On the top floor of a modest two-story brick building near the shore of Lake Superior, the executive director of northern Minnesota’s only abortion clinic flits from room to room, checking in patients, fielding phone calls from people seeking appointments and handling billing questions from those struggling to pay.

In the waiting room at WE Health Clinic in Duluth, patients from Wisconsin and Texas sit among Minnesotans — the leading edge of an expected uptick in out-of-state patients following the Supreme Court’s removal of the federal right to abortion.

“It’s just been really busy,” Laurie Casey, the executive director, said. “We’re trying to be as flexible as we can, especially with people coming out of state. A lot of our patients — even if they’re from Minnesota — travel one to three hours each way to get here. So we try to be as accommodating as we can.”

Even before Roe v. Wade was reversed, WE Health Clinic was the nearest abortion provider for some people in northern Wisconsin, northern Minnesota and Michigan’s Upper Peninsula.

Today, the clinic’s employees are acutely aware of their state’s status as an island for legal abortion in the Upper Midwest. Abortion is now illegal or treated as such in Wisconsin and South Dakota. North Dakota is expected to follow suit in late July and Iowa’s Republican governor is asking the state courts to severely limit the procedure.

The clinic has raised its cap on patients from 16 to 20 on the one day a week when abortions are typically performed. Its staff try to schedule abortions on other days when necessary, and may set aside an additional half- or full day each week for abortion services.

“We haven’t overcome our capacity to serve patients yet. And we are working on efficiencies so that we’re ready if we do end up with a flood of patients,” said Dr. Judith Johnson, one of three doctors providing abortions at the clinic.

Johnson said the increased pressure began months before the Supreme Court decision, with inquiries from people in Texas and Oklahoma as those states introduced highly restrictive abortion bans.

The extra patient load at WE Health Clinic includes people who have struggled to get speedy appointments at some Minneapolis-area clinics, where five of the state’s seven abortion clinics are located, following the Supreme Court’s decision. The seventh clinic is in Rochester.

“The number of patients we serve has gone up, and the places they come from have gotten further away,” Johnson said.

And the clinic isn’t able to help everyone who calls.

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