DAYTON, OHIO (AP) — In the dim light of a clinic ultrasound room, Monica Eberhart lies on an exam table as a nurse moves a probe into her abdomen. Waves of fetal heart activity ripple across the screen.
“The heartbeat,” says the nurse. “About 10 weeks and two days.”
Eberhart exhales. It’s good news. “That means I’m a little down,” she says, raising her hands and crossing her fingers.
The 23-year-old mother of three is fighting a political clock. When she learned she was pregnant again, she decided an abortion was her best option — even if it meant navigating a patchwork of state laws enacted since the Supreme Court overturned Roe v. Wade.
Hours after the ruling in late June, Ohio imposed a ban on abortions as soon as cardiac activity is detected, around six weeks into pregnancy. Since then, the Women’s Med clinic in Dayton has referred hundreds of patients like Eberhart to its sister facility of the same name in Indiana, 120 miles away. There, in-clinic abortions are allowed up to 13 weeks and six days of pregnancy — for now. Indiana lawmakers recently approved a ban on nearly all abortions after weeks of debate in the State House. The law takes effect on September 15.
Just 10 weeks into her pregnancy, Eberhart will need to travel to Indianapolis for an abortion. It’s annoying, a hassle — but she’s more than ready. With new state laws and court challenges popping up on a daily basis, he doesn’t want to wait any longer.
“I have to, I really can’t wait. I’ve put everything on hold just to handle this one thing,” says Eberhart. “I can’t afford another baby, be it financially or mentally.
Women’s Med has performed few abortions in Ohio since the state ban went into effect. Most women do not find out they are pregnant until after six weeks. The Dayton Clinic, a two-story building that blends in with its leafy suburban surroundings, has been in business for nearly 40 years. The last few days have become increasingly chaotic, workers say.
They see desperate patients — a teenager who was raped, women with ectopic pregnancies, families unfamiliar with Ohio law. Some workers have left for more stable jobs. Those who remain say they are determined to continue helping patients, even if it means sending them out of state.
“We’re going to see as many people as we can and do as much as we can for those people until we close,” says Dr. Jeanne Corwin, who works at both clinics. He knows they are likely to close next month. Until then, she’s focused on preparing her Ohio patients for travel.
During Eberhart’s visit, she and Corwin sit in her office. States have various requirements about what patients must be told — procedure details, aftercare instructions, birth control methods. But Indiana, Corwin explains, requires her to provide what she derides as false information about fetal pain and to discuss medical cremation. It is, he says, a bureaucratic process aimed at preventing abortions.
Eberhart listens. Like most of the women at the clinic, she is undaunted.
The Indiana clinic can squeeze it in the next day, despite the influx of patients. The appointment gives her just enough time to meet Indiana’s requirement of an 18-hour waiting period after the in-person training and counseling session. Anti-abortion advocates hope some women will decide not to have the procedure during this window, but Eberhart knows what she wants.
A manager of a beauty supply store, she lives paycheck to paycheck and has struggled with postpartum depression since the birth of her youngest. She relies on her parents to help care for all three children — ages 4, 3 and 10 months.
“I love my children to death and they are everything I could ever want in my life,” she says. “But if, logically speaking, I could choose to do it from… no kids at 18. “Wait until I’m like 35. Wait until I have a whole house, a pension, a 401(k), a savings, three Wait until you are financially capable and stable.”
Her children stay with her parents for a few days. Eberhart wants them to know nothing about her plans. That night, in her unusually quiet home, Eberhart plays video games and watches television. He does not feel fear or worry. However, he has trouble sleeping.
In the morning, the father, a friend who supported Eberhart’s decision to have an abortion, arrives to pick her up.
“I’m finally on my way,” she tells herself. She manages to sleep during the 2.5-hour drive, hoping to stave off pregnancy-induced motion sickness.
They arrive about noon at the Indianapolis clinic — a low, unkempt building in a modest neighborhood. As at the Ohio facility, anti-abortion protesters gather here almost every day, and an armed guard is posted at the door.
Opponents believe unrestricted abortion ignores human life and argue that strict limits or bans are needed to protect the unborn. For Eberhart, the protesters are not a factor in her decision. Adoption was never an option for her – she spent time in foster care herself and says she knows the system is overflowing with children. She wants to go ahead with the abortion. then, as she would later say, “no more unplanned babies.”
Eberhart and a steady stream of other patients flock to the clinic. They sit, some fidgeting in the waiting room’s overstuffed chairs, staring at the pastel walls and a soap opera on the television. Everyone feels the urgency that the impending legislation brings.
She’s the nurse who got pregnant when her IUD failed. The 27-year-old is still breastfeeding her 5-month-old and recovering from ovarian cyst surgery. She and her partner worry that another pregnancy is too risky. At 11 weeks pregnant, she also traveled from Ohio.
A retail worker in Louisville got a ride from a friend when her appointment was abruptly canceled due to a new state ban there. Indiana’s waiting period means she will have to make the two-hour drive again, on another day. The 27-year-old was on birth control when she became pregnant.
A southern Indiana factory worker says her strict, Catholic father will disown her for an abortion. She is sure she will go to hell. But as a 28-year-old single mom, she knows she can’t raise another child.
A high school honor student became pregnant when she broke her boyfriend’s condom. She told her mom, who revealed a secret she’d kept even from her husband—she’d had two abortions a long time ago, before marriage, when any idea that Roe v. Wade could be overturned seemed far-fetched.
All of those women — who spoke to the AP on condition of anonymity for fear that their family and friends would find out about their abortion plans — will see Dr. Katie McHugh. She and other staff in Indianapolis are performing twice as many abortions as before the Supreme Court ruling. In July, 474 patients had abortions there, compared to just 200 in May. At least half come from other states.
McHugh sees more fear in her patients these days and tries to extend extra kindness. “There’s a sense of desperation,” he says. “They feel so lucky that they got right under the wire.”
Depending on the laws in the patients’ home states, the clinic offers abortion by procedure or pills, with women taking two prescription drugs days apart. It is the preferred and most common method of termination of pregnancy in the country, usually for women up to 70 days into pregnancy.
Eberhart just passed that limit — but even if she qualified, she would still have to undergo the most invasive medical procedure to empty her uterus. The clinic will not risk legal liability for patients who use the pills at home in more restrictive states.
Over an hour after arriving, it’s time for Eberhart’s procedure. The doctor tells her, “I’m sorry you had to come all this way, but we’re glad we can help.”
Eberhart lies on the exam table in a cramped procedure room and places her feet in staples, a sheet of paper that covers her legs — like a routine gynecological exam.
McHugh talks Eberhart through every step—feeling for the uterus, applying a numbing drug. Eberhart winces as she feels a pinch, then relaxes. She makes small talk, telling the doctor about her children.
McHugh inserts a thin, hollow tube. Connects to a larger hose and suction pump. McHugh uses it to remove pregnancy.
The process is over in five minutes. Eberhart feels some pain. McHugh tells her to be careful.
Eberhart moves to a recovery area, props himself up in a reclining chair and snacks on a small bag of chips.
“I’m generally in a good mood,” he says. “I knew what I signed up for.”
The next few days, she has minor cramps, some hormonal mood — but no regrets.
Mostly, she feels an overwhelming sense of relief—that she was able to find a clinic to give her the care she wanted, that the fast-closing window for abortion had been open long enough.
“I just want to do what’s right for my body and my life,” she said.
Tanner reported from Indianapolis.
The Associated Press Health and Science Section is supported by the Howard Hughes Medical Institute Science Education Division. AP is solely responsible for all content.