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The Jackson Women's Health Organization is the only abortion clinic in Mississippi
The Jackson Women's Health Organization is the only abortion clinic in Mississippi
(AP Photo/Rogelio V. Solis)

"A Constant Battle"

What it's like to work in Mississippi's only abortion clinic

There are three doctors who terminate pregnancies at Mississippi's only abortion clinic, a bright pink building in Jackson. Two keep their identities private: legal documents only refer to them as "Drs. Roe and Doe." This anonymity is not atypical for abortion providers, who often face harassment and threats of violence. Eight abortion providers have been murdered in the past two decades, and another 17 have been victims of attempted murders. The third doctor who provides abortions in Mississippi is Willie Parker.

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"I've not been unwilling to make it known that I've delivered babies," Parker told me last week, as he drove through the backroads of Alabama. "And I'm not unwilling to make it known that I perform abortions."

Parker is a rarity — not only because he provides abortions in the Deep South, but because he is so public about his work. He was recently the subject of a lengthy Esquire magazine profile titled, "The abortion ministry of Dr. Willie Parker." He has conducted dozens of interviews, which he said he sees as a form of advocacy.

For years, Parker worked in urban areas of the country, places like Chicago and Washington, DC, providing abortions in areas of the country where the practice was largely uncontroversial. But last month, he moved back to his home state of Alabama with the express purpose of providing abortions in hostile territory — and leading the fight to keep Mississippi's one clinic, the Jackson Women's Health Organization, open.

"It was … a conscious decision to make myself more available to provide care in the region where access has been greatly limited by the political climate," Parker said. "It became important to me to make sure these services are available in the region of the county where I come from."

"Abortion access has changed dramatically"

The South has become increasingly anti-abortion. In 1995 and 1996, the Pew Research Center surveyed each region of the country on their support for legal abortion in all or most situations.

The area that Pew calls the South Central region includes Alabama, Kentucky, Louisiana, Mississippi, Tennessee, and Texas. In the mid-1990s, a very slight majority — 52 percent — of those living in the South Central region said they supported legal abortion in all or most situations.

But by 2012, the next time Pew repeated its survey, that number had fallen to 40 percent. It was the fastest drop in abortion rights support that the group measured anywhere in the country.

support abortion south

Pew Research Center

"Abortion access has changed dramatically," said Elizabeth Nash, state issues manager at the Guttmacher Institute. "The debate at the federal level affected what happened at the state level, and accessing abortion is much more difficult in 2014 than it was in 2009."

The drop in public support for abortion has coincided with a wave of new restrictions on abortion in the two states where Parker practices, Alabama and Mississippi.

Mississippi, for example has passed in the past four years at least five laws restricting abortion access. The state has prohibited plans sold on Obamacare's health insurance exchange from covering abortion in nearly all situations. It has banned telemedicine prescriptions of RU-486, the pill that causes abortions. And in 2012, Mississippi Gov. Phil Bryant signed House Bill 1390 — the one that now threatens to shut down the clinic where Parker works.

On April 16, 2012, the day Bryant signed the bill, he described it as a "historic" moment. "Today," Bryant said, "you see the first step in a movement, I believe, to do what we campaigned on to say we're going to try and end abortion in Mississippi."

It's Parker's fight  to stop that from happening.

"I don't carry a gun, but I'm prepared to defend myself"

willie parker

Willie Parker speaking at a recent event (Brett Deutsch)

Parker didn't always plan to become an abortion provider. About a decade ago, he was a mid-career OB-GYN with a plum position teaching at the University of Hawaii. He had long been a supporter of abortion rights, but only began thinking about doing the procedure himself when a university administrator started talking about banning abortions on campus. He began thinking about a Martin Luther King Jr.'s last sermon, "I've Been to the Mountain Top," that considers the parable of the Good Samaritan and what makes him good.

"In it, he talks about a fallen traveler who is in need of help, and most passersby would go by, concerned with what would happen to themselves," Parker recounted.

"What the Good Samaritan does is reverse the question and think about what would happen to that man," he continued. "I began to ask myself, what would happen to these women when I can't or won't help them? And that's how I made a decision to add abortion services to my practice."

Parker began providing abortion services in large urban areas, first Washington, DC, and then Chicago. He applied for a license to become an abortion provider in Mississippi near the end of 2011, so he could start flying down twice a month and work in a Jackson clinic.

He said he faces some harassment in this line of work, but nothing that would deter him from practicing. "I'm mindful of my circumstances," he said. "I lock my car. I have contact with law enforcement, in terms of reaching out if I need to. I don't carry a gun, but I'm prepared to defend myself."

Parker received his license in May 2012. That was one month after Gov. Bryant signed the admitting privilege law he hoped would "end abortion in Mississippi" — and two months before it went into effect.

"We haven't been successful at all so far"

Mississippi is among nine states that, since 2011, have passed laws requiring abortion providers to have admitting privileges at a local hospital. While these laws are not new, they have recently become more common.

admitting privilege chart

Three of these laws — in North Dakota, Tennessee, and Texas — are currently in effect. In those states, any abortion provider must now have admitting privileges at a nearby hospital.

Four states — Alabama, Kansas, Louisiana, and Mississippi — have laws that are on hold pending the outcome of court decisions. The other two laws, in Louisiana and Oklahoma, were just passed this spring and are still in planning stages.

These laws have become the center of fierce court battles. Parker is a plaintiff in the fight against the Mississippi law. He went to seven hospitals seeking admitting privileges after the law passed. He was turned down everywhere.

"Some of them did not return our request for an application, some of them sent an application," Parker said. "The ones that responded told us we weren't eligible for staff membership and then some just didn't give us any feedback at all. We haven't been successful so far."

Without admitting privileges, Parker couldn't practice under Mississippi law. So he's been fighting the law in court — and winning. In July, the Fifth Circuit Court of Appeals found the restriction to be an unconstitutional violation of abortion rights that placed "a substantial obstacle in the path of a woman seeking an abortion in Mississippi."

The Fifth Circuit's ruling put the admitting privilege law on hold, meaning Parker could keep running his practice.

But the decision is not the final word: another panel ruled in favor of a very similar law in Texas. Observers expect that, with the split opinions, the case will likely head to the Supreme Court.

"I think the Supreme Court has to decide this," said Caitlin Borgmann, a law professor at the City University of New York who has written extensively on abortion law. "The lower courts are conflicted over at least three separate issues: how to evaluate undue burdens, what counts as a state's compelling interest, and whether access to abortion outside state borders matters."

"It's hard to move forward"

Even though the law is currently on hold, Parker said it still has a palpable impact on his clinic. It's difficult, for example, to recruit other providers to the state when the legality of abortion remains in such flux.

"It's hard to move forward, because we're trying to make sure we can fight off this lawsuit and keep the clinic open," he said.

The Jackson Women Health Organization's place as Mississippi's only abortion clinic seems to draw opponents. On days when there are hearings on the lawsuit, the clinic tends to get more protesters.

"A couple of weeks ago there was a major caravan from Birmingham to Jackson to Nashville when I was working in Jackson," Parker said. "So that was a couple of busloads of students who, for two to three days, essentially laid siege to the clinic. But there's a consistent group of locals we have, too."

I asked Parker whether he has days where he thinks about throwing in the towel — if not giving up on abortion practice, at least doing so in a more supportive community, somewhere like the places he used to work. He said he doesn't.

"When I'm tempted to feel like I'm really tapped out, I look at the women in the clinic and what they go through," Parker said. "They have the waiting period, trying to raise the money, arrange transportation, arrange childcare.

"For me, if those women can go through that, it's energizing to make sure somebody can help them."

Sarah Kliff: How and when did you decide to become an abortion provider?

Willie Parker: At the time that I made the decision, I was in the middle of my career as an OB-GYN. I was at the University of Hawaii and had always been supportive of a woman’s right to choose, but I’d been wrestling with what it would mean to provide the procedure.

I was wrestling with the morality of it, and my epiphany came when listening a Martin Luther King Jr. sermon, about the parable of the good Samaritan. In it, he talks about the fallen traveler who is in need of help, and most passerby would go by, concerned with what would happen to themselves. What the good Samaritan does is reverse the question and think about what would happen to that man.

That resonated with me, since I was dealing with women on a regular basis in situations of unplanned pregnancy. And I began to ask myself, what would happen to these women when I can’t or won’t help them? That’s how I made a decision to add abortion services to my practice.

Sarah Kliff: Was it scary to get into abortion practice? This was a particular moment when there was a decent amount of violence against abortion providers, including a few murders in the decade prior.

Willie Parker: I did wrestle with it for years, so I was well aware of the violence at the time. But I can honestly say I was focused more on the rightness in providing the services. I was aware of the violence, but it didn’t factor into my decision. I just assumed that’s a risk, but in the way that doing anything meaningful has risks. You just focus on what’s the right thing.

Sarah Kliff:You’ve worked in larger urban areas like Washington and Chicago. For awhile, you flew back from those places to work in Alabama. How did you decide to recently move to Alabama, and work in a clinic there and in Mississippi?

Willie Parker: It was a combination of things. I have a younger brother facing some serious health challenges. So it was partly a decision to move home to be near him to assist in his efforts to get healthy. It was also a conscious decision to make myself more available to provide care in the region where access has been greatly limited by the political climate. It became important to me to make sure these services are available in the region of the county where I come from. It’s a bit of a regional loyalty. I prioritize making sure that services are available to all women.

Sarah Kliff: Can you tell me a bit about the women that you see in your clinics in Alabama and Mississippi? How far are they traveling, and what kind of circumstances they are in?

Willie Parker: I would say they are representative of the demographics of abortion all over. We know women of color and Latino women have the highest rate of abortions. The women who come to these clinics are mostly black women and women of color. Most of them live at or below the poverty level, but I also see lawyers and doctors sprinkled in as well. In Alabama we have three clinics. In Mississippi there’s one. Women drive from all over the state. There is a Planned Parenthood clinic in Mobile, and then one in Montgomery that serves the whole southern region of the state. There was a clinic in Birmingham, but that one closed about two years ago.

Sarah Kliff: Why are there so few abortion clinics in the areas you work?

Willie Parker: I think it's a combination of things. There’s abuse of regulatory authority and a lot of difficulties under which clinics have to operate. Clinics have to put a lot of resources into defending themselves here. When you’re the only clinic, that’s a constant battle. From the standpoint of providers, some are intimidated out of practice. There was one doctor who met me at the clinic in Montgomery, and somehow her application to work there was published with her home phone number. She was driven out of the community with harassment and public shaming and stigma. In Mississippi, there are people who are sympathetic to abortion but it would be a small part of their practice, and they’re not willing to put the rest of their medical practice at risk. So there’s that aspect going on as well.

Sarah Kliff: One of the things that has struck me about you is that you have a very public profile, like your recent profile in Esquire. Many of your colleagues are much more private about their work, out of concern about some of the issues you raised. Have you faced any harassment yourself since moving to Alabama?

Willie Parker: Certainly people say things like, "You’ve been warned." I’ve not had any personal confrontation. I try to take common sense measures. My decision not to hide is in part related to the fact I really believe I’m providing healthcare for women. There’s no aspect of my career I’ve been ashamed of. I’ve not been unwilling to make it known I’ve delivered babies, and I’m not unwilling to make it known I perform abortions. I’m mindful of my circumstances. I lock my car. I have contact with law enforcement, in terms of reaching out if I need to. I am prepared to defend myself. I don’t carry a gun. I don’t talk much publicly about what my measures are, because that would defeat the purpose a bit.

Sarah Kliff: In the admitting privileges lawsuit, it says that you and your colleague in Mississippi tried applying for access at seven hospitals in Jackson, MS, and were denied at all of them. Can you describe what that process was like?

Willie Parker: When the law went into effect, we began applying to all the hospitals. Some of them did not return our request for an application, some of them sent an application. The ones that responded told us we weren’t eligible for staff membership and then some just didn’t give us any feedback at all. We haven’t been successful so far.

Sarah Kliff: Supporters of the admitting privilege laws argue that this is a common sense measure to protect women’s health in emergency situations where they need additional help. That’s what the Fifth Circuit Court of Appeals essentially ruled in Texas. How do you respond to those type of arguments?

Willie Parker: These laws and these rules pass the common sense test, and that’s why they’re so dangerous. They sound good, but in their substance they don’t add anything to the quality or safety of abortion. They create barriers and deny women access to service. I’m for any safety regulation that is going to make abortion care safe, but, for women, abortion care is already safe. What really gets me are the targeted regulations that we’re required to meet and others aren’t. It’s unjustified. Abortion is already heavily regulated.

Sarah Kliff: Do you have regular protesters at your clinics?

Willie Parker: There are consistent protesters at both clinics, and then there is the targeted revving up of protest activity. The Forty Days for Life campaign, for example, brings a lot of protesters. The same thing when there were hearings regarding the lawsuit, the people in Mississippi would sync their protest activity. A couple of weeks ago there was a major caravan from Birmingham to Jackson to Nashville when I was working in Jackson. So that was a couple of busloads of students who, for two to three days, essentially laid siege to the clinic. But there’s a consistent group of locals we have, too.

Sarah Kliff: Do those protest tactics deter women from getting abortions?

Willie Parker: It absolutely deters women. With all of them, I’ve heard screaming at women, things like "don’t go in and kill your babies." It’s psycho-terrorism. When they’re not successful, upon the woman’s exit they’ll say things like, "How does it feel to have just killed your baby?" It absolutely serves as a deterrent.

Sarah Kliff: Are you thinking about how to get more abortion providers to work in the South?

Willie Parker: We’re constantly thinking about that. I do have one colleague who came down to see what it was like and really had a sense of purpose about wanting to come and assist. But right now it's hard to move forward, because we’re trying to make sure we can fight off this lawsuit and keep the clinic open.

I’m a plaintiff in the lawsuit, and have operated with good faith that we’ll stay open, so we’re constantly thinking about how we can distribute this resource. Right now, because of the climate, most people feel more comfortable working in larger urban areas.

We’re trying to figure out ways to get people to see the disparities. In some ways, it's easier to go to another country and provide care than it is to come here. I wish people would see the abject poverty, and we’re actively trying to get people to do that.

Sarah Kliff: You’re obviously facing a lot of challenges in the work that you do right now, particularly with the lawsuit, and with working in Mississippi’s only abortion clinic. Do you ever think about switching back to an OB-GYN practice that doesn’t involve abortion?

Willie Parker: I’m fortunate I feel sustained by the work I do and the fact that I’m making what I know to be a big difference in the lives of women. When I sit across the desk from a woman in Mississippi and she’s at the only clinic in the state providing abortion services, I know I’m making a difference. I don’t get distracted by feeling like we’re always fighting.

When I’m tempted to feel like I’m really tapped out, I look at the women in the clinic and what they go through. They have the waiting period, trying to raise the money, arrange transportation, arrange childcare. For me, if those women can go through that, it’s energizing to make sure somebody can help them.

I don’t want to come off as a goody two-shoes, but I’ve been a physician for 24 years and in practice for 20. I can say at this stage in my career that I’m doing my most rewarding work and don’t have any questions about that.


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