Roe’s Final Hours in One of America’s Largest Abortion Clinics

At seven o’clock on Friday morning, Ivy turned on the lights of the Houston Women’s Clinic, the largest abortion provider in the state, where she has worked as a supervisor for nearly two decades. Since May, when the draft of a Supreme Court decision leaked, revealing its conservative majority’s intention to overturn Roe v. Wade, Ivy, who is fifty-six and asked to be identified only by a nickname, went to work each day knowing that it might be her last. But neither the likely end of a woman’s right to an abortion, nor Texas’s existing onerous regulations against it, had altered her brisk morning habits. Tucking her graying, hip-length hair into a bun and covering it with a black surgical cap, she sterilized all the syringes, counted the curettes one by one, and waited for her colleagues to trickle in. Only Ivy’s message to her patients had changed. Now every greeting had to come with a disclaimer.

A ruling on Roe v. Wade was imminent and the procedure could be banned at any time, Ivy would warn the pregnant women who approached the front desk, after the perfunctory good mornings. Friday, patients began arriving at eight o’clock, having negotiated picketers who were working the parking lot. “Let me see your I.D., mija,” Ivy said to the first woman to reach the light-filled lobby, where a large fish tank was murmuring away. The woman, dressed in black pants and a gray hoodie, was assigned a patient number to protect her privacy. Only four weeks along, she, like the vast majority of the morning’s patients, was coming for her second of two visits. As mandated by Texas law, women have to wait at least twenty-four hours after receiving paperwork and a sonogram that confirms their pregnancies. Now she was returning in hopes of having a second sonogram and then the abortion. To the right of the desk where Ivy checked her in was a framed proclamation, signed by the mayor of Houston, honoring the forty-fourth anniversary of Roe v. Wade.

That day, despite Ivy’s warnings, only a few women at the front desk seemed to register that their access to abortion was in jeopardy. The dominant concern was whether the ultrasound would determine that they were more than six weeks pregnant or had electrical activity in fetal cells—eventualities that, following the passage of a state law last September, would mean they’d be barred from receiving an abortion in Texas and need to seek care in a different state.

One by one, women were called into the back of the clinic to receive their ultrasounds and counselling sessions, or to await the doctor, who had not yet appeared. A row of stiff wooden chairs where they bided their time faced a framed photograph of Portofino’s cerulean bay. As the women stared at the Italian village, or their phones, a dozen anxious staff members huddled by the front desk. One of the medical assistants placed her phone against a stack of patient files so that her colleagues could see the Supreme Court’s schedule for the day. A nurse started braiding the receptionist’s brightly dyed hair. Ivy’s boss, Sheila, who directs the clinic, had been in touch with lawyers at the A.C.L.U. “It can come any minute,” she told her colleagues of the decision, adding with a nervous smile, “My sister is trying to distract me. She just sent me an article: ‘How to Stop Dating People Who Are Wrong for You.’ ” Someone yelled from another room: “Send it to me!”

Despite the tension, for the next hour, the workers tried to focus on their particular responsibilities, including answering the phone, which rang constantly. The faster they worked, the more patients they could ready to see the doctor, who would either give the eligible women pills to begin a medication abortion or proceed with a surgical one. But at 9:11 A.M., before the doctor had walked through the door and any abortions had commenced, Sheila heard from an A.C.L.U. lawyer. “Roe, overturned,” she said flatly. Ivy, emerging from the lab, hadn’t caught Sheila’s exact words, but she understood them when she saw her hands shaking.

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