Abortion providers and advocates did not expect an early draft of the Supreme Court's opinion overturning Roe v. Wade to be leaked at least two months before the official ruling was expected. But they have been preparing for the end of the landmark ruling for the past decade.
"We are not surprised by the decision. We are very surprised by the leak," Robin Marty, an operations director at the West Alabama Women's Center, told BuzzFeed News. "A lot of what is in this decision was pretty much already written in the stars when we heard the arguments in December, and we've kind of been making assumptions ever since then. We always hoped that something would happen at the last minute, that somehow cooler heads would prevail."
The draft, published Monday night by Politico, was extraordinary both in substance and that it breached the norms of the highest court. Written by Justice Samuel Alito, the draft majority opinion overturns Roe v. Wade, which recognized a person's constitutional right to abortion, and Planned Parenthood v. Casey, which upheld Roe. On Tuesday, Chief Justice John Roberts confirmed that the draft was, in fact, genuine, and ordered an investigation into the leak.
Marty, who wrote a Handbook for a Post-Roe America, did not have much time to dwell on the surprise element of the bombshell report. Alarmed by the news, patients and even some of the staff at the West Alabama Women's Center assumed that Roe was definitively overturned on Monday night, and Marty said she had to assuage their concerns.
But abortion providers and advocates had long anticipated that the increasingly draconian anti-abortion legislation being introduced across the country was meant to gut Roe v. Wade.
"This has been the plan of anti-abortion extremists the entire time," Nika Vizcarra, an abortion provider in Las Vegas and a Physicians for Reproductive Health advocate, told BuzzFeed News. "We're still just devastated. I'm completely devastated for my patients, as well as all the providers who are fighting for access of this very essential, basic form of healthcare."
Vizcarra said she has seen patients from as far as Texas and Oklahoma, where restrictive abortion laws are already in place, and that she expects that to increase.
"A majority of the Midwest and South will lose access if Roe is overturned," Vizcarra said.
At the West Alabama Women's Center, Marty and her staff are already preparing for a world after Roe. They are trying to see as many patients who want an abortion in the next month, she said, with plans to potentially extend the clinic's opening hours and offer abortion procedures all day instead of just in the mornings.
The clinic is also planning to double down on programs to provide post-abortion care for patients if they can no longer provide the procedure itself.
"We know that [abortion] is not going to go away and people are just going to try to manage it themselves," Marty said. The clinic could not previously commit to these programs "because the abortion crisis has been so all-consuming," she said.
With access already so patchwork from state to state, some clinics in states hostile to abortion rights are also mulling their future.
North Dakota's only abortion provider, the Red River Women's Clinic, has been considering moving to Moorhead, Minnesota, just across the border from its current location in Fargo. Minnesota is one of the only states in the Midwest where abortion would remain legal if Roe is overturned; its neighboring states either have trigger laws outlawing abortion if Roe is struck down, or have lawmakers working to enact abortion bans.
"Our hope and our goal is to maintain the status quo in our region," Tammi Kromenaker, director of the Red River Women's Clinic, told BuzzFeed News. "If we just have to move our operations 10 minutes across the river, you know, we are lucky to be so close to a safe state. If we can pull that off then essentially nothing will really change for those patients that we see."
Abortion providers and advocates who spoke to BuzzFeed News emphasized how crucial abortion funds are in this moment.
"Right now it's going to be the time to show up with material support for abortion funds," Emma Hernandez, a spokesperson for We Testify, an organization promoting abortion storytelling, told BuzzFeed News. "They are really making it happen for folks who have to travel out of state who have to now account for flights, gas mileage, childcare, as they have to access abortions further and further."
Vizcarra, the doctor in Las Vegas, also encouraged people to volunteer as clinic escorts and contact their local legislators.
Kromenaker said she has noticed in recent months patients becoming more vocal about their support for her clinic and reproductive rights. And she believes this draft outlining the Supreme Court's intentions will further galvanize people.
The Red River Women's Clinic has already seen an uptick in donations, and the North Dakota WIN Abortion Fund, which Kromenaker is also affiliated with, has received more than 200 donations in the past two days, she said.
"It's unprecedented," Kromenaker added about the influx of donations. "Hopefully the sleeping giant will awaken, and people will act, and people will mobilize, and people are gonna say 'Enough is enough.'"
On Tuesday morning, President Joe Biden called on lawmakers in Congress to codify Roe if the Supreme Court rolls back the ruling. He also remarkably used the word "abortion" in his statement for what appeared to be the first time in his presidency.
Hernandez said it was not enough.
"We need him to go beyond commenting on the current abortion crisis, and to provide us a real plan on how he will provide constitutional protections for abortion rights," Hernandez said. "Codifying Roe isn't enough anymore. That's really the bar on the floor."