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Arizona clinic prepares for Supreme Court overturning Roe v. Wade

LEILA FADEL, HOST:

If the Supreme Court overturns Roe v. Wade in the weeks to come, in half the country, abortion will likely be banned or sharply restricted. So we're taking you to Arizona, a state where abortion could be partially banned or fully banned and criminalized if federal protections are reversed.

In Phoenix, on the fourth floor of an office building, Dr. DeShawn Taylor walks in through the back door of her small private practice, Desert Star Family Planning.

DESHAWN TAYLOR: Sometimes we can see parts at nine weeks, but we're now...

FADEL: This morning is a typical day. She's short staffed, like so many business owners in the midst of this pandemic. And before patients start to file in, she pulls the staff together for a huddle in the reception area.

ROSE ESPERICUETA: At 9:30, we have a surgical.

FADEL: That's the medical receptionist, Rose Espericueta, running through the day's schedule.

ESPERICUETA: And then at 10 o'clock, we have an abortion by pill. And then at 10:30, we have an abortion by pill follow-up.

FADEL: The doorbell pings as another patient walks in. In the small waiting room, a gaggle of people sit in black chairs. One woman's with her partner, another's alone and a third is with her mother. A nurse calls her name. Her mom kisses her forehead, and she heads in alone for her procedure - a surgical abortion.

TAYLOR: OK. We're all set. Rhi (ph), room's ready?

RHI: Yes.

FADEL: It all feels like a normal day, but there's an undercurrent here. Changes are coming. When the draft of the Supreme Court opinion, which would overturn Roe v. Wade, was first leaked, Dr. Taylor's phone lit up with dozens of messages.

TAYLOR: Every person who had a way to contact me, I was getting contacted.

FADEL: And what were they saying?

TAYLOR: Well, mainly, we're here for you. How are you? All these type of things. Now, I will say honestly that I was not surprised.

FADEL: She heard the oral arguments, she says. She knew this could happen. The leak - it gave her a glimpse into the future. She's getting ready.

TAYLOR: This is my practice, and I want to make sure people get care. And I have to do what I have to do to keep the doors open.

FADEL: Now, she's admittedly not an emotional person. She's solutions-oriented. On this day, she moves around the clinic in her magenta scrubs with authority. Gold hoops peek out from her shoulder-length curly hair, and a medical resident trails her.

Dr. Taylor started this clinic nine years ago because she had a vision for how abortion care should be delivered.

TAYLOR: It was never my intention to be in private practice ever, ever, ever. But then it just became very clear that if I was going to establish a way of care the way I envisioned it, I wasn't going to be able to do that working for somebody else.

FADEL: And what was it about the way abortion care was provided?

TAYLOR: Well, if we say that abortion is health care, then when people come in to an abortion appointment, then they should just feel like they're at the doctor's office. It shouldn't feel different. I want a patient seeking abortion care to feel like they're really cared about, thought about, that they deserve excellence.

FADEL: Yeah.

TAYLOR: And so I integrate the abortion care with my general gynecology care.

FADEL: Now, not everyone thinks abortion is health care. Arizona, like the country, is divided. About half of adults in the state believe abortion should be legal in all or most cases, and the other half thinks it should be illegal in all or most cases. On one wall of Dr. Taylor's clinic is a sign that says, let's be awesome today. There are medical pamphlets on weight control, contraception and fertility. And then there are pictures of people with their own stories about why they got an abortion - a single mother who didn't have the resources to care for a child with a genetic disorder, failed birth control, a teenager abandoned by an older man when they found themselves pregnant. The photos look like America - Black, Indigenous, Latina, white, transgender, cisgender.

If this leaked draft opinion becomes reality, what does that mean for your practice and your patients and you?

TAYLOR: So that would be no abortions happening at this clinic. I do provide miscarriage management, and I would anticipate that we'd see an increase in that.

FADEL: What do you mean?

TAYLOR: When more people start to try to induce their own abortions by whatever means are available - and now it's safer to do that with abortion pills - then there are going to be some unsuccessful attempts, and people are going to present to health care providers in what appears to be a miscarriage. This type of hostile environment creates fear. And this is how people die because they're - have pain, they're bleeding. They might do their own pregnancy test at home. And now they're afraid to be criminalized, so they're not going to seek care.

FADEL: So many things remain unclear. There are two laws that would come into play in Arizona if Roe v. Wade is overturned - a recent one that bans abortions after 15 weeks; the other has been on the books since 1901. It would ban abortion completely, and Dr. Taylor or anyone that helps with an abortion could face up to five years in prison if they continued. The only exception in that law is if the person giving birth would die.

Now, it isn't Dr. Taylor taking the confused calls from patients who want to know what will and what won't be legal if Roe v. Wade is overturned.

(SOUNDBITE OF PHONE RINGING)

ESPERICUETA: Desert Star Family Planning. This is Rose. How can I help you?

FADEL: It's Espericueta at reception answering the calls.

ESPERICUETA: So many. It's so many. I remember this call. It's this patient. She wants to continue with her pregnancy, but she's always had trouble. She's always had miscarriages. And she was calling, crying, basically stating that, what if this pregnancy that she's - currently has right now does become ectopic? But she's like, what if I have to travel out of state? She's like, what if I don't make it? What if I'm going to die on the way out of state if Roe v. Wade does go away?

FADEL: There is so much confusion.

ESPERICUETA: So it's scary.

FADEL: Just above her computer is a plastic sheet protector taped to the wall. A yellow Post-it note reads, violent reporting sheet.

OK, so I see for February 2022, you got an email. Quote, "I don't know how you sleep at night getting rich off killing unborn babies. You're a disgusting human being, and there's a special place in hell for people like you."

ESPERICUETA: Yeah. Oh, those come monthly. We get them from New York, Florida, everywhere.

FADEL: The clinic documents the threats it receives. Each month, there's a new entry. But the threat to this staff, Dr. Taylor says, may now come from the state.

TAYLOR: I have no interest in going to jail. I did not go to medical school to go to jail. I have no interest in performing illegal abortions ever. I'm just going to be honest. I don't have the complexion to assume the risk and say, slap my hand later. We see the people who have been criminalized already, the pregnant people who have been criminalized already. They have not been white. So I have no illusions about where I stand on the issue and what type of risk I can take and not take.

There is a patient waiting, so let's go.

FADEL: Down the hall, a woman named Martha is sitting in an exam room. We're only using her first name for privacy. The clinic medical assistant, Albany Jackson, is talking to her.

ALBANY JACKSON: As you know, you do have three options. There is abortion, adoption and parenting. It does look like you're going in the way of abortion, and you're just not fully sure on whether you want to do abortion by pill or by surgical.

MARTHA: Right.

JACKSON: Those are your...

MARTHA: Which one's more convenience, as in moneywise? How much is the pill, and how much is the other one?

JACKSON: All right. So for the...

FADEL: The pill is 620. Surgery is 640.

MARTHA: I'll do the surgical one.

JACKSON: OK.

FADEL: She chooses surgery because it's a quicker recovery. She can get back to work. Money is on Martha's mind. Her husband lost his job in the pandemic. She says she makes $17,000 a year if she's lucky, and she supports her family.

MARTHA: I have two kids.

FADEL: Oh, you have two kids already.

MARTHA: They're 10 and 12. Other than - my husband is going through some process. He is, right now, in the stage of drugs, where (crying) - where it's more difficult for me to have more kids. He's one of the victims that are, right now, struggling to get - I don't know. They're called blue pills.

FADEL: Blue pills. Like opioids?

MARTHA: Yeah.

FADEL: Yeah.

MARTHA: So he's on that stage. Plus me, you know, being a mom and all that - and I can't.

FADEL: It would all fall on you.

MARTHA: It would all fall on me. We lost our home.

FADEL: So sorry.

MARTHA: So now it's like - it gets worse. So I don't want to have a kid, knowing the situation I'm in.

FADEL: Yeah.

MARTHA: You know?

FADEL: And I heard her mention the prices.

MARTHA: Yeah.

FADEL: Is that - how is that for you? Because insurance doesn't cover any of this, right?

MARTHA: Um, it's...

FADEL: Just have - yeah.

MARTHA: I have to, yeah. This is not something where - I wouldn't think, as a woman, to do. I've never thought about it - never been against it, never been with it. But sometimes, as a woman, we get caught in a situation where we have to acknowledged the future.

FADEL: For a decade, she was on birth control. But a month ago, she says she just could not afford it anymore. That's why she's here.

TAYLOR: Thank you very much for the opportunity to take care of you.

MARTHA: Thank you. You know, thank you for everything that you do for me.

TAYLOR: You are very welcome.

FADEL: This week, she returned for her surgery and left with a doctor's note to give to her job. But if the Supreme Court overturns Roe v. Wade, Dr. Taylor will have to stop this part of her practice, and people like Martha will have to go somewhere else.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.