Dr. Sarah Traxler has been traveling to South Dakota twice a week for the past seven years: once to meet with her patients at the Sioux Falls Planned Parenthood (and read a 12-page disclosure required by the state) and once more 72 hours later, after the state’s required waiting period had passed, to perform their procedures.

This regularity came to an end in the middle of June when the South Dakota clinic ceased scheduling abortion appointments in light of the Supreme Court’s impending Dobbs decision. It was too precarious because of the states’ waiting period and a trigger ban that was ready to take effect the moment the Supreme Court ruling was announced. We wanted to be sure that no patients started the procedure and were unable to complete it because of the Dobbs ruling, according to Traxler. It was preferable for the patients to be scheduled in a location where your access would not be impacted by the decision.

So, on June 16, Traxler saw her final client of the day and apologized in advance if she became upset. All she could think of at the time was how bad things are already getting for South Dakotans and how much worse they are going to get. Following the Supreme Court’s ruling from last month, South Dakota is one of eight states that has a complete ban on abortion; four additional states have six-week restrictions in place. In the upcoming months, a number of further laws are likely to further prohibit the practice. Although the nation had been plodding along toward this truth for years, Traxler felt as though it had all come at once and all at once.

In 2015, Shed began operating in South Dakota. She recalls the state’s bizarre requirements at the time, including the lengthy script that clinicians had to recite to patients (part of it wasn’t even true, she claims) and a stringent time-stamping system to comply with the state’s 72-hour waiting period, but she still views those days as the past. We all began to recognize that our mission was in danger in 2016, so that’s when it all really got going.

In the year that Donald Trump was elected, the national family planning program known as Title X, which offered low-income women access to birth control and healthcare, came under threat. Additionally, Traxler recalls that it wasn’t just Title X that was under attack; it was also attacks on LGBTQIA and BIPOC persons, as well as attacks on sexual and reproductive health in general. Since 2016, we’ve been chasing after them.

Traxler oversees medical services, including abortion, in five Midwest states: Iowa, Minnesota, Nebraska, North Dakota, and South Dakota in her capacity as chief medical officer for Planned Parenthood North Central States. In the previous six weeks, access to abortion was just hanging on in Nebraska and Iowa before trigger prohibitions come into force terminating access in South Dakota and North Dakota (where, the day after Traxler performed the last abortion in South Dakota, she got word that the state supreme court had suddenly and unexpectedly upended its own abortion laws). In Minnesota, where access to abortion is protected, already-existing clinics must deal with a deluge of out-of-state patients who are frantically seeking treatment they can’t get in their home states. We are currently experiencing the Dobbs decision’s bottleneck impact, which means that capacity is limited everywhere.

Dr. Sarah Traxler, img1.
Mike Krivit for North Central States of Planned Parenthood

The pandemic’s residual impacts, including the departure of burnt-out medical professionals and support staff after two grueling years, have made those capacity issues worse. The clinic’s ability to perform abortions was put on hold for a full month due to the retirement of Planned Parenthood’s lone Nebraska employee. Following the departure of one of Planned Parenthood’s two providers, the doctors from Minnesota are now alternately flying into Iowa to give care. More than four weeks have passed since the last appointment for patients. We are recruiting as much as we can, but it is quite difficult to find doctors in states that are so hostile to access to abortion.

With all the turmoil, Traxler has been reduced to one of just a few physicians keeping abortion access in the Midwest together at the seams. She is now flying into Iowa and Nebraska for periods of the month to perform abortions, in addition to working days at her home clinic in Minnesota each week. I’m furious that we are in this situation right now. That the abortion story has been appropriated, altered, and changed to place the emphasis on an embryo rather than the living, breathing, walking, and talking person that I get to meet, claims Traxler. That seems like a tragedy to me.

Traxler, though, is aware of the appeal of the anti-abortion rights story and, at one point, even bought into it when she was younger. Every Sunday, there was a tiny table with a large placard that read: Abortion is Murder in the foyer of the Southern Baptist church Traxler attended.

They gave me a leaflet when I was 11 or 12 years old, and I can clearly recall seeing these extremely gruesome images. I had a strong dislike towards abortion after that. She discussed abortion with her friends, took part in prayer meetings in which she prayed for God to reverse Roe v. Wade, journaled about it, and sparred with a cheerleader who supported abortion. Then, during Traxler’s high school years, a close friend interrupted her in the middle of a tirade and informed her of their own abortion.

She had a really abusive spouse, and since I knew this, I naturally assumed that she should get an abortion. She need to remain married to this violent man for the rest of her life and never have children. It was the beginning of a slow-motion epiphany, one that finally lead Traxler to believe that not everything is as it seems and that the brochure that was given to me when I was twelve is not always accurate. There is nuance in this; people have their motives for doing it; it isn’t something they do carelessly. And neither I nor the government should be making decisions about what other people do with their own life.

Since Dobbs, Traxler’s job now includes spending hours on the phone with PPNCS’ general counsel, strategizing how to structure medical care in ways that keep their clinics on safe ground as the legal landscape shifts beneath them in real time. She also provides abortions on the ground in Minnesota, Iowa, and Nebraska.

These modifications have improved Minnesota: Only a few weeks ago, a lawsuit that successfully contested all of the states’ remaining abortion restrictions rules—including those pertaining to parental notice, who can perform the procedure, waiting periods and disclosures, etc.—was found unlawful. Since we are barely hanging on in Nebraska and Iowa, we are hopeful that Minnesota will serve as our safe haven.

According to Traxler, the organization in Iowa is observing the new 24-hour waiting period while keeping an eye on a six-week ban that has been ruled unconstitutional but that the state’s governor has begun making noise about revisiting. The Nebraska Legislature is considering calling a special session to try to ban abortion. (State lawmakers are actively working to change the state constitution to outlaw abortion, but this would need passing it in two consecutive sessions of the legislature before being placed to a vote by the general public. Traxler and her colleagues would be able to perform abortions in Iowa up until 2024 in that case.)

We are sewing together a very delicate quilt, explains Traxler. It’s currently functional. However, I constantly have the sense that something dreadful is about to happen or that a new legislation will be passed that will cause everything to fall apart.

Subscribe to us!