Although it’s too early to have specific numbers, Planned Parenthood leaders say the imposition of a six-week abortion ban in Iowa starting July 29 has resulted in increased numbers of residents traveling to Mankato to receive reproductive health services.
The necessity to travel, as well as a reduction in Iowa counties that can provide maternity care, increases potential threats to those patients, leaders said. And a continually shifting health care landscape adds confusion.
“I think one of the biggest challenges is just the ever-shifting landscape of what’s happening,” said Ruth Richardson, Planned Parenthood North Central States CEO, during a tour Friday of the Mankato clinic. That applies not only to patients but staff, she said, “because it can be really difficult to know what is legal on any given day.”
Iowa became the 15th state to ban nearly all abortions and was the fourth state with a six-week ban. Because Minnesota is one of only a few states around Iowa that has protected abortion rights, for example, cities such as Mankato and Rochester are frequent recipients of patients seeking care.
“The border communities have become so important within this space, and here in Mankato, for example, we expanded to offer medication abortion in January of this year after relocating to this bigger space (in November 2023),” Richardson said.
She said the space at 340 Stadium Road is larger than the previous site on North Victory Drive, and with the June 2022 decision reversing Roe v. Wade abortion rights, “We have to be prepared for every single scenario.”
The new location has five exam rooms, including one with ultrasound capabilities, and provides chemical abortions on a schedule to complement other facilities’ schedules.
Misty Parrow, a senior manager of one of Planned Parenthood’s regions, said while the organization has staff that helps patients determine their best options for receiving care, folks in Iowa have done a good job keeping track of court decisions that affect where they can go.
“I would say right around six weeks before the Iowa Supreme Court decision came out — where typically it was pretty common to see patients come in right around that 9-10 week mark of pregnancy for an abortion — really quickly we started to see patients that were, you know, 3, 4, 5 weeks pregnant coming in,” she said. “They were trying to do what they could to make sure they were going to get the care that they needed.”
But at least one Iowa legislator who was on the Mankato trip thinks the ban is making many Iowa women look more closely at whether they want to get pregnant, if they want to get pregnant while living in the state or if they should transport their embryos out of state because of uncertainties about invitro fertilization legislation.
“Thinking about it from the perspective of these individual Iowans is why this trip is so important to me, and I need to know where Iowans are going and what kind of care they’re getting,” said Iowa Rep. Jennifer Konfrst, a Democrat who represents a district near Des Moines. “And they’re going to get remarkable care here.”
When Richardson and Parrow noted they are continually hiring care providers and all other support service suppliers, Konfrst had this suggestion.
“You should advertise in Iowa because there are going to be a bunch of providers from Newton who are about to be available, right?” she said, in reference to MercyOne Medical Center closing its birthing unit due to recruitment and physician workload challenges.
Richardson had noted earlier in the tour that more than 30 of Iowa’s 99 counties are what she referred to as “maternity care deserts” that lack such care.
Gabrielle Smith is a registered nurse who provides care for many of the patients who travel from Iowa. She must prepare them for what may happen on their longer rides home.
“One of the things that I tell every patient is that while symptoms vary depending on how far along someone is, they are potentially having a large amount of bleeding,” she said. “They sometimes, in the first 24 hours after taking the second medication, misoprostol, they may pass a blood clot up to the size of a lemon, or approximately their fist.”
Because the trip to Minnesota often requires them to take time off from work, arrange child care and certainly cover costs of gas and perhaps a motel room, they may or may not have someone along to support them physically and emotionally, Smith said.
If there is a companion, whether it be a mother, sister, friend or partner, they can serve to help distract and reassure the patient if they experience any side effects.
“We try to get them set up with that kind of plan to manage any physical and emotional pain,” she added.
Planned Parenthood continues to provide such care as cancer screenings, vasectomies, family planning services and mental health, Richardson said. And they will continue, regardless of any future legislative or judicial decisions affecting abortion care.