As Michigan becomes abortion destination, foes and advocates expand services

• Nearly two years after the U.S. Supreme Court struck down Roe, much of the Michigan fight focuses on remaining abortion restrictions
• Meanwhile, both sides of the abortion fight are expanding services
• Planned Parenthood expanded procedural abortions to a 4th clinic, while pregnancy resource centers are uniting for a stronger voice and what they say will be standardized medical care

GRAND RAPIDS — Perhaps nowhere in the state of Michigan is the expanding divide in Michigan’s abortion politics more literal now than on both sides of two thick strips of asphalt.

To the east of these side-by-side driveways is the Irwin/Martin Health Center, a Planned Parenthood abortion clinic which in February began offering procedural abortions, also known as surgical abortions, for the first time.

The decades-old clinic expanded services from medication-only abortions after Michigan lawmakers last year repealed the state’s so-called TRAP laws that placed onerous building regulations on abortion clinics.

To the west on Cherry Street is PRC of Grand Rapids, one of 78 pregnancy resource centers statewide that oppose abortion and say they help support women as they instead choose to give birth.

PRC has expanded as well, boosting clinical staff and adding another ultrasound machine that allows patients to know gestational age and detect abnormalities, said Jim Sprague, PRC’s CEO.

Related:

• ACLU calls for ending Michigan parental-consent law for underage abortions
• U.S. Supreme Court to weigh limits on pill used in most Michigan abortions
• Whitmer signs pared-down abortion access bills in Michigan

This is ground zero in the abortion fight in Michigan, 18 months after voters extended a state constitutional right to abortion to replace federal protection that ended months earlier when the U.S. Supreme Court struck down Roe v. Wade. 

Now a “haven” state for residents of states where abortion is banned, Michigan continues to work out the edges of access — parental consent and a 24-hour waiting period, for example — in Lansing, in the media and in courtrooms — even as the issue takes center stage in the presidential election, too.

Yet, out here on either side of the asphalt, the fight is day-by-day and on a decidedly personal level. The door on the right offers another option to end pregnancy. The door to the left offers more than double the appointments now — 46 rather than 20 — to get an ultrasound and hear about giving birth instead.

Caught in the middle on this day is a young couple who chose the east side of the asphalt divide.

He is 20 and sits quietly against a wall of the second of the two new rooms at Planned Parenthood. She is 19 and perched at the end of an exam table. 

“Some part of me — I do want to keep it,” she says of the pregnancy, “but I know that it wouldn't be the right decision, especially not being able to give it the life that I would want to give.”

The young man looks at his feet.

“So definitely, it was really a hard decision,” the woman said. “I was going back and forth a lot.”

Michigan’s expanded role

They live nearby — as do most of the patients who come here for abortions. But the clinic’s expansion into procedural abortions reaches out-of-state residents, too. Since the Supreme Court dismantled Roe v. Wade, Michigan has become a “haven state” for patients living in states where abortion is illegal.

About 1 in 6 of the patients that seek an abortion at Planned Parenthood’s Kalamazoo and Grand Rapids clinics are from out of state, according to data provided to Bridge by Planned Parenthood.

In the aftermath of the U.S. Supreme Court’s 2022 decision to reverse Roe v. Wade, some states have banned abortions; others have more deeply rooted protections for it.

Michigan has expanded access, first through Proposal 3 and more recently with the Reproductive Health Act. Just eight states are more “protective” of abortion than Michigan, according to Guttmacher Institute, a reproductive-health research organization that supports abortion access.

Still, the fight continues and expands around restrictions that remain in place in Michigan.

The removal of one of those remaining restrictions allowed Planned Parenthood to begin offering procedural abortions in Grand Rapids.

‘Now we can meet the need’

Gov. Gretchen Whitmer’s signature last fall on the Reproductive Health Act repealed the state’s regulations that required abortion clinics to meet the same standards as freestanding surgical clinics, requiring for example, three feet of space around each exam table or special gooseneck faucets that could be operated by wrist, knee or foot. 

Those requirements were not possible in the 1950s building that became an abortion clinic in 1969, according to Planned Parenthood. But the provider had renovated the two rooms in 2015 — in anticipation that they might one day be used for procedural abortions.

The change, then, gave Planned Parenthood the legal ground to perform the first procedural abortion at the Grand Rapids clinics. The first procedural abortion was performed in Grand Rapids February 19 — just days after the law was effective. 

“The intent was there,” said Dr. Hannah Rosenfield, on a recent Monday just before patients arrived. “Now we can meet the need. We can do what patients need us to do.”

The Grand Rapids clinic became the fourth of Planned Parenthood’s 14 clinics to offer procedural abortions, in addition to other care. Planned Parenthood’s other Michigan clinics offer abortion by medication only.

That move built on another expansion a year ago — months after abortion access was enshrined in the state constitution — when Planned Parenthood opened a virtual clinic, cementing access to abortion through telehealth.

Moreover, abortion rights advocates have called for an end to the state’s remaining parental consent law, while Northland Family Planning Centers, which operates clinics in southeast Michigan, will appear in Michigan Court of Claims Tuesday to challenge three remaining abortion restrictions: Michigan’s 24-hour waiting period, the state’s requirement for counseling, and a law that bans advanced practice registered nurses and physician assistants from providing abortions.

Abortion opponents also step up the fight.

Right to Life of Michigan has challenged Proposal 3 in federal court, arguing Michigan’s abortion access violates federal constitutional rights for, among others, the ‘pre-born and born following a failed abortion.’

Meanwhile, the previously loose network of 78 pregnancy resource centers have begun to unite under the Michigan Coalition For Pregnancy Wellness (MICO) — a group designed to bring medical standards to all centers that will offer clinical services, said Executive Director Carolyn Doyle.

“It’s about delivering best practices and caring for women and children,” she said.

Some will continue to offer non-medical services — instead offering supplies — clothes and diapers and baby furniture, for example — or parenting classes, for example, she said.

But for those who offer clinical care — like Grand Rapids PRC that was one of the first crisis centers in the state to offer ultrasound services and began expanding those services in 2020 — the new organization will set standards for medical care, Doyle and Sprague said.

To become a member of MICO, for example, a center must have a medical director — preferably an ob-gyn — that is currently practicing, she said.  And they’ll have to meet standards set out by three doctors from across the state, Doyle said.

Doyle is also president of Life Matters Worldwide, which describes itself as “encouraging, equipping, and strengthening pregnancy care workers across the United States.”

The statement of encouragement, at least in part, reflects the growing need for such centers, said Eileen McNeil, president of Citizens for Traditional Values, which the Michigan coalition lists as a “strategic partner.” Citizens works “to promote and preserve Judeo-Christian values in local communities and at the state capitol,” according to its website.

McNeil accused abortion advocates of “heavily” promoting abortion in Michigan.

“You can't turn around without someone talking about how important it is for women to have abortions and make sure they have choices,” she said, noting that the choice should always start with birth. “So … it's a good thing that pregnancy resource centers are there so women who choose to carry their babies (have) organizations out there who also will surround them, and care for them.”

The coalition also answers the increasing attacks in Michigan and elsewhere on abortion opponents, Doyle, the coalition president, told Bridge.

Pregnancy resource centers have been criticized as deceptive — luring in patients with the promise of complete care, but then pressuring them out of abortions or delaying their decision so that patients are forced to undergo procedural abortions in a clinic rather than medication abortions that can be done in the privacy of their homes.

In 2022, the review site Yelp began posting notices on its pages warning consumers about the limited options at pregnancy centers and the fact they do not provide abortion care. In October, Michigan Attorney General Dana Nessel joined 15 other attorneys general in a letter supporting Yelp’s move and criticizing the centers as using “tactics” that misinform and “can have dire health consequences and rob patients of their healthcare choices.”

Such criticisms are unwarranted, Doyle and others said.

The coalition, she said, will give pregnancy centers a stronger voice.

Genevieve Marnon, legislative director of Right to Life of Michigan, agreed:  

“Women set on an abortion know where to go, yet often women want to explore their options and better understand if support exists to make a choice for the life,” she said.