Inside Jackson MS abortion clinic with Boston MA doctor

Inside Jackson MS abortion clinic with Boston MA doctor

Dr. Cheryl Hamlin once attended a demonstration against the Iraq War in the Boston Common, but she’s never felt like much of a radical. Then she started providing abortions in Mississippi.

Hamlin, a 60-year-old OB-GYN at Mount Auburn Hospital in Cambridge, Mass., spends three days a month at the state’s only abortion clinic in Jackson. Her work places her at the center of a decades-long national war that has culminated in the U.S. Supreme Court case poised to overturn the constitutional right to abortion: Dobbs v. Jackson Women’s Health Organization.

The job is too dangerous for local physicians, so she and other out-of-state doctors fly in on a rotation.

Though Hamlin always thought being a doctor meant you were supposed to help people, she describes her career as “kind of ordinary.” A mix of idealism, principle and shock at the election of President Donald Trump led her to start working in Mississippi in 2017.

And last week, during what may well have been her final shift here, she wondered how far she would be willing to go to ensure access to abortion remains.

On Monday, June 6, a little before 4 p.m., she leaned over the steering wheel of her rental car as she pulled into the parking lot, in a hurry to get to her patients. They sat in idling sedans and SUVs, cranking up the air conditioning against a hot and sunny afternoon.

Standing on the sidewalk just beyond the metal fence that surrounds the pink stucco clinic – known around Jackson as the Pink House – Pam Miller watched the doctor drive up. Miller, a 67-year-old grandmother of seven, is a regular presence outside the Pink House, wearing her blue 40 Days For Life baseball cap and clutching a stack of pro-life pamphlets.

“That’s Cheryl Hamlin,” she said to Zach Boyd, another frequent protester. “She’s just now getting here.”

Hamlin didn’t notice them. And she wasn’t thinking about the seemingly imminent fall of Roe and the end to a constitutional right to abortion in the United States – at least not directly.

She was thinking about her patients. She felt the extra pressure of knowing that clinics across the Southeast are packed with people seeking abortions, that some of them had driven hours for their appointments, and that soon it could be too late.

A clinic staffer came out of the building to tell patients they could come inside.

Boyd held out a tan rubber fetus, smaller than his fist.

“God’s going to judge you,” he called to the clinic employee.

“Why are you worrying about what I’m doing?” she shouted back. “Worry about yourself.”

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Dr. Cheryl Hamlin drives to the airport after completing what will likely be her last shift at the Jackson Women’s Health Organization in Jackson, Miss., Thursday, June 9, 2022. Dr. Hamlin travels from Massachusetts to Jackson to assist patients seeking abortions. Eric Shelton Mississippi Today

If the final ruling in Dobbs hews to the draft opinion that leaked in early May, the Pink House will close. The clinic and some of the staff will move to New Mexico. Hamlin will join them there once a month, just as she has done in Mississippi for the last five years.

“I don’t spend a lot of time dwelling on that fact,” Hamlin said of the possibility that this shift could be her last in Jackson. “But I guess I’ve been reading too much – it’s starting to affect my mind.”

While Hamlin began work inside the clinic, a young couple waited in their car down the block. As college students, they said, they’re not financially stable. They’re not ready to have a baby. The young woman had called Planned Parenthood in her home state, but they had referred her to Jackson.

The pregnancy was already causing health complications, and they were thinking about their future. There was nothing any protester or pamphlet could say to change their minds.

“I feel like everyone thinks that it’s an easy decision,” the woman said. “It’s really not.”

Inside Mississippi’s abortion clinic

On Wednesday morning, six women sat in high-backed chairs arranged in a semicircle inside a narrow room in the back of the clinic. A purple sign taped to a door said “Everyone loves someone who had an abortion.”

The patients gripped medical forms or held their hands together on their laps; one rocked back and forth in her seat, and another crossed her legs and jiggled her foot.

“Hi ladies, how are you doing?” said Hamlin, taking her seat at the front of the room. The doctor has short hair and an air of friendly professionalism.

“So, I’m Cheryl Hamlin, the doctor for the week, and I’ll be doing your counseling.”

She described the risks of the procedure: infection, blood transfusion, uterine perforation.

“To put it all in perspective, if you were giving birth, I would tell you you have all the same risks, but many more,” she said.

She delivered the line required by Mississippi law, that abortion increases risk of breast cancer.

“Nobody thinks it’s true. I’m pretty sure Governor Reeves doesn’t think it’s true, but it’s a state law that I say those words,” she told them. She recited another required line: If the only reason for the procedure is financial, “there may be organizations that will assist you as well as the father of the pregnancy should be providing child support.”

Then she turned to what she called “the elephant in the room:” the Supreme Court’s impending decision in the case that started with this clinic. In the best case scenario, she said, the Court will uphold Mississippi’s law and allow it to forbid abortions after 15 weeks.

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Dr. Cheryl Hamlin gets ready to drive to the airport after completing her shift at the Jackson Women’s Health Organization in Jackson, Miss., Thursday, June 9, 2022. Dr. Hamlin travels from Massachusetts to Jackson to assist patients seeking abortions. Eric Shelton Mississippi Today

Since the Pink House currently provides the procedure through 16 weeks, that outcome wouldn’t make a major difference for the clinic.

“The more likely and worst-case scenario is they overturn Roe,” she continued. “This clinic, and every clinic through most of the South and Midwest, is going to close.”

She urged her patients to vote. Then she moved on to explain the process for surgical abortions and for medication abortions.

Next came individual counseling. Each person had a number to indicate her turn in line. Hamlin told them to keep an eye on her office door. Lately, as abortion clinics across the country have cut back services, the Pink House has been busy, and the process is designed for efficiency.

“When she comes out, you go right on in,” she said. “You guys pay attention, don’t wait for me to call you, and we’ll get you right on out of here.”

The individual counseling room is a small office shared between the doctors when they come to the clinic for their shifts. Hamlin sat behind a broad, dark wooden desk. The patients sat in a chair across from her.

None of the generic furnishings reflected anything of Hamlin; this was the clinic’s office, not hers.

The fifth patient to talk to Hamlin was a young woman in running shorts.

“Come on in, how are you doing?” Hamlin said.

“Good,” the woman replied as she sat down.

Hamlin looked at her medical records spread on the desk.

“You’re 15 weeks, so you have to come…” She paused, glancing up at the monthly calendar taped next to her seat. It was June 8.

The calendar showed Hamlin’s shift, which would end just before 1 p.m. the next day, and another doctor’s shift on June 10 and 11. But that doctor only performs abortions through 13 weeks.

“So it’ll be the next available…” Hamlin looked at the calendar again. “…is the 16th or 17th. Gosh. You’re 15 – we’re not going to get you in.”

‘You want to give people all the choices’

The woman’s face betrayed no emotion. She explained that the nurse who performed her ultrasound had said the doctor might be able to do the procedure on Friday.

“Aaah,” Hamlin said in a high-pitched tone. “Let me just make sure what I’m saying is true.”

She ran the math in her head: The woman was already 15 weeks pregnant. The next time a doctor at the clinic could perform the procedure, she would be more than 16 weeks pregnant – past the clinic’s cut-off date.

Hamlin left the room. The woman looked at her phone on her lap.

Two minutes later, Hamlin came back. The patient wouldn’t be able to get an abortion in Jackson.

“But we can help refer you, we have a relationship with Huntsville, Alabama, that can do beyond (16 weeks),” she said.

“OK,” the woman replied. Hamlin guided her out of the room to talk to a staffer about the referral.

These were the limits of choice, even with Roe still technically the law of the land.

The patient might have waited weeks to get her first appointment at the Pink House because Texans were streaming into every clinic in the South following that state’s recent ban on abortions after six weeks. Then she ran into Mississippi’s mandatory 24-hour waiting period.

And the threats and harassment directed against local abortion providers meant that when Hamlin flew home to Boston, there would be no one in the state who could or would perform the procedure for days – critical days.

The Alabama Women’s Center in Huntsville, which performs abortions up to 21 weeks and six days, is more than five hours from Jackson by car. The clinic sees about five patients who have been referred from the Pink House every week, according to its office manager Makeda Harris.

That state has a 48-hour waiting period, meaning Hamlin’s patient would likely have to spend two nights in an unfamiliar city or make a long round-trip drive twice.

Hamlin felt terrible realizing that her patient would just barely miss out on being able to get an abortion in Mississippi.

Cases like this one raised the question of how much she was willing to sacrifice.

“I could do it today, but it’s a law that I can’t,” she said. “How many hoops do you jump through? … Should I stay a little bit later? I’ve done stuff like that, but you can also make yourself completely insane. If I miss my plane, I’ll be a really unhappy person … You can’t make yourself completely crazy.”

The constraints on the Pink House limit patient options in another way: Because there are so few slots available for surgical appointments, those whose pregnancies are under 11 weeks are urged to opt for a medication abortion.

That process is safe, but it involves hours of cramping and heavy bleeding, and often lighter bleeding for weeks afterward.

During Hamlin’s consultations on Wednesday morning, two patients whose pregnancies were early said they were scared of the pills and wanted a surgical abortion. Hamlin said she doesn’t hear that very often, and since the doctor coming in on Friday and Saturday could do the surgeries, she didn’t try to push them to take the pills.

“You want to give people all the choices,” she said. “If just one person does that, no big deal. But if people start coming in for their eight-week, seven-week surgical procedure, pretty soon we’re not going to fit all the 15-weekers in. So it’s always that balance of, how can you help the most people?”

The war outside Jackson, Mississippi clinic

The war outside the Pink House started years before Hamlin first arrived in Mississippi.

In the 1980s, Mississippi had more than a dozen abortion clinics. Around the country, the number of providers began to fall as abortion opponents bombed clinics and harassed doctors. States also began imposing strict rules around clinic operations; in 1992, Mississippi passed the country’s first mandatory 24-hour waiting period.

By the following year, there were only three clinics. And in 2004, the Pink House became the last clinic standing.

Barbara Beavers, who has protested outside Mississippi’s abortion clinics for decades, remembers those days. She and her husband founded an anti-abortion pregnancy center in 1988.

At one point, she was a frequent presence outside a building that housed an abortion clinic on the second floor.

“Maybe a few times I did chase them up the stairs, and say, ‘Come home with us! Come home with us!’” she said, sitting in a camp chair outside the Pink House on Tuesday afternoon. “My husband liberated me to do that, and we’ve had girls in our home.”

“Here, we have to stand here,” she said, reminiscing about the days of easier access to patients. “We have to shout at them for them to hear us.”

Since Derenda Hancock established the Pink House Defenders in 2013, the volunteers have served as a buffer between patients and the people aiming to dissuade them from entering the clinic. While escorts at other clinics may ignore protesters, the Defenders believe confrontation fights abortion stigma and can help change “the cultural narrative” around abortion.

Since the leaked opinion draft came out in early May, there have been relatively few protesters outside the clinic. Some of them are preaching and passing out supplies in Ukraine. Others, the street preachers, are using the early summer to do yard work. With June being LGBTQ Pride Month, some regulars are busy protesting those events.

For the escorts, this is a bitter time. Hancock and Kim Gibson, who joined the organization in 2017, have felt for years that this day would come. Now, the world is watching, and it’s too late.

They’re also exhausted, as the clinic’s operating days have increased from three days a week to five or sometimes six. They guide patients into the parking lot for up to 10 hours at a time while the temperature climbs into the 90s and the shade disappears.

“We’re just sitting here waiting for the ax,” Hancock said. “It just needs to go ahead.”

When Hamlin started working in Mississippi in 2017, she was motivated by the desire to help people outside of her “pretty nice bubble” in Boston.

She wanted to practice in a state where access to abortion is limited – so limited that advocates say many people already believe it is illegal here.

On the morning of Hamlin’s first full day at the clinic, an anti-abortion demonstrator known to the escorts as “Stepper” took up her usual spot down the street from the parking lot entrance. She declined to share her name with Mississippi Today; the nickname comes from her tendency to pace up and down the block as she waits.

“It’s a lot quieter than I thought it would be,” she said of the period since the leak. “I thought the community would have been all over this. That case is going to put Mississippi on the map.”

Around 9 a.m., a woman wearing a crucifix necklace got out of a car and headed toward the clinic. Stepper called out after her as the driver of the car idled outside the clinic.

“Do know that God loves you and you can make a different choice,” she said. The woman didn’t look at her.

“What is this?” asked the woman’s driver, a middle-aged woman who said she works for Uber, while gesturing at the Pink House. The passenger had told her she was going to work.

“This is an abortion clinic,” Stepper replied.

“I thought they outlawed that,” the driver said.

‘Because it’s the only (abortion) clinic in MS’

Brooke Jones, a 28-year-old Jackson native and a sonogram and lab tech at the clinic, spent her afternoon break sitting on the patio with a bag of chips she decided she didn’t want to eat.

Jones said it feels like everyone at the Pink House is thinking about the upcoming Supreme Court ruling, but not talking about it much. What would she do if Roe were overturned and the clinic closed?

“Cry,” she said. “And not just because this is my job. Because it’s the only clinic in Mississippi.”

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Brooke Jones poses for a portrait in Pearl, Miss., Wednesday, June 15, 2022. Jones is a sonogram and lab tech at the Jackson Women’s Health Organization. Eric Shelton Mississippi Today

Jones has always been pro-choice. She joined the Pink House staff two years ago, thanks to an acquaintance who worked at the clinic and curiosity about what took place there.

Before that, she worked at group homes for kids.

“I know the kids they want you to keep and tell you the state is going to help – they treat them like shit,” she said.

If clinic director Shannon Brewer approves, Jones wants to move to New Mexico to work at the new facility Brewer and Pink House owner Diane Derzis are opening there. She’s made a list of pros and cons, and doesn’t see many cons. It’s a chance to keep doing the work she knows how to do and experience life in a new state.

In the meantime, she keeps coming to work. Every morning and every afternoon, she walks past the protesters. She’s memorized their lines.

“‘You can find something else, we can help you, let’s get you something else, you do not need the blood of innocent lives on your hands!’” she recited. “I’m like, ‘shut the hell up.’”

They don’t bother her, but patients sometimes say they were already scared and the protesters made it worse, she said.

Jones gestured toward Beavers, who was sitting in her camp chair by the fence.

“She’s going to sit there until everybody clocks out and walks to their car,” she said.

Then Jones went back to work to prepare for the afternoon’s surgical procedures.

Beavers, a leader of the pregnancy center movement in Mississippi, was hoping to get women to turn toward the Cline Center, a crisis pregnancy center across the street from the clinic, where they could get a free ultrasound. Around the country, these centers aim to dissuade women from seeking abortions and often offer supplies and parenting classes.

Now, they are the centerpiece of what Gov. Tate Reeves calls a “new pro-life agenda.”

The state’s nearly 40 centers can receive up to $3.5 million in tax credits thanks to a bill passed in the most recent legislative session. They are not regulated by the state department of health, and there are no rules or reporting requirements on how they spend the money.

Beavers said that after Roe falls, she wants to see the pro-life movement focus on helping women who have had abortions deal with “this hurt and this pain.” She has been praying for “revival.”

While Beavers has her priorities, Hamlin and those who work with her see a bigger problem to address: the lack of health care access in Mississippi, the state ranked at the bottom of most health indicators and one of only 12 that has not expanded Medicaid.

When Hamlin started working in Mississippi, she was shocked to meet so many patients who didn’t have health insurance, which meant they couldn’t afford to see a regular OB-GYN and often weren’t sure how to get or pay for birth control.

But Beavers doesn’t see much value in paying for people to get health care.

“We’re giving money to have babies without husbands, in my opinion,” she said.

“You can get health care in Mississippi,” she continued. “… They’re getting all their money from the government anyhow.”

Around 5 p.m., Beavers packed up and left for her weekly “post-abortion healing meeting” with women who have had abortions. They are told that accepting that they killed their child “is the first step in grieving,” according to a lesson plan Beavers shared.

Not long after Beavers left, a 24-year-old woman walked out of the clinic holding a bag of pills and started down the block toward her car. She had just taken the first pill involved in a medication abortion, and within the next 48 hours she would take the second set.

“I’m young, and I already have children. I’m a single mother,” she said. “And it’s already basically hard for me. I’ve barely got my head above water, with the high gas prices and basically we’re in a recession, they just don’t want to admit it … I think it would be selfish to bring another child into this world, and I’m knowing that I’m not able, physically or emotionally or mentally.”

Even making $15 an hour, she was just scraping by, she said.

Growing up in Jackson, she saw the anti-abortion protesters around town from time to time. They once posted up outside her high school with big posters of fetuses, which felt to her like harassment.

She had mostly managed to ignore them walking into her appointments at the clinic. When she heard them offer help, she didn’t believe it. Would they help her pay for housing and child care? Would they do that for the dozens of people who visited the clinic every week?

“Y’all don’t know us by a cat or a dog walking down the street,” she said. “When they go home, they’re living comfortably, without a care in the world, besides what’s going on with our bodies.”

If Roe falls, advocates expect the nearest abortion clinic will be in southern Illinois, a seven-hour drive from Jackson. Would she make trip?

“I would go,” she said.

Will doctor see Jackson clinic again?

Just before 8:45 a.m. on what might end up being her final day working at the clinic, Hamlin turned off State Street and angled into the clinic parking lot. As the escorts waved her to her parking spot, 78-year-old David Lane left his place across the street and walked toward the driveway.

“Cheryl, you need to quit killing the babies!” he called. “You’ll answer for every child you’ve ever killed. Won’t you repent and quit killing the babies?”

As Hamlin got out of her car, escorts stood nearby, eyeing Lane. Because the protesters aren’t allowed to cross onto clinic property, Lane kept shouting at Hamlin from yards away.

“We know you make a lot of money, but it won’t do you any good when you’re in a casket and your soul burns in hell for dying as a murderer. Won’t you quit?”

Lane had no megaphone—the protesters who’d left for Ukraine typically brought that. Hamlin couldn’t even hear him, but that didn’t matter to Lane: He shouted at her as a matter of duty and custom.

Hamlin disappeared into the clinic, and Lane shuffled back to his chair. He understands why the clinic’s doctors must travel from out of state. He helped make it that way.

“Nobody will do abortions from Mississippi here because they’d get recognized. They don’t like people coming to their house,” he said. “We go to the neighborhoods and tell everybody in the neighborhood what they do. They don’t like that. But if it’ll get rid of them, and it’s legal, we’ll do it.”

The likely closure of the Pink House will change Lane’s life, and that of his brother, Doug, who also protests regularly. Before Doug left for Ukraine two weeks earlier, the brothers were driving down the road together. Doug put his arm around David’s shoulder, and David could tell he was about to cry.

“He said, ‘David, I’m sorry that we didn’t get to do what we planned,’” Lane recalled. “And our daddy raised us hunting and fishing. And what we wanted to do was retire one day, and go hunting and fishing. But now we come here.”

He paused to envision the world after the Court rules in Dobbs.

“So I’ll, maybe I’ll get to do a little hunting, and maybe I’ll get to do a little fishing.”

Hamlin walked out of the clinic just before 1 p.m. on Thursday. The parking lot was nearly empty. The escorts had left for the day. There were no protesters damning her to hell.

As she started the 20-minute drive to the airport, she thought about her work in Mississippi and what might come next.

In what she considered an otherwise standard career, performing abortions in Mississippi had, from the very beginning, felt bold. When she applied for her license to practice here, she almost hoped it wouldn’t arrive. Then it came in the mail.

“I’m like, ‘OK, here we go,’” she said.

Now, she was questioning how bold she was willing to be.

“I do feel like this is bigger than just abortion rights, and it really scares me,” she said. “And I’m feeling like … for the first time, questioning … How far am I going to take this? Would I do something illegal? I mean, I don’t know. Right now I don’t think I want to. I’m going to try to do everything through legal means. But…”

She paused.

“I guess at some point, if it’s really people’s lives at stake, I might.”

At the rental car drop-off, she got her duffel bag and backpack out of the Honda and retrieved a stray Earl Gray tea bag from the passenger seat. She walked across the parking lot into the airport, up the escalator and past the bust of Medgar Evers to security, a route she’s taken dozens of times before. She finished a can of seltzer, dropped it in a trash can, and headed for home.

She wasn’t sure when she would be back in Jackson. If Roe falls, the Pink House will close, and she’ll go to New Mexico for her next rotation.

But during her shift, she asked Brewer if she ought to buy tickets for July, just in case the Court doesn’t overturn Roe. Brewer said yes. So Hamlin left her spare t-shirts, running shoes, shampoo and toothbrush in the doctors’ shared apartment and booked her next trip to Jackson.

This story was originally published June 18, 2022 1:02 PM.

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