Dr. Cheryl Hamlin added a line to her standard message for patients during their counseling sessions at Mississippi’s only abortion clinic last week.

“As you hopefully have heard, the Supreme Court is probably going to overrule Roe v. Wade, which means this clinic will close,” she said to dozens of people who had traveled to Jackson from as far away as Texas for an abortion. 

About half of the patients hadn’t heard, she told Mississippi Today. So she explained: A draft opinion leaked May 2 indicated the court is poised to overturn the 1973 ruling that established a constitutional right to abortion and guaranteed at least a modicum of access to the procedure in every state in the country — even if states like Mississippi imposed such strict and medically unnecessary regulations that only one clinic was left standing.

If the Supreme Court officially overturns Roe, Mississippi has a law on the books that will almost immediately ban abortion in almost all cases. The Jackson Women’s Health Organization, the clinic at the center of the case before the Supreme Court, will likely stop providing abortions.

One woman asked if that meant Hamlin would be out of a job. Hamlin, who lives in Massachusetts and visits Jackson about once a month for three days of work at the clinic, told her she would be all right. 

“Well, I’m going to be fine,” Hamlin recalled the patient saying. “I’m going to take these pills and I’m never going to come back here.”

“I said, ‘Well, you and I are going to be fine. There’s a whole bunch of people that won’t be.” 

As an OB-GYN in the Boston area, Hamlin says she has lived “in a pretty nice bubble.” She received training in abortion care during her residency at the Boston Medical Center in the late 1980s and early 1990s, and it was always a part of her practice. 

“They would come to my office, say that’s what they wanted, I scheduled them in the operating room in the hospital, and they went without protesters and their insurance paid for it and it was no big deal,” she said. “I really thought that was what people did. And that was my job. I didn’t see it as any moral imperative.”

Then, Donald J. Trump was elected president of the United States. Hamlin read about the state of abortion access in other parts of the country. She wanted to do something. 

She had never spent time in Mississippi, but she got connected to the medical director at the Jackson Women’s Health Organization. She went to visit, liked it, and got licensed in Mississippi.

In the fall of 2017, she joined the team of out-of-state doctors who fly in for shifts at the clinic. Almost every month, she travels from Boston to Jackson for a three-day shift. 

Her work days at the clinic start around 8:30 a.m. Clinic staff spend the mornings providing state-mandated counseling, including the claim that having an abortion increases the risk of breast cancer, even though scientific studies show that’s not true. 

After that counseling, patients have to wait at least 24 hours for their next visit, per state law. 

In the afternoons, Hamlin provides surgical procedures and administers the first pill for medication abortions, as required by Mississippi law.

Patients take the rest of the medications at home. More than half of the abortions provided at the clinic are medication abortions, Hamlin said. 

During breaks in the day, Hamlin likes to go outside to visit with the clinic escorts. They call themselves the Pink House Defenders, wear rainbow-colored vests and try to shield patients from the protestors jostling to persuade them to turn around. 

When Hamlin came to Mississippi, she expected the demonstrators and seeing patients forced to travel long distances. But she didn’t foresee how many of her patients would lack access to any kind of regular health care. 

Massachusetts has one of the country’s lowest rates of people without health insurance, at 2.4%. Mississippi has one of the highest, at 11.9%. Among people under 65, the rate is 14.1%. 

Hamlin regularly talks to patients who couldn’t afford to fill their birth control prescription because they are uninsured. When she asks if they have a regular gynecologist, the answer is often no. 

“That’s almost unheard of in Massachusetts,” she said. 

Hamlin, through her work at the Pink House, has already glimpsed what the dismantling of Roe will look like. 

Last year, the Jackson clinic began to see something entirely new: patients from Texas. 

The state banned abortions after six weeks of pregnancy last year, with a unique and unprecedented enforcement mechanism. 

Private citizens can sue anyone who “aids and abets” an abortion, and win $10,000 in damages if they’re successful. (People who are sued and win can’t recoup attorney’s fees.)

The Supreme Court allowed the law to take effect. Since September, Texans have gone across the border to purchase abortion medication in Mexico. They’ve traveled to Oklahoma, New Mexico, Colorado, Louisiana, and the Pink House. 

Texas patients flooding Louisiana clinics pushed Louisiana patients to Mississippi. The Jackson clinic changed its opening hours from three days a week to five. 

Through it all, Hamlin has kept working, wondering how long it will last. 

She arrived in Jackson for her shift on the night of May 2. She was checking emails when she saw the news about the leaked draft opinion. It wasn’t a surprise. 

Since she started working in Mississippi, her counseling sessions have always included information about the movement to overturn Roe. She reminds patients from Texas that Gov. Greg Abbott is up for re-election soon. 

But it was still a shock. 

“Like yeah, this is really going to happen,” she said. 

The next morning, a Tuesday, was a quiet one at the clinic. Regulars passed the word that many of the usual anti-abortion demonstrators had gone to Ukraine for missionary work. 

Hamlin and her colleagues at the clinic are still waiting to see what the final ruling will be – likely in June or July – and what laws Mississippi will pass. The state’s trigger ban, passed in 2007, will likely ban all abortions except in cases of rape and to save the life of the mother. 

Though they haven’t been introduced in the state legislature, other potential laws could seek to prohibit travel or referrals for abortions. 

The Jackson clinic’s director, Shannon Brewer, told NBC last week she plans to open a clinic in New Mexico, about 1,000 miles away from Jackson. Getting patients there, or to southern Illinois, could be expensive and logistically difficult, but Southern abortion funds have vowed to keep helping people access abortions. 

Hamlin worries what could happen to a Mississippian who gets an abortion out of state but develops complications back home. 

In the decades before Roe, going to a hospital after an abortion could trigger a criminal investigation in which the patient was forced to participate. 

“I think people are going to be afraid to seek care, emergency room care,” Hamlin said. “They may be a little bit now actually. But I think it’s going to get a lot worse.”

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