RACHEL MARTIN, HOST:

Since Roe v. Wade was overturned, abortion patients have been traveling to Michigan in record numbers. But access to abortion there is not a done deal. The issue is on the ballot in this year's election. In Michigan and in other states, old abortion laws are being revived and fought over in the courts, and voters are being asked to make their preferences known.

But at Northland Family Planning, a clinic outside Detroit, the staff are focused on their work. Stanley Anderson (ph) is a security guard there. He keeps an eye on the protesters who gather out front every morning.

STANLEY ANDERSON: I've had one altercation here. They know. They don't want that. And you see that they're on the sidewalk. They're not blocking the driveway. It's all good.

MARTIN: Kate Wells of Michigan Radio spent several weeks at Northland talking with patients about what's at stake for them in the new fight over abortion. And a warning - some listeners will find the details of this story disturbing.

KATE WELLS, BYLINE: To get to Northland Family Planning, Melissa drove overnight from Ohio. She got to her hotel around 3 a.m. And by 8 a.m., she was here checking in at Northland, her hair swept in a loose bun, her hands pulled inside the sleeves of her sweatshirt. She spent three months trying and failing to get an abortion in Ohio. But finally, she was here. She'd made it.

MELISSA: I was relieved (crying) after the struggle, so - 'cause, like, I had to sit with it for weeks.

WELLS: Melissa and other patients here didn't want to use their full names while discussing intimate medical information. In the Northland waiting room, there are these inspirational quotes on the walls, like good women get abortions. Another one says, a lot of beautiful, wise women have been here before and are here today. It's very different from the place Melissa went to a few months ago back in Ohio. Melissa thought that she was calling a women's health clinic that would refer her for an abortion, which the staff promised they could do.

MELISSA: They were posing to be so pro-choice, and they're not.

WELLS: When she got there, a nurse gave her an ultrasound and said she was two weeks pregnant. But then...

MELISSA: She wanted to pray for me. She gave me a Bible. She - like, it didn't even seem like it was religion until the very end.

WELLS: Melissa had ended up at a crisis pregnancy center. They're usually religious, and most are not licensed medical clinics. They try to convince people not to get abortions.

MELISSA: I'm in this weird situation of - I'm going through a divorce, and I slept with somebody one time. And then I got pregnant. And then they were like, are you sure that, like, you don't see a future with this guy? Like, they were trying to talk me into having a baby that I (crying) couldn't have, and then they're trying to talk me into a relationship. Like, it's crazy.

WELLS: Once Melissa realized this place was not going to help her, she tried to make her own appointment. At the time, abortions in Ohio were banned after six weeks, and every clinic near her had huge waiting lists. By the time Melissa got this appointment in Michigan, she was 14 weeks pregnant.

MELISSA: (Crying) And I just feel so much better 'cause I have two kids. I have a 10-year-old and a 2-year-old, so - it shouldn't be this hard.

WELLS: Melissa's doctor for her procedure is Audrey Lance.

AUDREY LANCE: Yeah, hi.

MELISSA: Hi.

LANCE: So what questions do you have?

WELLS: At one point, Dr. Lance was dyeing the tips of her short brown hair purple. It helped nervous young patients relax when she walked in and they saw, oh, their abortion doctor was a woman with cool, purple hair. Dr. Lance says, ever since the Supreme Court decision...

LANCE: It has been a hard couple of months.

WELLS: Michigan has an old law on the books from 1931 banning abortion. And all summer, there was so much fighting in the courts about this law. Was it in effect or not? Could it be enforced?

LANCE: It seems like every week - sometimes every day - there was a new thing happening that was affecting how we could work or whether we could work and whether we could continue to provide care.

WELLS: There was even one day this summer where abortion was legal at breakfast, illegal by lunch, and then legal again by dinner.

LANCE: People care about this. People are pissed. They are really, really pissed.

WELLS: Ultimately, if abortion is going to stay legal in Michigan, it could come down to this election. Next week, voters will decide whether to pass Proposal 3. That would put the right to abortion and contraception in the Michigan Constitution. Dr. Lance says she is optimistic that Prop 3 will pass and nullify forever any threat from that 1931 ban.

LANCE: I am hopeful, but I think you just have to be. How could I come to work every day if I wasn't?

WELLS: At Northland, when I asked patients if they would talk with me, so many of them said, yeah, I want to talk. If people are going to be voting on this, I want them to know what this abortion means for me. This woman wanted to be called by her first initial, A.

A: (Crying) I don't think I could survive if I knew that I had to have these babies with an abusive person. That's insanity to me. I feel like a prisoner.

WELLS: A has two little girls at home, and now she is pregnant with twins. She told her 3-year-old daughter that she was not going to keep this pregnancy.

A: My daughter was so cute. She said, OK, well, maybe another time. Maybe later. And I was like, yes, maybe later, because she doesn't know that, at the end of the day, I can't physically, financially or mentally handle two more kids.

WELLS: A says she's not with her kids' father anymore, and she's even seeking a personal protection order. She says she's tried to get her tubes tied before.

A: (Crying) I've asked and begged to be, like, fixed or snipped or whatever it is that they have to do. They deny me, but then I end up on medication for birth control. It's insanity. And I'm so fertile that it's like, literally, I just - I have to stop having sex in order to not be pregnant. So abortion - even though this is my first one, I'm happy that it's here because I don't know what I would do right now.

WELLS: A is what you might imagine when you think about why somebody would need an abortion - abusive relationship, money problems, emotional distress. And you see a lot of that in Northland. But you also see people who are in great relationships. They're financially stable and emotionally composed - women like M, also her first initial.

M: I want to go back to work and just kind of have something for myself other than just being a mother all day, every day.

WELLS: M is married. She's got three kids. The youngest is about to start school, and now she's pregnant again.

M: And I wouldn't trade my kids for anything. I love them to death. But I just feel like that phase of my life is over. And it was an amazing phase, but I don't want to keep going back. I want to go forward.

WELLS: At Northland, medication abortions are done in the morning. And then, in the afternoon, they do the surgical procedures.

LANCE: Like right when my daughter started to be difficult.

UNIDENTIFIED PATIENT #1: Yes.

LANCE: Yeah.

UNIDENTIFIED PATIENT #1: Oh, my goodness.

LANCE: Yup.

WELLS: This next patient is not one of the patients you heard before. She's asked that we not use her name. She's from Michigan. She already has one kid. She's having her abortion at about 11 weeks. Nearly all abortions in Michigan are before 13 weeks. And like many patients at Northland, she said I could record her procedure. We're going to hear some of that now.

LANCE: OK, so I am just going to get you set up on the table, and we're going to do that sedation medicine.

UNIDENTIFIED PATIENT #1: OK.

LANCE: I'm going to pull this out under your legs.

UNIDENTIFIED PATIENT #1: OK.

WELLS: Most patients are partially awake during the procedures. They get IV medication for pain and anxiety. The lights are dimmed. There's soothing music. It actually feels a lot like a childbirth - the medical gown, your bare legs in stirrups and a person next to you, saying, you can do this.

BRANDEE: Squeeze my hand, and just keep breathing.

WELLS: That's Brandee. She's one of the staffers. Her job is to monitor vital signs, but it is also to hold the patient's hand and talk her through this. Whether it's a birth or an abortion, it is often women guiding other women.

LANCE: You're going to hear this machine turn on now, OK? It makes a loud noise.

UNIDENTIFIED PATIENT #1: OK.

(SOUNDBITE OF ASPIRATOR RUNNING)

BRANDEE: Blow it out. Blow it out. Breathe through it. Breathe through it. Blow it out. Listen to me. Blow it out. If you hold your breath, it just makes it harder for you. Keep breathing. Keep breathing.

WELLS: Just keep breathing, Brandee tells her over and over. I can't, the patient says at one point, when the cramps get painful. Yes, you can, Brandee tells her. You're doing it. And then, within just a couple of minutes, it's over.

(SOUNDBITE OF ASPIRATOR RUNNING)

LANCE: All right, one more time.

UNIDENTIFIED PATIENT #1: (Moaning).

BRANDEE: Take some deep breaths for me. Catch your breath.

LANCE: You did it.

UNIDENTIFIED PATIENT #1: Thank you guys so much.

BRANDEE: You did it.

LANCE: You are welcome.

BRANDEE: You did it.

UNIDENTIFIED PATIENT #1: Oh, I hope I didn't do too bad.

BRANDEE: You did good (laughter).

LANCE: You did great. You did just fine. Yeah.

BRANDEE: You're OK.

UNIDENTIFIED PATIENT #1: Thanks so much. Thank you so much.

BRANDEE: Don't you ever tell yourself what you can't do again.

UNIDENTIFIED PATIENT #1: OK.

(SOUNDBITE OF DOOR CLOSING)

BRANDEE: OK, so I'm going to bring the lights up, and we're going to get your underwear on so we can get you over to recovery, where you can relax, OK?

UNIDENTIFIED PATIENT #1: OK.

BRANDEE: So the lights are going up.

WELLS: One thing you hear a lot from patients is, I'm doing this because I have this picture for my life and the things that I want. One woman, who asked that we not use her name, says she wants to finish school. And she knows lots of women get abortions, but she says that does not make this feel easy.

UNIDENTIFIED PATIENT #2: Like, we almost feel like we feel filthy. We feel dirty. We feel like we have to sneak and do this. Some of us, yeah, put our lives at risk doing it.

WELLS: She says she didn't want to be trapped with the guy who got her pregnant. When she asked him to help pay for this abortion, he said the most he could do was split it.

UNIDENTIFIED PATIENT #2: Guys - they're never held responsible for things like this ever. It's always the woman. We always got to step up and take care of it. Whether we keep it or not, it's always put in our lap.

WELLS: At the end of the day, when all of the patients have gone home, Dr. Lance wraps up paperwork. Brandee restocks the rooms, and Stanley does his final rounds. They don't know what will happen after the election, but they do know that tomorrow, more patients will be here seeking abortions. For NPR News, I'm Kate Wells in Sterling Heights, Mich.

(SOUNDBITE OF MUSIC)

MARTIN: This story comes from NPR's partnership with Michigan Radio and Kaiser Health News.

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