A women’s clinic run by two generations of women braces for the post-Roe era

Photo for The Washington Post by Brittany Greeson
S. holds an old photo of the Scotsdale Women’s Center in Detroit on May 5, 2022.

DETROIT – The flowers seemed innocent enough, but Jakaiser Jackson wasn’t taking any chances.

The security guard at the Scotsdale Women’s Center in Michigan’s biggest city stopped the delivery before it could even reach the building’s outer vestibule.

Abortion clinics like this one have long been a target for protests and violence, so Jackson and others are extra vigilant about who comes inside and even what packages are accepted. Protesters rarely show up armed, but they do harass employees and patients.

“It’s like the devil comes in,” Jackson said of the protesters, who scream that the women are killers murdering babies. “When those ladies keep walking and don’t pay them no attention, that’s when they get real cruel.”

Photo for The Washington Post by Brittany Greeson
Left: An exam table is seen at the Scotsdale Women’s Center in Detroit on May 5, 2022.
Upper right: The waiting room at the Scotsdale Women’s Center in Detroit on May 5, 2022.
Bottom right: A sign is seen in the doorway at the Scotsdale Women’s Center in Detroit on May 5, 2022.

After the Supreme Court on Friday overturned the fundamental right to abortion established nearly 50 years ago in Roe v. Wade, abortion clinics like this one in states where, at least for now, the procedure remains legal are even more on edge.

Michigan is one of several states that have unenforced pre-Roe abortion bans that will now likely become a target in determining if access remains legal. A Michigan lower court judge in May froze a 1931 law not in effect that criminalizes abortion, but antiabortion groups are fighting to have the injunction tossed.

A ban would pose an existential threat to clinics like Scotsdale, where patients have come for half a century to get reproductive health care in a safe and welcoming environment. The clinic has been run since the late ’90s by two generations of reproductive health-care providers. Sam, Scotsdale’s executive director, bought the facility with her mother, Kathy, who worked in clinical care since the ’70s. The Washington Post is not identifying the last names of both women due to safety concerns.

For the mother and daughter, the post-Roe landscape is also worrying at a personal level. Kathy said she’s mostly blocked out the memories of when she felt the most scared to work as an abortion provider. Now, her fears are for her daughter.

“She’s done an amazing job and she’s very careful,” Kathy said. “But I worry about her, as a mother.”

Sam is resolute in the face of threats and ongoing pressure campaigns by those who want to see her close her doors for good for the simple fact that she knows her patients need the services she provides and often, they have no where else to turn for support or kindness.

“Generally, when I tell someone what I do, the first thing they say is, ‘That must be so depressing.’ Nope, not at all,” Sam said. “The patients are wonderful. They’re grateful and hopeful and appreciate getting care.”

Photo for The Washington Post by Brittany Greeson
S. the owner of the Scotsdale Women’s Center in Detroit on May 5, 2022.

Sam grew up steeped in the business of reproductive health care, collating papers as a 9-year-old in the clinic run by her mother, Kathy, shortly after Roe v. Wade became the law of the land. The two bought Scotsdale when the previous owner retired. Sam would go on to steer the clinic through a volatile era when threats to clinics and staff were at their height and social and political victories by antiabortion groups put a squeeze on the business.

Since 1977, there have been 11 murders, nearly 500 assaults, 42 bombings, 196 arsons, and thousands of criminal incidents directed at patients, providers, and volunteers, according to the National Abortion Federation. The organization says several worrying trends have emerged in recent years: Assaults are up from 15 in 2018 to 123 in 2021; incidents involving hoax devices or suspicious packages are on the rise, climbing from four in 2018 to 71 last year; bomb threats, stalking and invasions have also increased.

Multiple women who still work at Scotsdale said they have been followed home or sent harassing mail at their personal address. Some clinics, including those owned by Sam’s friends, have been targeted by self-described “rescue” groups that storm clinics and barricade themselves inside as they seek to physically bar the doors so procedures can’t continue.

Sam’s mother, Kathy, has been retired for more than a decade but still slips into conversation as if she’s still at the clinic. To see the picture of reproductive rights in 2022 looks increasingly like a reverse image of the 1970s has been crushing.

“To me, it’s like the world is upside down,” she said.

At 78, Kathy has already lived once through the era of largely illegal abortions. When she needed to terminate a pregnancy as a young woman, she had to go to New York, one of four states where it was legal before Roe after being referred by the Clergy Consultation Service on Abortion – a group of religious leaders who helped women find licensed doctors in New York for safe abortions.

When the CCSA clinic in Detroit she worked at began providing local abortions in 1973, the staff could hardly keep pace with the influx of patients, most of whom were college students.

“When we opened it was absolutely nuts. People would park in the parking lot overnight to get in, and wait for hours and hours,” she said. “It was difficult to keep up with it, but we had wonderful doctors, and very compassionate staff.”

Ministers, sometimes in small groups, would counsel roomfuls of patients, while non-clergy counselors would describe the procedure and detail its safety.

“It was dealing with people’s feelings, families, young women,” she said. Counselors would also pull out people who didn’t seem to be comfortable or sure of the decision to have an abortion. “Part of the counseling is making sure women were sure of their decision.”

While “picketers” were a regular presence, antiabortion protesters with aggressive tactics didn’t emerge at her clinic until Pope John Paul II visited Detroit in 1987. Anticipating a blockade, Kathy said she hired an Israeli security consultant to help them fortify the clinic.

The early 1990s were the most dangerous – the decade that saw the highest concentration of arson and clinic bombings and murders of abortion providers, according to data from the National Abortion Federation.

“We treated it almost like a war: We made sure mail chutes were closed, the roof was secure, the doors were closed,” she said. “People had to give their name and have an appointment to come in.”

Ironically, fighting for patients to have the freedom and choices has in some ways made life smaller and more controlled for women like Sam. She jokes, in half-frustration, that she can never find her car in a parking lot of similarly dark-hued vehicles. She considered putting a sticker on her car – something fun, something meaningless – but Kathy warned her it would make her vehicle easier for antiabortion protesters to track.

She wrestled with using her full name for this story, but knows how much her own child, who does not work with the clinic, worries about her. The murders of abortion providers like David Gunn and George Tiller loom large in her family’s memory, and her own.

Her children had to learn to be vigilant when retrieving the mail and wary of anyone who purported to be picking them up from school on their parents behalf. Sam is even vigilant about her landscaping; she’s can recite safety protocols the way some people recite baseball stats.

Looking at the dirt border between the clinic’s exterior and the grass, she longs to plant handsome shrubbery, or maybe a flowering bush.

“But then you gotta worry about bombs,” she said.

She learned that from a friend who worked at the Birmingham, Ala., abortion clinic that was targeted in 1998 by Eric Rudolph, the Olympic Village Bomber. The dynamite and nail bomb hidden in shrubbery killed a local police officer moonlighting as clinic security and maimed a nurse.

Most of protesters that come to Scotsdale are more distracting than dangerous; Sam’s biggest frustration with them is what she says is a hypocrisy that undermines their goal of fewer abortions.

“The people who don’t want abortion to be legal also don’t want sex ed in schools. To me it’s an endless, horrible cycle,” she said.

Photo for The Washington Post by Brittany Greeson
Registered nurse Ashia George, 35, in the hallway at the Scotsdale Women’s Center in Detroit on May 5, 2022.

Ashia George, a 35-year-old nurse at Scotsdale, suspects some of the protesters aren’t posted outside the clinic to persuade patients – most of whom are Black Detroiters – but dictate to them.

“It is something about White people wanting to tell Black people what’s best for them,” said George, who is Black. “It’s like, how dare you come down here to this side of town and try to tell somebody what they should and shouldn’t be doing?”

Jackson, Scotsdale’s security guard, keeps a red binder on his workstation with profiles of the clinic’s regular protesters. They have photos and often names and hometowns, often because the protesters identify themselves on social media during their demonstrations.

Upon further inspection, the bouquet that arrived on a recent day turned out to be innocuous. Tucked in the spray of yellow roses and red carnations was a note to Sam from a loved one: “I am so proud of you, an amazing and strong woman.”

George has had two abortions, once before she was a mother and again when she and her then-husband had two children. Her devoutly Catholic upbringing led her to believe women who had abortions were making bad choices. Both times she knew getting an abortion was the right choice for her – one that enabled her to pursue a career as a registered nurse.

To George, the right to an abortion is so sacred, she is wiling to leave her hometown to practice reproductive health care in a state that doesn’t criminalize aspects of it.

“I’m already looking at jobs in Illinois. I don’t see myself living in a state where my kids can’t get access to abortion if they need it. I don’t want to ever live in a place like that,” she said.

Sam knows her staff will have to take jobs elsewhere – in other kinds of health care, in other states – if abortion access becomes illegal in Michigan. A Republican state legislator has introduced a bill styled after Oklahoma’s law that punishes abortion providers with up to 10 years in prison. Abortion rights groups are gathering signatures to get a voter referendum on the November ballot protecting abortion access in the state.

The pandemic, and decades of restrictions on abortion providers, have winnowed away other services the clinic used to offer. Insuring the business gets costlier every year. She imagines at the very least, she could keep a lightweight operation for making phone referrals to out-of-state providers like Illinois, where abortion access remains protected.

“The real the way to fix this is education and access and lowering the overall need for abortion,” Sam said. “But people deserve to have a warm, secure, nonjudgmental place to go to until that happens.”

Photo for The Washington Post by Brittany Greeson
S., the owner of the Scotsdale Women’s Center, depicted using an exam lamp in Detroit on May 5, 2022.