About nine years ago, Sarah Knowlton sought an abortion at a now-closed clinic in northern Indiana, where she encountered anti-abortion protestors while approaching the entrance.
Knowlton reflected on how that experience drove her to Whole Woman's Health in 2019, another abortion clinic in South Bend, she wished she had access to years ago.
However, the program — and Knowlton's work at the clinic — will end on September 15, when Indiana's abortion ban comes into force, effectively closing down abortion clinics statewide.
Indiana's Legislature was the first to approve abortion restrictions after the U.S. Supreme Court overturned Roe v. Wade, and Republican Gov. Eric Holcomb signed the ban into law on August 5.
This ban prohibits abortion clinics from providing any abortion care, leaving such services solely to hospitals or outpatient surgical centres owned by hospitals.
"My last shift as a clinic escort is coming up," Knowlton said Wednesday. "And I'm not ready for it."
At Indiana University Health, which is the state's largest hospital system, providers have been trained to continue offering abortion care in the allowed circumstances.
As per the new law, abortions will be permitted only in cases of rape and incest before 10 weeks post-fertilization; to protect the life and physical health of the patient; or if a fetus is diagnosed with a lethal anomaly. A doctor who performs an illegal abortion or who fails to file required reports will lose their medical license.
IU Health officials outlined a new 24/7 response team — which includes a clinician, an ethicist and a lawyer — that providers can contact to evaluate nuanced emergency situations.
"The law is broad," said Dr Caroline Rouse, medical director of maternity services at IU Health. "Patient situations are very specific and unique." Last year, a majority of the abortions in Indiana happened in such abortion clinics.
Hospitals performed 133 of the state's 8,414 abortions, according to a 2021 annual report from the state Department of Health, while the remaining 8,281 took place in abortion clinics.
The clinics in Indiana that will not be able to provide abortion services on September 15 include Whole Woman's Health in South Bend, Women's Med in Indianapolis, and Clinic for Women in Indianapolis.
The four Planned Parenthood clinics that provide abortion care in Indiana will no longer do so, but will continue to see patients for other medical services such as STI testing and treatment, contraception and cancer screenings, said Rebecca Gibron, CEO of the Planned Parenthood division that includes Indiana.
"Planned Parenthood has been a leading reproductive health care provider in Indiana since 1932. And we are not going anywhere," Gibron told the AP in August.
Sharon Lau, Midwest Advocacy Director for Whole Woman's Health Alliance, said that though the South Bend clinic will cease abortion care, patients can still access a program that directs patients to abortion appointments in other states.
"We will keep going until we're forced not to," she said. Lau also mentioned that her clinic's plans could hinge on two lawsuits filed by the American Civil Liberties Union of Indiana that seek to block the abortion ban before it takes effect.
The first lawsuit, filed August 31 in Monroe County, states the ban violates the Indiana Constitution, while the one filed Thursday in Marion County claims the ban is at odds with the state's religious freedom law, which Republicans enacted seven years ago. The timing of both lawsuits is unclear.
Mike Fichter, CEO of Indiana Right to Life, said in a statement that delaying the ban would mean "the indiscriminate killing of unborn children will continue at abortion clinics in Indiana."
"We are confident the state will prevail and pray the new law is not blocked from going into effect," he added.
Women's Med will also stop providing abortions after the ban but continue referring patients to states where abortion is legal until about one month after, said Dr Katie McHugh, an abortion provider at the clinic.
McHugh also said how she has seen a shift in patient behaviour since the Indiana ban was passed. While some are pursuing abortion earlier, others are choosing surgical over medication abortions to avoid complications, she said.
McHugh also added that other patients are under the assumption that abortion is already illegal.
Knowlton said she worries for those patients who will put their health or lives at risk if they cannot get an abortion. She knows what the feeling is like as it was her mindset nine years ago.
"I was going to find a way, come hell or high water, whether there was a clinic I was able to access or not," Knowlton said.