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As originally published by The Press Enterprise, OC Register, and Pasadena Star on July 10, 2022.

On June 30, a 26-year-old mother of two and her friend left the Phoenix area at 10 p.m. and drove hundreds of miles to the Planned Parenthood clinic in San Bernardino.

They arrived about 4 a.m. and slept in their cars until the clinic opened at 6:30. The mother had an abortion and left the clinic around 10 a.m. to drive back to Arizona, where abortion faces new restrictions, if not an outright ban.

Such a journey, described by Dr. Janet Jacobson, is much more common since the U.S. Supreme Court overturned Roe v. Wade, which guaranteed a woman’s right to an abortion.

Even before the June 24 decision in Dobbs vs. Jackson Women’s Health Organization, Southern California abortion providers saw a surge in clients from states where, unlike California, abortion is outlawed or severely restricted.

The number of patients from other states spiked 900% at nine Planned Parenthood clinics in Orange and San Bernardino counties in the week following the ruling, Nichole Ramirez, a spokesperson for Planned Parenthood of Orange and San Bernardino Counties, said via email. A new San Bernardino County clinic could be in the works to handle the influx.

“I have patients driving all night, leaving their kids with others, leaving work, leaving school, and that’s going to be hundreds of patients per month coming just to my health center,” said Jacobson, medical director for Planned Parenthood’s Orange and San Bernardino counties affiliate.

“So across the entire state of California, that’s thousands of people traveling hundreds of miles and this is a five-minute procedure. That’s crazy.”

With abortion either illegal now or expected to be outlawed in 26 states, California — with its robust abortion-access laws and state leaders vowing to expand abortion rights — is set to become a national sanctuary for women who want to end their pregnancies. And Inland Empire counties, which border Arizona and Nevada, look to be common entry points.

“We know that this is something that is going to continue to escalate in the post-Dobbs decision, that women in states that don’t have access to care are going to find their way to San Bernardino County,” Rep. Pete Aguilar, D-San Bernardino, said Tuesday, July 6, after touring the San Bernardino clinic with state Sen. Connie Leyva, D-Chino.

Post-Roe v. Wade, between 8,000 and 16,100 women annually are expected to travel to California for abortion care, according to a study from the UCLA Center on Reproductive Health, Law and Policy. A Planned Parenthood campaign includes signs in malls and billboards such as a postcard-style one in the Riverside County desert city of Rancho Mirage that states: “Welcome to California where abortion is safe and still legal.”

In the past 12 months, Planned Parenthood’s San Bernardino, Upland, and Victorville health centers accounted for about a third of California’s out-of-state abortions, Ramirez said. In the past 13 days, those three locations now account for 45% of out-of-state abortions in California, Ramirez added.

It’s a similar story for Planned Parenthood of the Pacific Southwest, which has health centers in Corona, Riverside, Moreno Valley, Hemet, Coachella and Rancho Mirage.

Since the Supreme Court ruling “we have had a significant increase in the number of out-of-state patients seeking abortion care,” Sandra Duran, a spokesperson for the Pacific Southwest affiliate, said via email. “Our health centers closest to the Arizona border in Riverside, Coachella, and Imperial have all seen the most significant increases in out-of-state patients.”

Since the ruling, Planned Parenthood Pasadena & San Gabriel Valley has seen a 567% increase in patients coming from other states for in-clinic abortions. The nonprofit group runs five health centers in Alhambra, Baldwin Park, Highland Park, Pasadena and Glendora.

As a result, the organization has ramped up training for clinicians to become abortion providers, expanded telehealth services, opened new centers and bought more medical equipment.

The organization does not collect data on abortion to protect patient privacy, said Diane Padilla, the affiliate’s vice president of communications and marketing.

But ”people who need and want to get an abortion will do everything they can to get an abortion,” she said. “The bans in states don’t stop people from getting an abortion, it just makes it harder for them to get the care they need.”

Planned Parenthood Los Angeles, which runs more than 20 centers across the county, declined to discuss the number of patients it has seen since the Supreme Court ruling or to answer other questions.

Sheila Green, central vice president of the California ProLife Council, is not surprised to hear of the influx of out-of-state women seeking abortions in California. The council plans to make the public aware of California’s “extreme” abortion laws, she said.

“Our hope is that the Dobbs opinion will awaken the consciences of the voters in California,” Green said. “We’re inviting minors, even sex traffickers, to take advantage (of California’s abortion laws) … I’m sure most Californians don’t want their own daughters getting an abortion without their knowledge or consent. Well now, we’re bringing them in from other states …”

Green said she hopes protesters outside California abortion clinics can persuade some women to change their minds, but “it would be very difficult to reach across to other states because how would you even locate women who wanted to have an abortion?”

Clinics Were Ready for Ruling

California abortion providers have been planning for the end of Roe v. Wade for years and those efforts intensified when a draft of the Dobbs ruling leaked in May.

That has meant fundraising, hiring more staff, buying equipment like ultrasound machines and rearranging schedules and workflows to handle greater demand, Jacobson said. Planned Parenthood intends to open another clinic in San Bernardino County in January “to assist with patients coming from Arizona mostly,” she added.

Late last year, staffers at two Planned Parenthood affiliates — Arizona and Pacific Southwest — hammered out a plan. They knew the health centers in Southern California would face the greatest demand and wanted to coordinate.

A patient’s pregnancy is confirmed in Arizona. Then, with medical records and ultrasound in hand, she is referred to clinics in California. It’s up to the woman to decide how to proceed – but if she does, the plan is clear and well organized.

Besides Arizona, many women traveling to California for abortions come from Texas, where a 97-year-old abortion ban is on the books and lawmakers last year banned abortion from the moment of fertilization in a law set to take effect in late July.

Last September, Texas banned abortions after a fetal heartbeat could be detected. After that, “patients from Texas were then leaving Texas (and) going to neighboring states seeking care, and there were limited spots in those states which pushed people further and further out (to California) in sort of a ripple effect,” Jacobson said.

Patients from Utah, Nevada and Idaho have come to the San Bernardino clinic, Jacobson said, with some hailing from as far as Missouri and North Carolina.

Because many women seeking abortions already have children, child care is a big obstacle for those traveling to California, Jacobson said. “Some people cannot afford to leave their jobs or get time off from school to travel,” she said.

“Some people don’t have cars. Some people are undocumented (immigrants), so flying out of the question … And unfortunately, not everyone will be able to travel and those are the people that will be forced to continue the pregnancy.”

Getting a clinic appointment is “time critical, especially for people seeking medication abortion that can only be done up to a certain point in the pregnancy,” Jacobson said. “And so waiting for an available appointment for a couple of weeks is not really a good option and if we have appointments available immediately, then people will come all the way to us.”

‘Absolutely Willing’ to Help Out-of-State Women

Since the ruling, Gov. Gavin Newsom and fellow Democrats, who control the state legislature, have taken steps to bolster abortion rights for Californians and out-of-staters.

A ballot measure going before voters in November seeks to make abortion a state constitutional right. The governor this year signed bills shielding doctors, women and others from civil lawsuits in states where abortion is illegal and eliminating insurance copays for abortion services.

While she’s grateful for the donations that have come in, “I do think that it is not sustainable for us to depend on donors with the number of patients we’re going to be seeing,” Jacobson said. “The governor’s budget does provide a funding stream that’s going to be very helpful to us.”

The influx of out-of-state patients “is going to be a strain on our system with more people than we usually see,” Jacobson said. “But we are absolutely willing to do that.”

She added: “It is a necessary and essential part for people everywhere to be able to control their own bodies and their futures by determining whether they want to (be a) parent or not. So I feel just very glad to have patients coming from out-of-state that we can help. I feel terrible and really heartbroken for the people who can’t get to us or to someone who can help them.”