How abortion clinics in sanctuary states are handling a surge in out-of-state care

Nationwide, workers at clinics that shuttered abortion services are feeling fear and stress as they chart a path forward following the U.S. Supreme Court's decision to overturn Roe v. Wade.

With more than half of U.S. states geared up to enact full bans on abortions, some removing all exceptions including rape and incest, some states like California have vowed to become a sanctuary for people seeking reproductive care that has been stripped from them. 

According to a report from Guttmacher Institute, a research organization that publishes data related to sexual and reproductive rights, California is expected to see an estimated 3,000% increase in the number of people visiting for reproductive care.

Abortion clinics have been preparing for this moment for nearly 50 years

Abortion providers like Planned Parenthood have been preparing for this ever since 1973 when the Supreme Court first made its decision on Roe v. Wade. 

"We have been preparing for this moment for quite some time, so I’m proud to say it didn’t catch us completely off guard," Juliana Serrano, Planned Parenthood vice president of advocacy and equity in Pasadena and San Gabriel Valley, said in an interview with FOX TV Stations on July 5. "We have been planning to build up our infrastructure and our workforce so that we can make additional appointments and serve additional patients that will be coming to us from out-of-state, and that is true for all seven of the affiliates here in California. 

Serrano says she feels confident in other Planned Parenthood locations across the U.S.

"I know from our colleagues where they are in states where abortion is still protected that they too have been meeting the moment, and preparing for this moment, and so our doors remain open," Serrano added. 

RELATED: Nationwide abortion ban could raise maternal death rate by 24%, study suggests

Serrano says her clinics have already been handling a surge in out-of-state patients following a Texas law that took effect in September, which bans abortions once cardiac activity is detected, usually around six weeks of pregnancy and without exceptions in cases of rape or incest

She says they have not only seen patients coming from Texas, but also the surrounding states that are experiencing an influx from Texas patients seeking health care. 

"It’s demonstrative of a potential trickle effect that we will continue to see expand in time, but we are seeing out-of-state patients. Just last week on Thursday. As a matter of fact, I know we saw three patients come to our affiliate from out-of-state for their abortion care," Serrano explained. 

Who is impacted the most and what resources can help them?

"I want to note in particular those people who will struggle the most as a result of these bans being put in by their state are Black, indigenous, Latino, people of color, women and trans men who are already marginalized and oppressed by society, already struggling to receive adequate care from health care systems that exist in their home state," Serrano explained. 

"They are the ones that are going to struggle in particular because they may not have the resources to be able to travel out-of-state into another state where they can get the abortion care that they need or want. So that’s who we are mostly thinking about and our attention is drawn to at this time." 

While California Gov. Gavin Newsom has pledged to make the Golden State a safe haven for people seeking an abortion, the Associated Press reported on June 28 that his administration won’t spend public money to help people from other states travel to California for the procedure.

Newsom’s decision, included in a budget agreement reached last month, surprised abortion advocates who have been working with the governor for nearly a year to prepare for a potential surge of patients from other states coming to California for abortions now that the U.S. Supreme Court has overturned Roe v. Wade.

California’s operating budget includes $20 million for an "Abortion Practical Support Fund" to pay for things like airfare, lodging, gas and meals for people seeking abortions in California. But the money can only be used to help people who already live in California, not people traveling from other states. The fund will accept private donations, but it’s unclear if that money can cover out-of-state travel expenses.

This presents a serious challenge for clinics in sanctuary states as they currently handle the ongoing surge of patients.

In other sanctuary states like New York, Planned Parenthood and civil liberty groups are urging lawmakers to start the process of passing a constitutional amendment protecting access to abortion care in case a future legislature repeals the state law.

Planned Parenthood of Illinois says it expects to handle an additional 20,000 to 30,000 patients in Illinois in the first year following the reversal of Roe.

But Serrano says local abortion providers typically have funds that exist in hopes of helping those patients. These funds help patients either pay for the procedure itself, getting them connected to a provider, transportation, or child care they may need in order to make an appointment. is a national website that Serrano says is a valuable resource to help connect people seeking reproductive care, especially for those confused as to whether or not their home state even provides care. 

A common misconception about Planned Parenthood

Many people misunderstand what Planned Parenthood and similar clinics actually do for the community. A common misconception is that they only provide abortions. But the recent bans on the procedure are going to make it harder for people to get access to other services that Planned Parenthood provides. 

Maybe someone in a state where abortion is now banned has been misled to believe their local Planned Parenthood has closed. It’s this sort of misinformation that can be detrimental to patients seeking other critical and currently legal care that the organization offers, according to Serrano.

Essential health care includes STD testing, HIV testing, hormone therapy for people who are transitioning, breast exams, pap smears and much more. 

"We’re often times the only health visit that a patient may see over the course of a year," Serrano said. "They may be coming to us for birth control but then we discover other health issues and we can meet them in their particular need."

"So for those affiliates across the nation that are no longer providing abortion care because their state has banned them for providing care, they are still providing critical life-saving health care services to members of their community," Serrano added. 

What does the future hold for Planned Parenthood?

Serrano says her organization has been leveraging any and all powers they have to work with state officials, the legislature and the governor to ensure they get adequate funding to support California residents, as well as those coming from states where abortion is now banned. 

Of the 26 states which run the risk of facing full bans on abortions, 13 of them have trigger laws that went into effect as soon as SCOTUS overturned Roe v. Wade. Serrano says there is a line of communication to help clinics in those states in order to help those most impacted by these legislative decisions. 

"I want to stress that this movement that has been at work for some time, nearly 50 years, is beginning with abortion but by no means will end with abortion, and it wants to really see women denied access to contraceptives as well," Serrano said. "That is in jeopardy for every provider including Planned Parenthood, and that is something that is of deep concern to us."

Following the court’s decision, Justice Clarence Thomas said the court should review other precedents, including its 2015 decision legalizing same-sex marriage, a 2003 decision striking down laws criminalizing gay sex and a 1965 decision declaring that married couples have a right to use contraception.

Serrano says she feels confident in the success of a campaign to codify in the state’s constitution the right to abortion and the right to contraceptives through a constitutional amendment that California voters will vote on this November. 

In the meantime, Serrano says organization by people at the local level will be the most effective tool in order to help the millions of people who have not only lost access to life-saving health care but those who have more difficulty attaining it due to the ongoing bans across the U.S.

The Associated Press contributed to this story. It was reported from Los Angeles.