One year post-Roe is an as-told-to series led by Prism’s Editor-at-Large Tina Vásquez, marking the milestone by featuring new and veteran advocates and organizers, abortion storytellers, providers, clinic directors, abortion fund volunteers, and reproductive justice organizers. You can read the complete series here.
Alison Dreith has spent years of her life fighting for abortion rights in a region of the country where attacks on bodily autonomy are the norm, not the exception. As the Midwest Access Coalition’s (MAC) director of strategic partnerships, she’s helped hundreds of people maneuver through the increasingly complicated process of accessing abortion care. Since Roe was overturned last year, the abortion fund’s net of support has expanded further across the country. MAC now helps a large population of Southerners access care in Illinois, an outlier in the Midwest that allows abortions to take place until the time a fetus can exist outside of the womb, around 24 to 26 weeks gestation.
For the last three years, Dreith has also worked part-time for Women’s Health Specialists of California, a small clinic nestled in California’s Sierra Nevada mountains. Dreith told Prism the clinic has recently seen multiple patients from Texas. This is part of a larger, nationwide trend. When Roe was overturned, it created a dangerous domino effect: More abortion bans and restrictions meant fewer clinics providing care. Fewer clinics providing care meant clinic wait times got longer. Those living in states with six or 12-week bans do not have weeks to wait for a clinic appointment.
Dreith recently spoke to Prism about how these dynamics are playing out on the ground and the extraordinary steps the anti-abortion movement takes to control the bodily autonomy of marginalized people. Here she is, in her own words:
I had a strange moment of grief after the [Supreme Court] leak; the following Wednesday, something very visceral happened inside of my mind and body. I went on a drive to try to shake it off, and I ended up at my dad’s gravesite, which I don’t really visit and don’t really have a spiritual or physical connection to. I sat there, put on a George Harrison album, and wept for an entire hour. After that, I haven’t felt any emotion. I feel numb, and I’m weirdly aware that I have no emotion. I suspect it’s some sort of protection mechanism. I can’t sit around and really assess what’s happened; I can’t obsess over what they could possibly do next. I have to keep moving to support our clients. I just have to keep working because pausing means having to think about the trauma.
The Midwest is really complicated to talk about. We have [Illinois], an outlier in the region, and then a mix of bans and restrictions tied up in the court system. I wish we had talked more about how confusing this atmosphere is for people. It’s hard to make sense of where things are, especially when you factor in regulations like waiting periods that are imposed by the state. Clinics also have longer wait times because of the 14 states that are no longer providing abortion care. It’s such a weird time when a whole region of the country is in limbo. Abortion may still be legal in many states, but it’s not accessible.
I spent over a decade of my career in Missouri where there was one abortion clinic, and pretty much everyone had to travel for care. Even before Dobbs, Midwesterners had to travel for abortion care. The biggest change for us is that, prior to 2022, I would say about 90% of our clients were Midwesterners. Now we are supporting Midwesterners and a whole lot of clients from the South who are coming to the Midwest for care. Navigating the legalities is more challenging because the scope of the work has changed. Before, I had to monitor about 11 states very closely, and I generally knew each state’s abortion laws. Now I can’t keep up because it’s changing weekly, if not daily.
The environment is just so different. Now, it’s not unusual to get a call from someone who has an appointment in Georgia. We have to make sure they can still access care in Georgia and also figure out what turn of events led them to seek help in the Midwest to get to an appointment in Georgia. The other scary shift is how horribly things are compounding for people.
Prior to Dobbs, most clients were in search of the most affordable abortion care option because they were getting help from a practical support organization, and they were low-income and couldn’t afford to get to their appointment, let alone pay for their abortion. Now—because of bans from Texas to West Virginia and as far north as Missouri—people are frantically trying to get the earliest appointment possible. It wasn’t enough that money wasn’t on their side; now, time isn’t either.
I recently had a client from Kansas, a state that still provides some abortion care and is a destination state for people from Oklahoma, Texas, and the rest of the South. But clinics in Kansas are booking appointments two or three weeks out because they’re so busy. People can’t wait two or three weeks for abortion care. This client learned that a clinic in Minnesota could see her on her day off of work, so she went to Minnesota. This is the new normal we’re seeing for people who are up against the clock and working-class people who don’t get paid time off. I work part-time at a clinic in Northern California—and I’m not talking about San Francisco. I’m talking about a Republican-led area in the mountains, three hours away from Sacramento. We’re now getting clients from Texas. I just keep thinking: how the hell did they even find us? But they find us because they have to. There might be closer states where they can access care, but they can’t get an appointment in time.
As abortion care is getting harder and harder to access, you also have clinics facing more attacks. In Illinois, a state that tried to codify the right to abortion, an anti-choice protester rammed his truck into a new potential clinic on the border of Indiana in Danville. The mayor of Danville is anti-choice, and there has been a lot of organizing against the new clinic. The city passed a “sanctuary for the unborn” ordinance, the kind that was very popular in Texas a few years ago. Now that there are three clinics in tiny, rural Carbondale, Illinois, anti-choice protesters are coming for Carbondale and trying to pass a sanctuary ordinance there too. Attacks and hateful rhetoric are on the rise–—even in “protected states” like Illinois. I really think that, as we see more restrictions and bans, the attacks are going to get worse. They successfully overturned Roe; what else do they have to do with their lives but travel and harass abortion seekers? Every day across the country, clinic workers, physicians, patients, and clinic escorts are getting harassed and stalked, and surveilled. It’s very dangerous right now.
I’ve been around for some really tough abortion battles, especially in Missouri. When the governor called a special session on abortion, my name was specifically called out on the floor of the Missouri Senate. I have received death threats at my home. I’ve been doing this work a long time, and it feels like abortion rights activists have been gaslit for 50 years.
We’ve always been very clear that this was never just about abortion or a so-called concern for people’s health. This has always been about control, patriarchy, and white supremacy. If they cared about health, would Missouri have just banned gender-affirming care for minors [and some adults]? They are coming for all marginalized groups, like we knew they would. We need to break out of our silos and fight for all marginalized communities. It was all happening in the shadows, and now it’s in the forefront. It’s made this work more dangerous, and it’s made it more dangerous for people who need the kind of support we provide.
And yet, this moment has also made me feel kind of relieved. That might sound weird to say, but it’s like we’re not screaming into a void anymore. People can’t just say we’re being “hysterical.” It’s not just us watching shit get chipped away day by day. The whole country is watching now.
The effects of overturning Roe will be felt across generations, and we have to take some responsibility. When Bill Clinton said abortion should be “safe, legal, and rare,” the abortion rights movement accepted that. That wasn’t a great step forward after all of the clinic bombings in the 1980s by the anti-abortion movement. Less than 10 years ago, the movement laughed at All Above All’s efforts to overturn the Hyde Amendment. Pretty consistently, we’ve seen a handful of reproductive justice groups try to make abortion more accessible for everyone, and we see reluctance across the movement. We’ve come a long way, but we have a long way to go. Planned Parenthood is now “restructuring” in favor of sending resources to [state] affiliates, and we’ve also confirmed affiliate staff are being laid off. It’s fucking horseshit. We always knew this would come down to the states. Did they just come to that realization? That was always the game plan.
The anti-abortion movement went into overdrive in 1973. They started in church basements and worked their way up to school boards, city councils, and courts. Now, they’re running Congress. The anti-choice movement has figured out how to use every tool at their disposal; no level of government is too low. In Missouri, the Department of Health tracked the periods of Planned Parenthood patients. They are going to attack abortion through any means necessary.
If we want abortion justice in the future, we need to operate in a similar way. We need pro-abortion champions at every level of government, on every board. When there are appointments or elections, we need to ask where people stand on abortion—no matter what the role is. Why is that important on a school board? Because they are deciding the sex ed curriculum. They’re running for state representative in six years. It’s all connected. We should absolutely ask where people stand on abortion for every fucking position. When bans started to go into effect, CEOs of companies had the power to make sure their company’s health insurance covered abortion; they offered to pay for employees’ abortion care. Abortion needs to be talked about in everything that we do, but unfortunately, so many people still treat it as a niche issue or because it’s still so stigmatized, it’s treated like something controversial we shouldn’t talk about. Now is the time to start asking questions about whether people are unapologetically pro-choice.