With the Dobbs ruling allowing states to restrict abortion access, health care practitioners have been forced to innovate in order to deliver care.
Planned Parenthood of the St Louis Region and Southwest Missouri announced last week it will provide reproductive health care via a mobile clinic parked in southern Illinois. They converted a 37-foot recreational vehicle into a mobile health care center, which will be able to conduct medication abortion for patients up to 11 weeks' gestation.
Dr. Colleen McNicholas, chief medical officer for the regional group, said the plan is to eventually expand services.
"Once we iron out the operational work of delivering medication abortion, we will be quickly looking to pivot to expanding that service line to include first-trimester procedural care as well," McNicholas explained.
Before the Dobbs decision, medication abortion accounted for more than half of all abortions. The clinic is expected to be able to see patients by the end of the year.
Demand for reproductive health services has increased dramatically in the wake of the Dobbs decision. At its Fairview Heights, Illinois, clinic, 20 miles from the Missouri border, Planned Parenthood reports there has been a 30% increase in abortion patients, with appointment wait times increasing from four days to two and a half weeks.
Yamelsie Rodríguez, president and CEO of the regional group, described the mobile unit.
"It has a standard lab, it has a little waiting room, it has two exam rooms that further down the road can be converted into procedural rooms for abortion care," Rodríguez outlined.
Planned Parenthood said the initial goal is to be able to serve 30 patients per day.
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Vending machines commonly found in workplace break rooms generally contain soft drinks or snacks but one machine in Indianapolis dispenses unconventional items at the turn of a knob.
The Plan B morning-after pill, pregnancy tests and condoms are displayed in a clear glass case inside a colorful blue and orange dispenser. The items provide easy access to protection against an unwanted pregnancy and are free of charge.
Melissa Gruver, organizing director of the feminist organization Indiana Task FORCE, said it operates like a traditional vending machine.
"You just push whenever you want and it falls down, and you reach your hand through the little door and you pull it out, take it with you," Gruver explained.
A 2022 Indiana Department of Health Termination Report indicated 9,600 pregnancies were aborted, with Marion County recording the highest number of unwanted pregnancies. The report also noted the average age of a woman in Indiana who sought an abortion was 27, and 67% of all terminated pregnancies occurred within four to eight weeks of conception.
The state's contentious near-total abortion ban, which was upheld by the Indiana Supreme Court last year, has stoked fears lawmakers may begin restricting a woman's choice of birth control.
Indiana Task FORCE and reproductive health groups All-Options and the Midwest Access Coalition want the emergency contraceptive vending machine to serve as a gathering spot for community conversations on reproductive rights and sexual health.
"We've long been organizing our communities to bring about reproductive justice, which we didn't have before and we definitely don't have it now," Gruver pointed out. "But what we know to be true is that there are more of us that want access to reproductive care than those that try to stop it. We're excited to continue to work to meet this need now, and to organize for a better community."
Gruver hopes to have one dispenser in every Indiana region in the future to add to the single machine currently in an eastside Indianapolis grocery store. She added some universities in the state already have vending machines offering similar contraception products but users have to purchase the items.
This story is based on original reporting by Mary Claire Molloy for Mirror Indy.
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On Tuesday, the Arizona Supreme Court upheld an 1864 ban on nearly all abortions, except in situations when it is necessary to save the life of a pregnant person. It makes abortion a felony punishable by two to five years in prison for anyone who performs one or helps someone obtain one.
Arizona's near-total abortion ban will be one of the harshest in the country, along with Alabama, Mississippi and Texas.
Gov. Katie Hobbs said the law, written well before Arizona became a state or women had the right to vote, is placing lives in danger.
"I've personally experienced the anguish of losing a pregnancy," Hobbs noted. "I know it's outrageous to have the government tell you that the best decision for your health or future could now be considered a crime."
On the social media platform 'X,' Gov. Hobbs described it as a "dark day for Arizona." But anti-abortion advocates are celebrating a big win, even as some Republican lawmakers think the ban should be repealed. The Arizona Supreme Court put its decision on hold for 14 days as additional constitutional challenges are cleared up.
The ruling has rattled Democrats, including mother and nurse practitioner Sen. Eva Burch, D-Mesa. Just a couple of weeks ago, Burch announced on the state Senate floor she had an undergone an abortion procedure. She contended Arizonans of any political affiliation do not want an abortion ban.
"Somebody took care of me. Somebody gave me a procedure so I wouldn't have to experience another miscarriage; the pain, the mess, the discomfort," Burch stressed. "And now, we're talking about whether or not we should put that doctor in jail. This is outrageous."
Kris Mayes, Attorney General, said in a statement as long as she is in office, no person or doctor will be prosecuted under what she called a "draconian law."
Vice President Kamala Harris is set to visit the Grand Canyon State later this week to champion reproductive rights. And Arizona pro-choice advocates recently secured enough signatures for a ballot measure to enshrine abortion rights in the state Constitution.
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Planned Parenthood Arizona is expanding vasectomy services to its Central Phoenix health center, a year after it launched a similar program in Tucson, with increased requests following the Dobbs decision.
Dr. Jill Gibson, chief medical officer for Planned Parenthood Arizona, said her organization remains committed to its mission of protecting and expanding reproductive health care access in Arizona. She pointed out nearly half the patients seeking services in Tucson were coming from Phoenix and Northern Arizona.
"So many patients were saying that the traditional methods of birth control that were available really didn't work for them," Gibson explained. "They tried them and had adverse side effects or they couldn't afford them, they didn't have insurance, and really the method that so many people wanted to rely on for their families and for their partners was a vasectomy."
Gibson pointed out vasectomies are an effective form of permanent birth control amid constant attacks on reproductive health rights in Arizona and nationwide. Vasectomy services are available for those with insurance or self-pay, with a $750 cost. She emphasized it was a "real no-brainer" to bring the service line to the Phoenix area. Appointments can be scheduled at 602-277-7526.
Gibson stressed Arizona is facing a significant shortage of providers and added the Dobbs decision has opened the door for further restrictions in medical professionals' ability to practice, which she contended is pushing providers away.
Every county in Arizona is what is called a partial health professional shortage area, meaning there are 3,500 or more patients for every one provider. She said it is hard to find people who are willing to work within the reproductive health care space, even for family planning services which have nothing to do with abortion, such as vasectomies.
"I do think that is part and parcel of the whole picture of how we have to look at bodily autonomy and access to reproductive health care and sexual health care," Gibson asserted. "If we continue to have all these regulations and restrictions, we won't have providers to provide this service at all."
Gibson added it is "overwhelming" to see elected leaders and officials play politics with Arizonans' health care and threaten access to birth control and abortion. But just last week, backers of an initiative to ensure abortion rights in the state got enough signatures to put the measure on the ballot in November.
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