Mississippi has been a target of pro-life activists working to make the state abortion-free since it has passed several laws over the years that limit abortion access. It also has only one abortion clinic. Although some parts of the country view the new court alignment as a threat to abortion access, Mississippi advocates have been fighting against restrictions on abortion for decades and are now preparing for a dual-pronged battle to protect existing providers and fight any legislative attempts to undermine abortion rights. Shannon Brewer, director at Jackson Women’s Health Organization (the only state-run abortion clinic), stated that the main goal right now is to keep the doors open. “But, our main objective right now is staying open because that’s what we are constantly dealing with,” said Shannon Brewer, director of Jackson Women’s Health Organization. The Jackson Women’s Health Organization has been the sole abortion clinic in Mississippi for more than a decade. It has used targeted regulation repeatedly to ensure its doors remain open. The Center for Reproductive Rights filed a lawsuit in 2018 on behalf of the clinic challenging Mississippi’s 15-week abortion ban. This includes complaints against five other state abortion regulations, including a telemedicine ban and mandatory 24-hour waiting period. Providers must also state that there is a medically unfounded link between abortion and breast-cancer. During the court case, the ban on abortions after 15 week was stopped from taking effect. Lawyers representing the Jackson clinic claim Mississippi’s abortion laws, which proponents of expanded abortion access call Targeted Regulations of Abortion Providers or TRAP laws, were invalidated in 2016 Whole Woman’s Health v. Hellerstedt. This decision said that states can’t restrict clinics in a manner that places undue hardship on women seeking abortion. After the Legislature passed a 2012 law that required doctors who work at abortion centers to be admitted to a local hospital, the Jackson Women’s Health Organization sued the state. Federal court was sued by the clinic, arguing that the law was an unconstitutional obstacle to abortion access as it is protected under the Roe decision. Mississippi is one the four states with a law that can ban abortion immediately if Roe is reaffirmed. Planned Parenthood has just announced its new “Care for All” plan. It promises to expand access to abortion across the country via policy initiatives, regional networks, and cultural changes to decrease the stigma surrounding abortion. According to a Pew poll, while public discourse has moved to Roe’s reversal scenarios, the majority of Americans still support abortion access. The Care for All plan’s details, including expanding telemedicine abortion access, are currently impossible or unthinkable in Mississippi where powerful anti-abortion organizations have the ears of state officials. Felicia Brown-Williams is the state director for Planned Parenthood Southeast. “What’s going on around the country right now? People in other states are suddenly confronted with the reality of the issues we’ve been facing here for a decade,” she says. “And that in practice means that we may as well ban abortion for Mississippians beyond the city of Jackson.” Planned Parenthood’s political arm invested resources in political mobilization. The Mississippi’s 15-week ban was considered the most restrictive in the country at the time it was passed, and is now the benchmark for conservative state legislatures looking to pass similar legislation. Georgia’s Republican governoral candidate Brian Kemp resigned this week as secretary of state. He promised to pass legislation similar in Mississippi if he is successful against Stacey Abrams (a former leader of the Georgia state House minority). Alabama approved a ballot initiative giving rights to unborn children. The bottom line is that they aren’t confident in women’s health and safety and it’s hidden in their lives. They don’t believe women can make their own personal, private decisions. Staci Fox, president and CEO of Planned Parenthood Southeast, says that they don’t care about women’s health. “If they cared, they would make it a priority rather than trying to enact barriers through legislation–it is just rhetoric.” Mississippi’s only Planned Parenthood facility, Hattiesburg, doesn’t offer abortions due to building restriction TRAP laws. Brown-Williams, local director, said. Despite not offering abortions, they often find themselves in the crosshairs of Mississippi lawmakers who have promised to “defund” them. Although federal funds do not pay for abortions the sentiment is strong among lawmakers who oppose Medicaid reimbursement payments. This includes preventive services like annual pelvic and breast examinations, infection tests, contraception, and preventive services. A federal judge blocked the Mississippi Legislature’s 2016 attempt to block state reimbursements. U.S. Senate candidate Chris McDaniel rallied recently in front of Jackson Women’s Health, promising to defund Planned Parenthood. The abortion clinic is not associated with McDaniel. Brown-Williams said that it is important to know your face in order to lobby effectively in Mississippi. She said, “You employ them.” She said, “Your taxes pay their salaries and it’s your responsibility to communicate with them what your expectations are. “Until we have more people who care about these topics and feel comfortable in the halls, there won’t be people in those seats who can reflect those values.” Other Mississippians involved in reproductive health work say that culture change has been a priority for them for many years and they want to see more collaboration with community networks. “Cultural change doesn’t happen without building movements. According to Laurie Bertram Roberts (co-founder and executive Director of Mississippi Reproductive Freedom Fund), a fund that raises money for reproductive health care and funds abortions, a cultural shift plan can’t happen without movement building. Roberts is part of the National Network of Abortion Funds and believes that part of the problem, both with legislative restrictions as well as those who fight to preserve the current limited abortion access, is Mississippi’s unique place in the reproductive health conversation. This can be stigmatizing. She stated that there is no option if you don’t fully have all your options. Roberts stated that most of our clients do not have access to all their options from Day One. They have not received adequate sex education and they have not had access to family planning. Roberts also said that they have not had access to adequate prenatal care. This can impact on whether they are able to have an abortion or want to continue having children. Public health research frequently points out the dangers of the state’s inability to provide preventive and maternal care for children and mothers, as well as thedisproportionate impact on African Americans. According to the United Health Foundation, Mississippi is last in terms of mother and child well-being. It has the highest infant mortality rate and the highest maternal death rates. Black babies are 70% more likely to die before they reach their first birthday than babies born to white mothers. Mother mortality in African American mothers is nearly twice that of white moms. According to a March of Dimes report, more than 40 Mississippi counties are considered “maternity care deserts”, meaning that they don’t have access to OB/GYN providers. Brown-Williams from Planned Parenthood says that five of the state’s rural hospitals have closed since 2010, and other counties face uncertain futures. However, lawmakers should keep access to prenatal care in mind, rather than further restricting abortion. She said, “It’s just a matter of whether lawmakers have the political will and make the necessary changes to prevent (high infant mortality rates)–whether their intent is to substantially harm women of color in this state, that’s their impact.” Those opposed to abortion are also stepping up their efforts to change the culture. Terri Herring, president and CEO of the non-profit Choose Life Advisory Committee says that the group wants to reduce the stigma surrounding adoption and promote it as an option for unintended pregnancies. Herring has also advocated for Americans United for Life. Herring is keen to broaden a conversation that, she claims, focuses on only two options. She says, “We only consider two options.” Unintended pregnancies are very common in Mississippi. According to the Mississippi Center for Health Policy, 56 percent of pregnancies in Mississippi were unintended in 2011 compared to 45 percent nationally. Herring’s group is behind “Choose Life,” car tags that have raised more than $3 million since 2002 for Mississippi crisis pregnancy centers. Tax records show that this amount has exceeded $3 million. She spoke out about the centers that the tags fund, saying that her hopes were to offer every option for women in the state to choose life. Herring admits that there has been some criticism of crisis pregnancy centers. These centers are not regulated and do not provide any medical care other than an ultrasound to confirm pregnancy. Herring also acknowledges the negative reactions. She said, “They are not providing medical care. They are providing moral support.” Izzy Pellegrine is a Mississippi State University sociologist and doctoral student studying sex education and its impact on decision-making and health outcomes. She also believes in the importance of cultural shifts prior to policy changes. She believes that women need to be able to make their own reproductive choices and more needs to be done. She also studied the impact of disenfranchising Mississippi women on reproductive decisions. She stated that Roe would not affect the access of many Mississippi women to abortion services if Roe is repealed. She stated that Roe would not affect the access of many Mississippi women to abortion services if it fell. However, data and on-the ground organizing showed that Mississippi’s white women were more likely to travel across state lines to obtain abortion care. In contrast, low-income and African-American women relied on Jackson’s limited access. “If you knew exactly nothing about Mississippi and you landed in the middle of the state one day, it wouldn’t take you long to pick up on the idea that there is a lot of movement in anti-choice organizing activity–billboards, car plates, bumper stickers, the whole nine–but you would probably be less likely to see immediate signs of the work that the pro-choice movement is doing on the ground in Mississippi,” Pellegrine said. “And that’s why the already-strained resources for pro-choice work in Mississippi are going into service provision or high-level advocacy work just to keep doors open and lights on,” Pellegrine said.