‘My last resort’ — thousands come to Illinois to have abortions

July 15--The young woman in a gray hoodie and backpack boarded a bus alone just after midnight, departing for an interstate trip to make the most pivotal choice of her 24 years.

A lightning storm raged outside her window, illuminating in flashes the gently rolling landscape of the Ozarks in southwest Missouri. Her family and most of her friends didn't know the sweatshirt covered a 12-week pregnancy she was planning to terminate, the reason for her travels some 260 miles north to Illinois that winter weeknight.

"I've seen what unplanned pregnancies do to people," said the woman, who requested anonymity to keep her recent abortion a secret from those closest to her. "I don't want to be put through that. I don't want to be forced into a marriage. I don't want to raise a child alone."

Illinois health data show that each year around 3,000 women come from out of state to have an abortion in Illinois, which has some of the least restrictive laws in the Midwest.

While the landmark U.S. Supreme Court case Roe v. Wade has guaranteed the right to an abortion since 1973, lawmakers and courts across the country continue to tussle over the boundaries of that reproductive freedom. That has created pockets of access in places like Illinois amid what has been termed the U.S. abortion desert of the South and Midwest.

Shrouded by privacy laws, data from the Illinois Department of Public Health reveal little about those who cross state lines to terminate pregnancies except the annual number. Four of these women, though, have shared the stories of their abortions with the Tribune, chronicling the legal obstacles that led them to Illinois as well as their fears and frustrations.

A young woman from Missouri, just starting to meet her own needs, felt it would be unfair to bring a child into the world.

An Indiana mother longed for a baby but terminated for medical reasons.

A Wisconsin mom, regretful and grieving for years after her abortion, recently began leading a recovery group at her church for others experiencing a similar loss.

A teen from Ohio came to Illinois seeking a judicial bypass so she could have an abortion without her parents learning of her pregnancy.

One Chicago clinic -- citing an uptick in patients from other Midwest states -- offers on its website a discounted rate at a hotel about a block away. Volunteers with a burgeoning nonprofit, Midwest Access Coalition, share their spare bedrooms, prepare meals and give rides to help women traveling to Chicago for abortion care.

Reproductive rights have risen to the forefront of national debate since the contentious fall presidential election. During the campaign, President Donald Trump once commented that Roe v. Wade could be reversed "automatically, in my opinion, because I am putting pro-life justices on the court," sending the matter back to the state level.

Many states, particularly those in the Midwest, fluctuate when it comes to abortion laws.

Locally, Gov. Bruce Rauner has threatened to veto a bill that would expand the availability of taxpayer-funded abortions, indicating Illinois isn't immune from challenges even as it remains a haven for access.

The governor of Missouri last month called a special legislative session to focus on abortion, and a bill moving through the legislature includes various new regulations. Iowa's governor in May signed legislation enacting a 72-hour waiting period prior to an abortion as well as a ban on the procedure after 20 weeks of gestation, except when a woman's physical health is at risk. Hours later, the Iowa state Supreme Court issued a temporary halt to the waiting period portion of the law.

Nationwide, recent moves to restrict reproductive rights have sparked a series of protests inspired by "The Handmaid's Tale," with activists in Missouri, Ohio, Texas and other states donning red cloaks and white bonnets in the image of characters from the 1985 dystopian novel and recent Hulu series.

To those who oppose abortion, these constraints are considered the last defense of the unborn.

"I don't think having few protections is something Illinois should celebrate," said Emily Troscinski, executive director of the nonprofit Illinois Right to Life. "It is embarrassing, because we are so out of line with the rest of the Midwest when it comes to protecting women and the unborn."

To those who support abortion rights, these measures are unnecessary burdens wielded inequitably by geography.

"It's unfortunate that in some states politicians have felt they can restrict access, and that means women need to go out of state," said Brigid Leahy, director of public policy for Planned Parenthood of Illinois. "Your rights shouldn't depend on your ZIP code or the state you live in."

Relieved

The Missouri woman in the hoodie recalled feeling vulnerable and a little exposed a few months ago as she stood in front of the Hope Clinic for Women in Granite City, Ill., just across the Mississippi River from St. Louis.

The air was chilly, the skies partly cloudy just before the clinic opened that morning. Protesters holding anti-abortion signs called her and other patients who walked past "murderers," she recalled.

Growing up, she moved to and from various rural towns, and it was hard to form lasting childhood friendships. She describes her education as very poor.

"I wasn't prepared for life," she said.

Her conservative Christian family was against abortion. When her parents learned they had conceived a fetus with a severe and typically fatal birth defect, they chose to deliver rather than terminate.

She remembers holding the newborn, who died shortly after birth.

Yet when she learned of her unplanned pregnancy, the young woman decisively chose to abort. No longer with her ex-boyfriend, finally independent but just starting to save her retail job paycheck, she said she couldn't provide a good life for a baby.

"I'd want them to have a better life than I did," she said. "I don't think I could make a child feel valued because I don't know how to value myself. I'm learning right now, I'm taking care of myself. I'm finally getting there."

She said she didn't feel an emotional connection to the pregnancy.

"I knew this was the right choice for me," she said. "I just didn't know if I would be able to get it done."

She did pick out names in case she couldn't have the procedure: Garrett for a boy, Caroline for a girl.

The only clinic in Missouri offering abortion services was hours from her home -- a Planned Parenthood in St. Louis -- largely due to state laws requiring abortion providers have hospital admitting privileges and clinics meet the same standards as surgical centers. A federal judge struck down those measures in April, and Planned Parenthood announced plans to expand or restore abortion services at four clinics throughout the state.

Missouri also requires in-person counseling followed by a 72-hour waiting period, essentially requiring two trips to a clinic. Nationally, 27 states have some kind of waiting period after mandated counseling, and 14 states require that counseling be provided in person, said Elizabeth Nash, a policy analyst with the Guttmacher Institute, a research group supporting abortion rights.

The young Missouri woman didn't know how she could travel twice, and she also didn't want to miss any days of work. Online, she found the nonprofit NARAL Pro-Choice Missouri and was advised to go to Illinois, which has no waiting period.

Alison Dreith, the organization's executive director and a St. Louis resident, said she often refers women to Illinois, where she had her own abortion in May 2016.

"Because I know what our laws are," Dreith said. "It's devastating, especially for low-income women or women who don't live in the area. That's extra time off work where they're not getting paid. ... It's an undue burden."

While filling out paperwork at the clinic, the woman in the hooded sweatshirt recalled saying, "I'm very confident in my decision."

It was a weird sensation to have a vacuum inside her body, she remembers thinking during the procedure, as her stomach dropped and clinched similar to the way it would on a roller coaster. Because she was by herself and had to catch a bus back home that night, she declined anesthetic but tends to have a high pain tolerance.

She held the hand of a nurse but didn't feel the need to squeeze.

"It just took a few minutes," she said. "It's not a long procedure."

Before leaving the clinic, she got a three-month hormonal birth control shot.

A little before midnight, back at the bus station, she looped the straps of her backpack around her shoulders and pulled her hoodie over her head. Curled up on the floor, she fell asleep for a little while.

She would arrive home early the next morning. The entire trip took about 30 hours.

"I felt relieved," she said.

Her only regret was that she couldn't talk about her abortion with her loved ones, particularly her sister.

"It's a taboo thing, but it shouldn't be," she said. "I wish I didn't have to be anonymous. I wish my family wouldn't shut me out because of this. It should be something that is accepted and not hated upon. I really don't think this is the wrong choice for me."

August brings pain, healing

Their family was to be complete.

Cyndi Portteus, of the Indianapolis area, recalls her belly was already quite swollen by the ultrasound at 22 weeks, when she and her husband learned they were having a boy in August 2013. They both loved the name William.

This pregnancy felt no different from her first, when she carried her daughter about two years earlier. It was her husband who noticed the technician seemed to linger around the heart more than the rest of the image on the screen, the first subtle sign something wasn't right.

A fetal echocardiogram shortly after revealed the defect: hypoplastic left heart syndrome, which afflicts some 960 babies born in the United States each year, according to the U.S. Centers for Disease Control and Prevention. The left side of the heart, the side responsible for pumping oxygenated blood throughout the body, was too small and underdeveloped.

Portteus briefly wished there was a way to keep the son she longed for in her womb forever. It was safe in utero, nourished by her oxygen-rich blood.

"But once they've been birthed and they're not in their mom, that's when they're really in danger," she said.

There was very little time to determine the fate of the pregnancy because it was so far along.

Specialists went over the options. One was a series of three open-heart surgeries, the initial one shortly after birth, likely followed by lifelong medical care. While statistics online varied, Portteus said her baby was given a 50 percent chance of survival to age 5. Another alternative was delivery followed by hospice care, keeping the baby comfortable until his natural death.

The third choice was termination for medical reasons.

Indiana law prohibits abortion past 20 weeks post-fertilization -- or 22 weeks into pregnancy as calculated by physicians -- unless the woman's life or physical health is endangered.

Nationwide, about two dozen states prohibit the procedure after a certain number of weeks and 18 have laws in effect that ban abortion at about 20 weeks, according to the Guttmacher Institute. The governor of Kentucky signed a 20-week ban in January. Ohio's 20-week ban took effect in March. Proponents argue these laws are critical because a fetus can feel pain at this point in pregnancy; the American Congress of Obstetricians and Gynecologists, however, has refuted that premise.

Portteus, now 37, recalled that a physician suggested she could try appealing to an in-state hospital's medical ethics board, but a ruling might not be favorable with surgery still an option. This process would also take time, potentially threatening the back-up plan: traveling to neighboring Illinois, which permits the procedure until approximately 24 weeks, what is considered viability.

"What these 20-week bans force people into is making faster decisions than they want to," she said.

While growing up in a conservative Catholic family in rural Indiana, Portteus' views on abortion were ambivalent. In her early 20s, while getting a master's degree in Indianapolis, she shifted to staunchly "pro choice." While it was not a right she would ever need, she reasoned at the time, it was not a choice she could make for anyone else.

She now considers her younger self to be a bit naive.

When weighing options, the rounds of surgery seemed so intense and the prognosis so poor; the prospect of delivery into a certain death also didn't feel right, she said. One week after that first troubling ultrasound, she was at a Chicago hospital getting a final physician opinion before terminating.

The night before the procedure was agonizing.

"We'd made our decision at that point but he's still kicking, he's still getting good oxygenated blood," she said. "We had seen my son's heart in 3-D. They can turn on colors that show you the blood flow through the heart. We had seen my son's heart through 9 million angles."

Afterward, empty and numb, she went through the motions of life as if in a fog for the rest of that painful August.

The hospital was able to get prints of the tiny feet on the kind of card often given to the parents of newborns. Lines reserved for a baby's name, birth date and size remained conspicuously blank. She fingered that ink-stained paper while sitting at her kitchen table on a recent weekday afternoon.

It was the right choice, she said, but one made with no good alternatives.

"Suddenly you're not pregnant, and you don't have a baby," she said. "It's awful."

In March 2016, when Vice President Mike Pence was governor of Indiana, he had signed a bill that prohibited abortions based on race, sex or disability, though the legislation was later blocked by a federal judge.

"I believe that a society can be judged by how it deals with its most vulnerable -- the aged, the infirm, the disabled and the unborn," Pence had said in a statement.

To Portteus, this kind of legislation seemed "horribly inhuman," particularly for prospective parents who might have undergone years of fertility treatments before learning of a potentially life-threatening defect.

Portteus had expected to give birth Dec. 13, 2013.

On that night, she conceived once again.

After another pregnancy laced with fear and anxiety and many nerve-racking ultrasounds, she gave birth to a son with a healthy heart.

"It was healing," she said.

His name is August William, a now impish 2-year-old who follows his big sister everywhere, completing their family.

'Will he know who I am?'

As the teen gazed at the positive pregnancy test, her choice was never in doubt.

Still in high school and a rocky relationship, Hannah Malliett, of Racine, Wis., recalled the fear and disappointment of that winter of 1999. The 17-year-old was partying a lot, smoking blunts and drinking in the homes of friends. She wasn't ready to become a mother.

Later, while lying in a hospital bed, Malliett was so grateful for her decision: The 6-pound baby girl with a little patch of fine hair was beautiful even as she cried. Malliett named her Alexis. Malliett remembers her parents were supportive though they hoped her lifestyle would change with motherhood.

"A baby is always a blessing," her mom would say.

It was the next positive pregnancy test, roughly a year after the birth of her daughter, that flooded the teen mom with shame.

"Having to say again, here I am pregnant. Again," said Malliett, now 35, in her home less than 20 miles from the Illinois state line. "I know I shouldn't be having sex outside of marriage. I know that I'm young. I can't take care of another baby."

After hiding that little plastic test from her family, she went to a local clinic and announced what had once been unthinkable: She was having an abortion.

"I was so high all the time that, by the time I figured out I was pregnant, I think I was 20 weeks," she said.

Wisconsin implemented a 20-week ban in 2015, except when necessary for the woman's life or physical health. Even before, Planned Parenthood of Wisconsin officials say their clinics didn't perform the procedure that far along in pregnancy; women were often referred to hospitals or another provider out of state.

The 90-minute drive to the Chicago-area clinic was convenient, Malliett recalled.

"And it was far enough from everybody that I knew," she said. "That was a big thing ... I wasn't going to run into someone there that I knew."

The night between the two-day procedure in spring 2001, she slept on and off in the hotel bed.

"Soon it will be all over, and I can just put it behind me," she had thought.

At the age of about 9, Malliett once held a "pro-life" sign on Respect Life Sunday along high-traffic Green Bay Road in Racine. She had accompanied her mother, Rose Erickson, who has worked at a pregnancy resource center inside a local hospital for the past 37 years; one of the services she provides there is abortion recovery for women struggling after the procedure.

Years after her own abortion, Malliett wished Illinois had not been so convenient. She regretted her decision. The guilt began to consume her.

"Depression. Anxiety. Self-hate," she said. "And the emotional part, knowing that I had ended the life of my baby, was so much I almost couldn't bear it."

Thumbing through her mother's Bible-based recovery books about 10 years ago, she tried to find healing on her own. Until the day her mother found those texts under Malliett's mattress.

"That's how I knew she had an abortion," Erickson said. "And it was very devastating for me."

When both women were ready, the mother began leading the daughter through the most intimate recovery of her experience, the two letting go of their grief together.

As one of the later steps, Malliett wrote a letter to God about her terminated pregnancy. Although she never learned the gender, she said she sensed that it was a boy.

"I never got to hold my baby or sing to him, to brush his hair or push him on the swing," she wrote in careful handwriting on a piece of light green stationery. "When I get to heaven, will I know him? Will I see his face and feel in my heart that he is my son? Will he know who I am? I am afraid he will ask me why I didn't want him. What will I say?"

Atop a shelf in the foyer of Malliett's home are two identical figurines of hands holding cherubs. One is in memory of the terminated pregnancy, the other in remembrance of a later miscarriage.

Erickson and Malliett say they favor many of the current abortion restrictions in Wisconsin such as in-person counseling, a 24-hour waiting period and ultrasound requirements. Nationwide, 26 states in some way regulate abortion ultrasound services and in a few of them, including Wisconsin, the provider must show and describe the image on the screen.

"There's a difference between a woman who has her mind totally set on having an abortion and a woman who is not so certain," Erickson said. "Those things might make a difference for the woman who is not so sure ... You can't go back once it's over with."

Now Malliett, a single mom of four, directs local Christian youth groups, helping mentor young women.

She also recently began leading a local abortion recovery group at her nondenominational Christian church, taking another woman through steps similar to the ones she had shared with her mother years ago. She plans to begin a new session in a few months.

"It is because I have walked that path," Malliett said. "I know what it's like to have to carry that burden that I ended the life of my child. But that's part of why I use my testimony to help other women with their healing."

Last resort

She was known only as Jane Doe, as far as the courts were concerned.

The young woman, just two months from her 18th birthday, spoke a little shakily as she told her story to the judge at the Daley Center in winter 2015, each word punctuated by the click of the stenographer's keys. The transcript and any other records from the proceeding would be sealed.

"It was a highly potentially dangerous situation for me, for my parents to know about this, especially my father," the teen from Ohio recalled telling the judge. "I was afraid that I would be hurt physically by my mother and then disowned completely by my father."

The petite teen with long blond hair was embarrassed to be in a new, big city telling a stranger she was a little over eight weeks pregnant and decided to terminate. The high school student had bought her bus ticket to Chicago with a gift card, leaving no paper trail of her five-hour trip.

Her parents thought she was sleeping over at the home of a friend.

"It can be anyone," said the teen, who asked to tell her story anonymously because her parents don't know about her abortion. "It's the girl who has straight A's. It's the girl who has a conservative family. It very well could be your daughter, your niece, your granddaughter."

Illinois requires that minors notify a parent, grandparent, stepparent who lives in the home, or legal guardian before having an abortion, though the law does not mandate parental permission as is the case in some states. If a young woman doesn't want a parent or other family member to find out, she has the legal right to request a waiver of parental notice. This process is known as judicial bypass, granted in Illinois if a judge either deems the minor mature and well-informed or finds that notification would not be in her best interest.

While the number of young women who seek judicial bypass statewide is unknown due to strict confidentiality, "the vast, vast majority of petitions in Illinois are approved," said Emily Werth, Judicial Bypass Coordination Project staff attorney at the American Civil Liberties Union of Illinois, which offers free legal representation to these minors.

She estimates that 5 to 10 percent of clients come from out of state. "It is not surprising, given the restrictions in their home states," Werth said.

The 17-year-old from Ohio remembers the judge's voice was soothing and compassionate. The waiver was granted.

The teen's nausea had grown so intense she was surreptitiously ducking in and out of her Advanced Placement classes to be sick. Although terrified, she was not entirely surprised when the second line appeared on the pregnancy test.

"What are we going to do?" she asked her boyfriend as she cried. "We're going to figure something out," she recalls him saying as he hugged her.

They had met six months earlier, when the young man with bright blue eyes approached her in the school library, complimenting her performance in the recent school play. He was an athlete and clean-cut, not a big partyer, traits she liked. She said they were always careful to use condoms.

"I thought I'd done everything to prevent this," she said, adding that she has since been fitted with a copper intrauterine device.

She never tried to get a judicial bypass in Ohio; she said she had consulted an attorney back home and was told the process was very difficult. In 2011, Ohio tightened its standards, including that the courts "specifically inquire about the minor's understanding of the possible physical and emotional complications of abortion" and determine whether the minor has been coached on her answers.

Regardless of the age of the woman, Ohio law also mandates in-person counseling followed by a 24-hour waiting period.

"Illinois was the closest place to me that had really any hope of a judicial bypass," she said. "So that was my last resort."

Home of a stranger

The teen from Ohio had a second dilemma: Her appointment at the clinic wasn't until the day after she met with the judge. In Chicago by herself -- she and her boyfriend thought it would be too suspicious if both of them were missing at the same time -- she had no money for a hotel because her savings was going to pay for the abortion.

A little snow seeped in her Converse sneakers as she contemplated sleeping outside the clinic.

Instead she found a warm bed and hot meals in the Bridgeport home of a woman she met for the first time that day, a volunteer with the nonprofit Midwest Access Coalition, which provides hospitality and transportation to folks traveling to the Chicago area to have abortions.

She recalls sharing her fears the morning of the procedure with her host over bowls of oatmeal with brown sugar.

The organization was founded in 2014, when executive director Leah Greenblum felt Chicago needed what is known as a practical abortion fund. While nonprofits here and in other states raise money to help women pay for the procedure, Greenblum realized there were all sorts of other costs -- bus tickets, gas money, lodging, meals -- associated with traveling to have an abortion.

"We are also here to be cheerleaders in a system that is so systematically disenfranchising poor women," she said. "If they're trying to make a choice and hitting barrier after barrier, we recognize that. We recognize that is so challenging and we want to help ease some of that burden."

Greenblum, who began hosting women from out of town in her own apartment more than two years ago, now has a network of around 90 Chicago-area volunteers who open their homes or give rides to and from clinics. The organization has served 194 clients as of late June, with 70 percent coming from out of state. The majority of out-of-town women are from Indiana and Wisconsin, though some have also traveled from Ohio, Iowa, Michigan, Minnesota and other states, Greenblum said.

Volunteer Kate Barutha hosted a Wisconsin woman over the winter in the extra bedroom of her Pilsen loft overlooking the Kennedy Expressway. Barutha left her guest a bottle of lotion and a chocolate bar on the nightstand as homey touches.

"I feel that's the least I can do, is make someone feel like, even if there are things happening that are hard and emotional and difficult, that you can still have those comforts around you and feel safe in that way," she said.

Volunteer Amanda Franck drew some historical parallels to the Jane Collective -- formally known as the Abortion Counseling Service of Women's Liberation -- an underground network that provided abortion access, founded in the Hyde Park neighborhood during the final years when the procedure was illegal.

"I wasn't expecting to keep fighting that fight again as I got older," she said. "But I will, because I have to."

She recently hosted a woman from Indiana.

Before the guest left, Franck packed a care package with a few clementine oranges along with a handwritten note listing her guest's train number and directions. There were so many other things Franck wanted to say. I respect your decision. I think you're a really strong person for doing that. I really wish you didn't have to go through all this just to have a medical procedure. Things will be better once you get home. But she didn't want to assume how her guest was feeling or put any of her own emotions on a woman she had just met.

So she settled with a simple "have a safe trip home."

As for the Ohio teen with the long blond hair, she now attends college near the ocean, with mountain peaks looming in the distance. She and the young man with blue eyes are still together.

"More than anything, I wanted to go to college and get a degree, do something I'm passionate about and have a job," she said. "I feel like the people who helped me get through that, even though they were complete strangers, they gave me a rebirth. A second life."

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