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April 13, 2007

The Last Clinic Standing

On most Monday mornings, Dr. Miriam McCreary wakes up before her pet parrot at 5 a.m. and dresses in the dark in order to make a 7:20 flight from her home in Minneapolis, Minnesota, to her office in Sioux Falls, South Dakota.

Abortion Clinics in South Dakota

Photo Credit: Andrew Hetherington

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The Planned Parenthood where she works looks like a typical 21st-century American abortion clinic. The bulky brick exterior defends the edifice against bombs. Deliberately high windows protect those inside from snipers. A rear parking lot hides patients from protestors who might hurl slogans, spit, or Molotov cocktails. On Monday mornings, the patients-many of whom wear hats and all of whom study the ground-enter the locked, bulletproof doors pregnant. Since no South Dakota doctor will work at the clinic, 71-year-old gynecologist McCreary, grandmother of 10 and daughter of Lutheran missionaries, hops her early flight to Sioux Falls, population 141,000. Her husband, a retired businessman, kisses her good-bye, then tries to get through the day and get past his worries-foreign terrorists who hijack airplanes, domestic terrorists who murder doctors-with military-history magazines. The Minneapolis flight is often delayed; Midwest weather is iffy. So a Planned Parenthood staff member regularly watches the sun rise over a tall-grass field from the curb in front of the regional airport, where she waits for the doctor to arrive. Week after week, she comes to understand how frontier women periodically went crazy from the prairie wind's whisper-whistle, while back in the clinic's waiting room, a more complex tension thickens despite the generous supply of People magazines.

To begin a surgical abortion, Dr. McCreary injects a patient's cervix with an anesthetic. She'd like to offer general anesthesia, but there aren't enough nurses at the clinic to watch IV lines. So Dr. McCreary gives the women what she calls "verbal anesthesia." "I talk to them," she says. "Most have the same favorite topic: their kids." Sixty percent of abortion patients in the U.S. are already mothers. Next, Dr. McCreary dilates her patient's cervix to about the width of a pen. Then, taking something that looks like a mini vacuum-cleaner hose, she sucks out the contents of the uterus. Sixty days after conception, a fetus is about the size of a kidney bean. It has a head, a rump, and tiny webbed fingers, but limited brain function. Along with the placenta, Dr. McCreary pulls the fetus, in pieces, into a glass jar. Like amputated limbs, abortion material is considered regulated medical waste and is cremated or incinerated. About three hours after entering the clinic, most patients leave with their wombs empty- though about twice a month, a woman is so distraught that Dr. McCreary sends her home still pregnant to reconsider her options. "I tell her, 'Think about what you really want to do,'" says Dr. McCreary. "I say, 'We'll be here if you need us.'"

On the sidewalk in front of the brick fortress, two other grandmas, from Brookings County, SD, recite the rosary. Each carries a poster of a baby that reads, "Look it in the face." "This clinic protects rapists," one informs me. "If a woman has been raped by a family member, the law says you're supposed to report it. But if you come here and get an abortion, it doesn't get reported. The man gets a free ride." Then she confides, "And the clinic sells baby parts to manufacture cosmetics." It would be an abortion clinic like any other, except that the Sioux Falls is the last facility in all of South Dakota, a state of 775,000 people scattered across some 77,000 square miles. It is also the most imperiled clinic in the country-endangered not from the kaboom of violence, but from a silent smash of law.

Last winter, the state legislature passed House Bill 1215, The Women's Health and Human Life Protection Act, which bans virtually all abortions, even in cases of rape, incest, and threat to a woman's health. "If you have high blood pressure or heart disease and a pregnancy will make the condition much worse, too bad," says Sarah Stoesz, president and CEO of Planned Parenthood in Minnesota, North Dakota and South Dakota. "Even if you already have small children. Same if you're carrying a severely damaged fetus." For now though, the Act cannot be enforced. The South Dakota Campaign for Healthy Families gathered enough signatures to put it to a statewide vote on November 7. On that day, if South Dakotans choose to rescind the Act, pro-life advocates will likely introduce a slightly less-stringent ban in the State Legislature. If South Dakotans vote to uphold the Act, Planned Parenthood will file a federal lawsuit against the state. Either way, both sides agree, the battle will rise up through appeals courts, and sooner rather than later, the U.S. Supreme Court will decide-based on HB 1215 or similar measures introduced in Ohio, Indiana, Kentucky, Georgia, and Tennessee-whether abortion remains legal in America.

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