Michigan abortion waits stretch for weeks as out–of-state patients pour in

August 1 update: Michigan abortion ban is — then isn’t — in effect after two court rulings

• Wait times at some Michigan abortion clinics have stretched up to four weeks since Roe fell 
• The Supreme Court ruling this summer handed abortion decisions back to the states
• For now, abortion remains legal in Michigan

Wait times to schedule an abortion at Michigan clinics have recently stretched from days to weeks, as out-of-state patients flood to Michigan where — at least for now — the procedure remains legal.

Abortion appointments “are booking out anywhere from three to four weeks,” said Paula Thornton-Greear, CEO of Planned Parenthood of Michigan. A national researcher is seeing similar increases in Michigan. 

Before the Supreme Court ruling in June that struck down a federal right to an abortion and led to bans in several states, the 14 Planned Parenthood clinics in Michigan collectively performed about 15 abortions a week for out-of-state patients.

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• With Roe overturned, Michigan becomes an abortion ‘haven,’ for now
• Michigan's emotions span from tearful to jubilant over abortion ruling
• New Planned Parenthood CEO: We have abortion options for post-Roe Michigan

In two recent weeks, that number climbed to 55 out-of-state patients, Greear said.

That’s bumped up the organization’s overall caseload in Michigan from an average of 184 abortions a week to 228, she said.

In June, the U.S. Supreme Court upended nearly a half-century of federal abortion protections when it struck down the landmark Roe v. Wade. In  weighing the legality of Mississippi law that would make most abortions illegal after 15 weeks of pregnancy, the conservative court determined the 1973 Roe justices were wrong to conclude the U.S. Constitution protects abortion rights. 

Roe’s June reversal returned the decision on whether to legalize abortion to the states. Currently, seven states have bans on abortion. To the south, Ohio is one of four states that now ban abortions six weeks after a patient’s last menstrual period — so early that many patients haven’t yet realized that they may be pregant. At least 43 clinics across 11 states stopped offering abortion care.

To the west, Wisconsin’s 1849 abortion ban is not yet being enforced, but with a lack of clarity over what’s legal and what’s not, providers in the state have closed.

In Michigan, abortion remains legal for now. A court injunction has put on hold a 1931 state law banning abortion. That ruling is now being appealed by abortion opponents, including the Republican-led legislature, as abortion rights advocates seek to enshrine abortion rights in the state constitution through a November ballot issue.

Thornton, of Planned Parenthood, draws a direct link between abortion restrictions elsewhere and the surge in appointments across Michigan. She and two other providers say their biggest increase is from Ohio women seeking abortion care.

“That's reflective of this crisis that we're in because of the Supreme Court's ruling and the loss of access that other states have incurred,” Thornton said. “It's a harsh number to look at, but it's solely a reflection of the reality that we are facing.”

Renee Chelian, founder of Northland Family Planning Centers, which operates three clinics in southeast Michigan, said scheduling complications have ensued and more patients seek services. She said some out-of-state patients try to book appointments at multiple clinics, resulting in no-shows when they fail to cancel their Michigan appointment.  

Chelian said clinic staff try to call to confirm appointments, but “people don't answer their phones anymore. Or they get a text message confirmation but they're not responding.” 

Patients are frantic — “consumed with trying to get their medical care,” Chelian said.  Canceling appointments “is probably the last thing they think of but it is having an impact on other patients.”

Delays can have medical consequences

Providers say longer wait times for abortion are more than inconvenient; they can be emotionally agonizing and physically dangerous for patients, said Dr. Audrey Stryker, who performs abortions at the Women's Center facilities in Flint and Saginaw.

While complications from U.S. abortions are rare, research suggests they are more likely in the second trimester than the first.

Medication abortions using the “abortion pill” can be done in the privacy of a home, but they’re only available within the first 10 weeks. After that, patients must get an in-clinic or surgical abortion. 

When wait times stretch to the 10-week mark, woman are “right on the border,” so that they no longer have the option of a medical abortion, Stryker said.

The Saginaw clinic where Stryker works is Michigan’s northernmost abortion provider, and is seeing an increase, too. Stryker said she has gone from working at the clinic once or twice a month to providing abortion care weekly at the Women’s Center, around her other work as an OB-GYN at a community health clinic.

Patients from Ohio are “flooding” the abortion network, Stryker said. One Ohio woman drove several hours to get an abortion, without realizing Michigan’s informed consent law requires a patient receive information about the abortion 24 hours in advance — a “pause” Stryker feels is appropriate.

Without the paperwork having been signed a day earlier, Stryker said, “she had to turn around and go right back to Ohio.”

Decisions over abortions are emotional; and sometimes women are sick from being pregnant, she said. So having to wait weeks to get an abortion can be “agony” to patients. 

Vicki Moore, the Center’s executive director, said she’s been able to reschedule doctors and that, for now, wait times have remained stable.

“If you call today, a Friday, I can get you in Wednesday,” she said.

“It will change as Detroit gets busier and busier,” she said. “It’s a matter of time.”

Chelian and Greear said the scheduling squeeze is likely to get worse as more states tighten restrictions.

An ongoing national survey conducted by researchers at Middlebury College in Vermont suggests as much. 

A research team led by economics professor Caitlin Myers called more than 800 clinics in Michigan and around the nation in March, asking for an appointment. 

Even then, Myers said, roughly half of Michigan’s 25 abortion clinics had longer wait times than the national median time, which was then about four weekdays. Eight Michigan clinics reported wait times of more than 11 weekdays.

By July, 15 of Michigan's 25 clinics surveyed reported wait times had increased, including four clinics that now had wait times of 21 work days; effectively, more than a month’s delay when weekends are factored in.  

Those clinics, as well as clinics in Jackson, Kalamazoo, Lansing, and Marquette, reported wait times of 10 to 21 days in July.  

One clinic reported it had no appointments at all for at least a month, Myers said, while 11 Michigan clinics were scheduling appointments in five days or less.

In metro Detroit, where 13 of the state’s 25 abortion facilities are located, wait times for most clinics held steady —  inching up from 3 days of waiting in March — below the national median — to four days in July.

Wait times likely to grow

Uncertainty over abortion access is growing across the nation. 

Kentucky and Florida have begun rolling back access to abortion by implementing bans after 15 weeks. In Wisconsin, abortion remains legally uncertain, so providers have stopped offering abortions, according to the analysis by the Guttmacher Institute, a New York-based research group that supports abortion.

As many as 26 states are either certain or likely to ban abortion now that Roe is no longer in place, Guttmacher reported Thursday.

“We have fewer clinics and greater distances (to travel), both of which lead to delays,” said Elizabeth Nash, Guttmacher’s principal policy associate. 

Over time, she said, wait times may shorten again as new clinics open in states without restrictions and some women aren’t able to travel to get abortion. 

“This isn’t going to shake out quickly,” she said.

Chelian and Greear said clinics are eager to hire more medical and office staff to address capacity issues. 

“All of us are trying to hire more people to answer our phones,” said Chelian, who said she’s trying to collaborate with other clinics to take the overflow of patients.

The Michigan women and Meyers, the Vermont researcher, said the longer wait times also underscore a widening disparity in access to abortions between women with the financial means to travel and those without.

“This is a poverty story,” Myers told Bridge. “It's a story about preventing access and … trapping a particularly vulnerable group of women.”