Update July 6, 2022: The Jackson Women’s Health Organization, the only clinic in Mississippi, was at the center of the case that overturned Roe. On July 6, it performed its last abortion.
“We knew this was coming,” told NPR, Jackson Women’s Health’s owner since 2010. Derzis plans to open Pink House West, a new clinic in Las Cruces, N.M.—less than an hour’s drive from El Paso, Texas.
Walking up to the Jackson Women’s Health Clinic Organization on an early Thursday morning in August, you see a smiling older woman in a reflective vest stop and greet cars driving by. She stands at the bottom of the hill that leads to the clinic’s parking lot, positioned in a way that makes it seem like you’re supposed to stop and talk to her. It’s not until you reach the front gate of the Pink House, the clinic’s nickname, that it becomes clear she’s simply posing as a volunteer patient escort. The smile and pleasant greeting distract people from realizing her real purpose: taking down the license plates of patients headed into the clinic.
The anti-abortion presence is light that day. Shannon Brewer, the clinic’s longtime director, jokes that the anti-abortion protesters must be on vacation. Sitting in her office explaining the general run of the clinic, Brewer points to several security monitors on the wall.
The security presence is, unfortunately, necessary. And the harassment experienced by the staff and patients is real. Brewer says they have regular meetings with the local FBI to deal with threats. Because of the threats and the harassment, the clinic doesn’t even have a doctor who lives in the state.
“Every local doctor we’ve ever had here, the antis are gonna harass them,” Brewer said. If they work at another location, such as a hospital, abortion opponents are “gonna call their jobs all day. They’re going to their houses. They’re going to all their neighbors’ houses,” she said.
Instead, five doctors rotate at the clinic, all flying in from out of state. “We cannot have a local doctor here; the antis will not allow that. No ma’am,” Brewer added.
“We cannot have a local doctor here; the antis will not allow that. No ma’am.”
The Pink House has also weathered a storm of regulations and restrictions that have left it the last clinic standing in Mississippi. Serving approximately 200 patients per month, the staff has had to adjust to slightly longer days during the pandemic due to COVID-19 mitigation measures.
“We still try to see the same amount of patients,” Brewer said. “We don’t want to turn patients away because we know a lot of patients are coming far.”
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The fate of Mississippi’s last clinic—and, quite possibly, abortion access nationwide—rests in the hands of the U.S. Supreme Court. In May, the Court announced it would hear Dobbs v. Jackson Women’s Health Organization in its upcoming term, which begins the first Monday of October. The state’s 15-week abortion ban, at stake in the case, has garnered much media attention. Lower courts have blocked the 2018 law as unconstitutional—precedents established in Roe v. Wade and Planned Parenthood v. Casey prohibit states from outlawing abortion before a fetus reaches viability. An injunction put in place by the federal district court and upheld by the 5th U.S. Circuit Court of Appeals has prevented the enforcement of the 15-week ban as the case has made its way through the court system.
According to the Center for Reproductive Rights, which is representing the clinic before the Supreme Court, the underlying litigation challenged the constitutionality of not just the 15-week ban but also six other restrictions enacted by the state legislature, including a six-week abortion ban, a requirement that patients make two trips to the clinic before receiving an abortion, and restrictive licensing provisions.
Brewer doesn’t dwell on the clinic’s case before the Court. She and her staff continue to do the day-to-day work of caring for their patients, who travel from as far as three hours away.
Still, after 20 years of running the Pink House, Brewer says being the only remaining clinic is scary.
“It shows what they can get accomplished over time by chipping away little by little,” she said. “This is the big impact that they have been trying to get accomplished the whole time. They just do it little by little. And now they’ve gotten it down to one clinic.”
In their filings, the attorneys for the state of Mississippi have made clear they intend to use the case to overturn Roe. If they succeed, 22 states would be at high risk of enacting total bans on abortion.
But safeguarding Roe is not enough for the Pink House and the women and girls of Mississippi. Common refrains around abortion don’t hold up here. The promise and protection of the landmark case have been whittled away for years. Those who are pregnant and those who may become pregnant are already forced to navigate a system of rules and regulations with the sole intention of frustrating access.
Safeguarding Roe is not enough for the Pink House and the women and girls of Mississippi.
Meanwhile, Mississippi continues to have the highest rate of infant mortality in the country. And earlier in the year, the state’s elected officials refused to extend postpartum Medicaid coverage, critical for reducing maternal mortality.
In truth, abortion legislation in Mississippi is about personal values—not the moral posturing of elected officials who are determined to cut off access to legal and safe abortion, and who are more focused on protecting the “lives of unborn children” than on supporting children and their families currently living and breathing in the state.
“One thing I’ve learned is that our government of Mississippi don’t seem to care about children,” Brewer said. “Everything that they vote for and against shows that they have no desire to uplift women or children.”
Brewer notes that many of the same people who protest her clinic also oppose birth control. “There’s nowhere here in Jackson that somebody can walk in and get some good birth control,” Brewer said. She says getting an appointment could take three to six months at the Hinds County Health Department.
“Girls come here to get birth control,” she continues. “We do the Depo shot. We were doing pills. We done ran out of pills. We can’t even get pills right now.” The clinic has a partnership that allows it to offer Mirena IUDs. The IUD is provided for free for low-income people, though there is a $50 insertion fee. Brewer notes that beyond birth control access, people in Mississippi have issues acquiring and affording childcare and quality healthcare.
Tyler Harden, the Mississippi state director at Planned Parenthood Southeast, reframes the conversation through a reproductive justice lens, saying that the underlying issue is people’s ability to decide to have kids or not have kids. “And if you’re going to have kids, be able to raise them in a safe and productive environment,” she added.
And yet, in the middle of a pandemic in which people are screaming about the loss of civil liberties from being forced to wear masks as a matter of public health and safety, those same people are denying bodily integrity to pregnant people.
Paraphrasing Audre Lorde, Harden said people don’t live single-issue lives. Clean water, access to grocery stores and fresh produce, and equitable educational opportunities are just a few things that affect their life outcomes.
“When we only focus on abortion access, we leave a lot of people out of the fight,” Harden said. “If we talk about abortion access in a traditional way, then we leave out LGBTQ folks, specifically trans men. We don’t talk about their stories.”
Driving east from Jackson you’ll reach the West Alabama Women’s Center in Tuscaloosa. Supported in part by the Yellowhammer Fund, an abortion fund and reproductive justice organization, the clinic has approximately 10 percent of its clients coming from Mississippi, according to the staff. With the unfolding situation in Texas, where a six-week abortion ban has gone into effect and the Supreme Court has refused to intervene, the whole region is at a crisis point.
Brewer wants people to get more comfortable speaking up and being publicly pro-choice. She says people need to be unafraid to say it’s wrong to tell someone else what to do with their body.
“Pro-choice do not mean that you will have an abortion,” she said. “Pro-choice do not mean that. It just means that you have no say-so of what the next person does with their body. That’s all pro-choice means.”
Florida is the only state in the South that is considered “safe” for abortion—though the state is currently eyeing a six-week ban of its own. Brewer sees Mississippi’s current law as targeting Black women and people with low incomes; she says it creates a geographical barrier for those who cannot afford to travel out of state.
“This is an attack on Black women,” Brewer said, “on lower income women, on people who cannot afford to travel out of state and, you know, go to these private doctors’ offices and get them to privately give them the pill and privately give them an abortion.”
Montinique Monroe is a freelance photojournalist based in Austin, Texas.