The Hope Medical Group for Women in northern Louisiana fields phone calls every day from anxious pregnant women who ask if abortion is still legal and if the clinic, one of only three that provides abortions in the state, is still open.
Despite the protesters who sometimes gather outside, the threats that forced the clinic to board up all the windows and the repeated restrictions put upon abortion providers in this staunchly anti-abortion state, the clinic stands. Abortion remains legal in Louisiana and elsewhere in the United States. But a Supreme Court case set for arguments Wednesday could lead to the clinic's closure and, more fundamentally, a retreat from protecting the right to abortion that the high court first announced in 1973.
The case is just one in a series of high-stakes disputes the more conservative court, now with two appointees of President Donald Trump, is expected to decide by late June as the 2020 election campaign gathers steam.
"We're fighting this as hard as we possibly can. And for now, all three clinics are still open. And for now, abortion is still legal in all 50 states," said Hope's administrator, Kathaleen Pittman.
Ms. Pittman tries to keep her focus on the women who come through the door every day – generally poor women who are forced to travel increasingly longer distances as other clinics in Louisiana and neighboring states have closed. Ms. Pittman estimates as many as 80% of the women who come in get financial assistance to help pay for the abortion.
They travel from 200 miles or even 300 miles away and from neighboring states to do a state-mandated counseling session and then return another day to have the abortion, Ms. Pittman said.
"I've been here for 27 years. And the constant refrain we hear regarding the reason for terminating a pregnancy has always been primarily lack of financial resources. People are broke," she said. "It's the women who have the least that are going to suffer the most."
Anti-abortion groups, the Trump administration, and members of Congress hope the court will take its first steps to roll back protections for abortion and uphold a Louisiana law that would require doctors at abortion clinics to have admitting privileges at a nearby hospital. "This case is about the health and safety of women," said state Sen. Katrina Jackson, a Democrat who sponsored the 2014 law.
More than 200 members of Congress, almost all Republican, suggest in a court filing that the court could go further and overrule the landmark 1973 Roe v. Wade decision.
States have passed dozens of abortion restrictions in recent years, including measures that would ban abortion as early as six weeks into a pregnancy. Those laws have so far been blocked by courts.
The issue of abortion providers' relationship with local hospitals is familiar to the high court because in 2016, the court struck down a similar law from Texas.
The only thing that has changed since then is the makeup of the Supreme Court, notably Mr. Trump's appointment of Justice Brett Kavanaugh to take the place of the retired Justice Anthony Kennedy. Mr. Trump pledged to appoint "pro-life justices" and his opposition to abortion has been crucial to his support among socially conservative voters.
The outcome, though, will likely come down to the vote of one man, Chief Justice John Roberts. Justice Roberts has mainly voted in favor of abortion restrictions, including joining the dissent in 2016 that would have upheld the Texas law. But he cast the decisive vote a year ago to prevent the Louisiana law from being enforced while the legal case played out.
Justice Roberts did not explain his vote. But it is extremely rare for a justice to cast the key vote in a case at a preliminary stage and then vote the other way later on.
A trial judge had said the law would not provide health benefits to women and would leave only one clinic open in Louisiana, in New Orleans. That would make it too hard for women to get an abortion, in violation of the Constitution, the judge ruled. But an appeals court upheld it in 2018. The clinic appealed to the Supreme Court.
As recently as 2011, there were seven abortion clinics in Louisiana, according to the New Orleans Abortion Fund, which raises money to pay for women who want to have an abortion.
Two doctors perform abortions at the hospital, Ms. Pittman said. One has admitting privileges and the other does not. A third doctor, who also does not have admitting privileges, rotates in as needed. If the law were to take effect, the one doctor with the admitting privileges has testified he would not continue as the lone doctor performing abortions in northern Louisiana, which would force Hope to close.
On a recent day in February, the clinic waiting room was filled with women – some alone and some who appeared to be accompanied by friends, partners, or relatives. Oil paintings with occasional pieces of abortion rights artwork or signs covered the waiting room's walls. A small sticker pasted to the receptionist's window read "Mind Your Own Uterus." Outside the clinic, a small sign read "Please do not feed (or speak to) the protesters."
There were no protesters on this cold and rainy day but just a few blocks away a tall billboard, one of the many across the state, asks women to "Choose life" and gives them a number to call for help.
Two women at the Hope clinic who agreed to speak to The Associated Press said they did not want their names used because of the stigma around abortion. One was a pregnant woman who already has a year-old daughter. She said abortion is morally wrong, but that she cannot take care of another baby. She questioned why anyone would want to force a woman to have a baby she didn't want and worried those children will be mistreated.
The other pregnant woman drove about three hours from southern Louisiana for her counseling session. She knew almost immediately when she found out she was pregnant that she wanted to have an abortion, she said, because she did not feel ready physically, emotionally, or mentally for motherhood.
She feels strongly that women shouldn't be forced to have children if they're not prepared and able to give them all the love and attention that children deserve. If the Shreveport clinic and others in the state were to close, she worried about how she or others could access abortion.
"I think I'd find a way, but it would be much more difficult and much more just exhausting and stressful," she said. "And I think women are going to do this no matter what. So ... why not help us?"
Check out The Christian Science Monitor series, "Looking past Roe."
This story was reported by The Associated Press.