CARBONDALE, Ill. — Two years ago, this community had no abortion providers. 

But now, the 21,000-person college town boasts three — all which opened following the overturn of Roe v. Wade amid a growing need to support patients traveling from states with stricter abortion laws.

The opening of three separate clinics in the southern Illinois town is no coincidence. 

Illinois — the site of this week’s Democratic National Convention in Chicago, where reproductive rights has been a major theme — has emerged as an oasis for those in the abortion rights movement, particularly given bans and ongoing litigation in much of the South and Midwest. 

It’s also centrally located: From Carbondale, you can drive about 100 miles to reach St. Louis, 70 miles to Paducah, Kentucky or 260 miles to Indianapolis. 

And it’s about 215 miles to Memphis, the home of CHOICES, a longtime abortion clinic that stopped performing abortions in August 2022.

In October, CHOICES opened a second location in Carbondale to fill the void left in Memphis. 

“We’ve got to come to Carbondale. It’s where most of our people are gonna be able to get to,” said Jennifer Pepper, president and CEO for CHOICES. “We couldn’t figure out any math that meant anything else.”

CHOICES was not the only clinic to shift locations in the aftermath of the Supreme Court’s 2022 Dobbs v. Jackson Women’s Health Organization decision: Alamo Women’s Clinic of Illinois relocated from Texas to Carbondale in 2022. Last December, Planned Parenthood unveiled its own Carbondale location.

Pepper, who grew up two hours north of the town, said the CHOICES team visited Carbondale for the first time in November 2021 and spent the following year building up support with elected officials, law enforcement and community and religious leaders before opening its new location.

Carbondale’s shift to becoming an abortion destination has largely been accepted by the community. 

“We have a lot of support around here from people who are locals, people who are even from other surrounding cities,” said Aaliyah, a health center assistant for Planned Parenthood of Illinois based in Carbondale who requested to use only her first name for privacy purposes. Carbondale Mayor Carolin Harvey once offered to be a volunteer clinic escort.

CHOICES is in a nondescript former dermatology office, near a Kroger and a frozen yogurt chain. During a three-day stretch in July, few protesters surrounded the building.

One of the only people protesting beyond the clinic’s white fence was Bob Owens, a 78-year-old retiree who wore a shirt saying “A child is not a choice.” Owens said he was disappointed the town has become a destination for abortion clinics.

“We’re dictated here by Chicago. Above I-80 controls everything that happens and most of the time they don’t even know we exist,” he said.

Broader Illinois

While Carbondale is a hub for the southern part of the state, Illinois is, more broadly, at the forefront of many emotional and social support programs in the wake of Dobbs.

After CHOICES announced they were opening their Carbondale clinic, Pepper said she received a message from Illinois Gov. J.B. Pritzker that welcomed them and offered his assistance.

Pritzker has signed multiple laws protecting abortion access for residents and those traveling to the state since the Dobbs decision.

“It’s night and day,” said Pepper. “It is wildly different than providing care in Tennessee in the best way possible.”

That emotional support for reproductive care in Illinois predates Dobbs.

Planned Parenthood of Illinois runs a statewide behavioral health program, meaning patients who want to talk through any distress can be connected to an eight-person team of social workers and clinical counselors. Planned Parenthood can also connect patients to long-term counseling options or resources for intimate partner violence.

Clinics within Illinois which provides surgical abortions typically have a behavioral health provider there, said Elizabeth Ellis, lead behavioral health clinician for Planned Parenthood of Illinois.

An abortion decision in the United States “is consistently fraught because of all the stigma. I don’t think Dobbs has changed that at all. I do think it has added a level of distress because of logistics and enhanced stigma,” said Ellis, a licensed clinical social worker.

Since Dobbs, Ellis said patients are more likely to connect with her team later in pregnancy than if abortion were accessible locally to them.

The planning and logistical hurdles needed to get to a clinic in Illinois can be daunting, not to mention the “emotional processing that a patient needs to do,” she said. Other times, she’s seen patients who’ve traveled express doubt and simultaneous guilt that they’d be wasting aid money if they changed their mind.

“I spent a lot of time just listening and validating a patient’s experience because sometimes people just don’t have that,” said Ellis. “I would say the most heartbreaking thing for me is when patients come in, and they have literally nobody in their life they can talk to.”

Carbondale 

The 11,200-square foot Planned Parenthood is 4 miles from CHOICES. 

Pamela, a health center manager for Planned Parenthood of Illinois based in Carbondale who requested to use only her first name for privacy purposes, said that sometimes patients coming in will ask to talk about their behavioral health. Other times the staff may assess the situation to determine if the patient needs to be connected to someone.

Someone like Aaliyah is available to coach the patient through breathing to relax and advocate if they want any breaks or to pause during the procedure.

“A lot of the time, I feel like our patients come in here and they feel like they don’t have a support system,” said Aaliyah. “But even if they can’t turn to friends or their state, there are people that are out there to help them and then we are a part of those people. And if it means that we have to go the extra distance to make sure, we will seek that care for them.”

Hiccups

Most patients coming to Carbondale make a considerable journey.

The largest share of patients to CHOICES come from Tennessee and Mississippi. For Planned Parenthood, it’s largely from Kentucky and Missouri. Both clinics also get patients from Louisiana, Texas or even farther. 

Following Florida’s implementation of its six-week abortion ban on May 1, the clinics are expecting more patients from farther away that would have otherwise gone to Florida. 

Several states are within driving distance, but things become more complicated for a patient who does not have a car. For patients traveling farther, the nearest major airport in St. Louis is also more than a two-hour drive away.

For patients without a car, it can be a challenge.

“Carbondale is actually one of our challenging sites to get patients to. It’s our newest site. It’s like in the perfect spot…  but it is very challenging because there isn’t immediate airport access,” said Courtney McDowell, the patient navigation program manager of Planned Parenthood of Illinois.

McDowell said while she’s able to assist patients paying for fuel or with Greyhound or Amtrak, transportation within town is difficult.

“A lot of folks do drive into Carbondale, but Carbondale doesn’t have the best rideshare accessibility. After a certain time it is unavailable, which really hurts us,” said McDowell.

The Memphis-bound Greyhound bus only stops in Carbondale at 3:35 a.m., when rideshares aren’t operating and the town’s two taxi services are also closed. They’ve tried to connect to them unsuccessfully to expand availability.

The Amtrak to New Orleans and the bus to the St. Louis airport also operate graveyard shifts to and from Carbondale — though a frequent hurdle is that the buses are often not on time.

Chastity Mays, a birth doula and owner of Hathor Doula Services, also volunteers with the  Midwest Access Coalition, that provides practical support for abortion patients.

“It’s weird to some people that I’m a birth doula and that I’m helping out with the abortion clinics, but for me, it’s just health care,” said Mays, who provides rides for abortion patients with another volunteer.

About three times a month, she gets a text saying someone needs a late night ride from Amtrak to their hotel or from the airport. She’s hoping they’ll be able to either get more support volunteers to help with driving or another form of transportation for people coming to Carbondale.

“We’re not like a big city where transportation is simple,” said Mays. “Uber is not dependable. You are not going to be able to depend on them getting that.”

This story is part of a series supported through the Rosalynn Carter Fellowship for Mental Health Journalism.