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The last abortion clinic in Mississippi only employs out-of-state doctors. Two are from Massachusetts.

Cheryl Hamlin, a doctor at Mount Auburn Hospital in Cambridge, travels regularly to Mississippi to provide abortion care.Dr. Hamlin Photographs Rory Doyle/The New York Times

The Jackson Women’s Health Organization, known colloquially as the Pink House for its flamingo-colored stucco exterior, is the only abortion clinic in the state of Mississippi.

It will almost certainly be the last.

The Mississippi law at the heart of the Supreme Court case that could soon overturn Roe began as a crusade to close the Pink House, a 27-year-old Jackson institution. If the court decision leaked in May stands, the clinic — as well as dozens of others across the South and Midwest — will be shuttered almost immediately.

But, for now, Roe still stands.

And the Pink House remains open, kept afloat by countless volunteers, dedicated staff, and seven out-of-state doctors, who perform the abortions that local doctors refuse, often for fear of harassment or the loss of local job opportunities.

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Derenda Hancock, co-organizer of the "Pink House Defenders," stood outside the Jackson Women's Health Organization, Mississippi's last abortion clinic, also known as the "Pink House," early this month in Jackson, Miss.Rogelio V. Solis/Associated Press

Two are obstetrician gynecologists from Massachusetts. Once a month, they set off from Logan Airport and land 1,255 miles away in Mississippi’s capital, where they spend the next three days providing abortion care at the Jackson Women’s Health Organization.

Cheryl Hamlin, a doctor at Mount Auburn Hospital in Cambridge, had never been to Mississippi before she decided she wanted to work part time at the Pink House after Donald Trump triumphed in the 2016 presidential election.

“I had this feeling that I was up in my own little bubble in Massachusetts and didn’t understand the rest of the country,” said Hamlin, 59, who also works part time at Women’s Health Services in Brookline.

Hamlin was the only physician willing to use her full name for this story. A second Massachusetts doctor asked to be identified by a pseudonym, Amanda, and that the Globe withhold the name of her hospital. Both expressed a fear of retribution from Mississippi officials, as well as from antiabortion advocates. Several states are currently considering laws that would threaten abortion providers with jail time.

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Hamlin flew to Jackson most recently on May 2, her phone buzzing with news of the leaked Supreme Court draft opinion. Written by Justice Samuel Alito, it upheld the Mississippi law banning abortions after 15 weeks, effectively overturning Roe v. Wade, and opening the door to state laws that seek to ban the procedure entirely. Hours later, Hamlin arrived at the small pink building on North State Street that had inspired the lawsuit four years earlier. Jubilant abortion protesters waited outside. She gave up on trying to engage with them years ago.

“The staff had a little cry,” said Hamlin of the mood inside the Pink House that morning. “Lots of press were hanging around. But then the clinic opened and we just went on with the day’s appointments as normal.”


Dr. Cheryl Hamlin (left), who travels to Mississippi from Massachusetts to help women who are seeking abortions, outside the Jackson Women's Health Organization in Jackson, Miss., May 3. RORY DOYLE/NYT

While the draft ruling looks likely to shatter the almost 50-year-old bedrock of reproductive rights in America, it does not surprise abortion providers in the South. The Pink House had been in the spotlight for months. As the last remaining abortion clinic in Mississippi, it’s an island in a landscape flooded in the last few years by waves of restrictions that have made abortions progressively harder to obtain, here and through much of the South and Midwest. Just three clinics remain in both Louisiana and Alabama.

Hamlin said none of her colleagues doubt that the Supreme Court’s decision, expected in the next few weeks, will finally wipe out the Pink House, but until it arrives, there are patients to see.

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Patients like a 15-year-old who arrived at the clinic roughly 15 weeks pregnant after being raped. It was her second time that week wading through the gauntlet of protesters, because Mississippi law requires two in-person clinic visits, separated by at least 24 hours. Her mom accompanied her, as state law also mandates that adolescents receive consent for an abortion from at least one legal guardian.

Doctors at the Pink House are limited by state law in their ability to administer or provide medication to their patients, so all procedures are performed under local anesthesia. Full sedation is not allowed. Midway through the procedure that day, the teen began to panic and curled into a ball.

“I couldn’t continue safely, but I also couldn’t send her home at that point,” Hamlin recalled. “So I sent her to the hospital because this wasn’t a pregnancy that could be continued anymore. But the people at the hospital wouldn’t intervene. They waited until she bled more and was nearly septic before giving her what she really needed, which was the sedation needed to complete the procedure. I mean, God, that could have been such a simple thing.”

If the same teenager had sought an abortion in Massachusetts, how would her experience have been different? Hamlin took a deep breath.

“Oh geez,” she began, envisioning the teen walking into Women’s Health Services in Brookline.

The girl would still need a parent or guardian’s permission, per state law. Then she would meet with a licensed social worker, who would counsel the teen on her options. If she wanted to proceed, she would be deeply sedated. Since the teen was a victim of rape, MassHealth would pay for the procedure.

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“At the maximum,” said Hamlin, “it would take five hours.” Instead, the procedure was a weeklong ordeal, punctuated by two several-hour visits to the Pink House and a night in the hospital.

It was this type of disparity in care that drove Amanda — another Boston-based obstetrician gynecologist — to pick up shifts at the Jackson Women’s Health Organization in 2019, after visiting the clinic

“It is just a total 180. It’s practically a different country. Nobody even knows where my abortion clinic is up here. I’ve never seen a protester in my life,” she said of her practice in Boston.

An antiabortion activist offered a potential patient a packet of antiabortion material including a coupon for a free sonogram outside the Jackson Women's Health Organization this month.Rogelio V. Solis/Associated Press

Whenever Amanda or Hamlin sees a patient for the first time at the Pink House, they are required by the state to share certain information with the patient. Or, as Hamlin calls it, disinformation.

“I have to say that abortions increase the risk of breast cancer. I can negate it in the next sentence, which I do. But I have to tell them that,” said Hamlin.

A substantial body of medical research indicates there is no link between abortion and breast cancer. The National Cancer Institute has stated, “There is no evidence of a direct relationship between breast cancer and either induced or spontaneous abortion.”

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Many of her patients give her a knowing look, acutely aware of the discrepancies between the narrative spun by the state and scientific reality, she said. But others are understandably alarmed.

“Just the fact that I’m being forced to lie to my patients is really frustrating,” said Hamlin.

The state of Mississippi also requires providers to explain that “the father is liable to assist in the support of her child,” even in instances in which the father has offered to pay for the abortion.

“It is very judgmental to assume the patient is not with the father of that pregnancy, and if they were then that is all they would need to continue the pregnancy,” Amanda said. “Sure, money is a part of it, but it’s not the only factor in determining whether to carry a pregnancy to term.”

Take, for example, a patient with a documented history of preeclampsia, a rare pregnancy complication that can lead to serious — even fatal — complications for both the mother and baby. The condition doesn’t arise until the third trimester.

“Does this qualify as a life-threatening condition? Maybe not at eight weeks, but at 35 weeks, it absolutely does. In a post-Roe world, this woman won’t have the choice ... even if she nearly died in the last pregnancy,” said Hamlin.

Neither Hamlin nor Amanda has roots in Jackson beyond the Pink House. During the day, they rarely venture beyond the 8-foot-tall concrete and iron walls surrounding the clinic, in part because they don’t have time, and in part because they want to avoid interactions with the protesters. The share an apartment outside the city limits. They drive rental cars. They swoop in and out of Mississippi for just three to four days at a time.

This transience is intentional. It reduces the risk of being harassed or targeted. It also enables them to do this work and keep their jobs back home. It is a choice that most employees at the Pink House do not have.

“I frankly don’t know how they do it. They really believe in the work, in helping women, and that’s why they keep coming, despite the protesters and the laws and the stigma,” said Amanda. “Just by deciding to be there every day, they are the greatest advocates of the cause.”


Hanna Krueger can be reached at hanna.krueger@globe.com. Follow her on Twitter @hannaskrueger.