ATLANTA — About a month ago, as speculation grew that the U.S. Supreme Court was preparing to overturn the landmark decision that made abortion legal throughout the country, Planned Parenthood's Southeastern office quietly created a new position.
The new staffer, based in Atlanta, was envisioned as essentially an abortion air traffic controller for a post-Roe v. Wade South, a region likely to take away or severely restrict access to the procedure if the federal constitutional protection is lifted. Among the staffer's duties would be helping pregnant women get to states where abortion remained legal.
While Planned Parenthood was laying the groundwork for how it might respond to such a Supreme Court decision, Mike Griffin was shoring up his relationships with state lawmakers. Griffin, a longtime lobbyist for the Georgia Baptist Mission Board, sensed that the day was coming that local elected officials, not judges, would have the final say on abortion access.
"Overturning Roe," Griffin predicted, "will not end the fight over abortion."
In fact, it may only heat it up.
Americans were jolted into a new reality this week when an early draft of the Supreme Court's opinion in a Mississippi abortion case was leaked to the news organization Politico. The 98-page document, authored by Justice Samuel Alito, confirmed that the court's conservative majority was on track to gut the country's 49-year-old national guarantee of abortion rights.
While the court has confirmed the document's authenticity, it issued a press release saying that the draft does not represent "the final position of any member on the issues in the case."
Even so, many local abortion rights advocates are now setting their sights on raising money for abortion travel funds. Health care providers are preparing to work harder on pregnancy prevention messaging, contraception education and counseling.
Meanwhile, anti-abortion activists — who have waged a decades-long campaign to strike down Roe v. Wade — are holding their breath, hoping that the final Supreme Court decision isn't significantly weakened from Alito's draft.
And all are watching the federal 11th Circuit Court of Appeals, which has put on ice the challenge to a restrictive abortion law passed in Georgia three years ago as it waits for the Supreme Court to first weigh in on the Mississippi case.
The Georgia statute outlaws the procedure in most cases once a doctor can detect fetal cardiac activity, typically about six weeks into a pregnancy. If the Supreme Court overturns Roe, legal observers are expecting the appellate court to quickly greenlight Georgia's statute.
All of that will affect lives across the Southeast, where Georgia has become a hub for abortions as other states' services have been scaled back under pressure.
"We've been preparing for this fight for decades," said Lauren Frazier, a spokeswoman for Planned Parenthood Southeast, which operates four health centers in Georgia that provide services such as health screenings and abortions.
There are currently 28 facilities that provide abortions in Georgia, according to the abortion rights group NARAL Pro-Choice America.
Michelle Bennett, who lives in Decatur, volunteers as a clinic escort for women at one of those facilities in northeast Atlanta.
"It is heartbreaking the number of out-of-state (license) plates that we get," said Bennett, recalling a couple from Texas who recently came there because they couldn't find an open appointment closer to home. "This was their only option."
Abortion rights advocates are worried Georgians might find themselves in the same situation should the Supreme Court retract Roe.
Doctors say that many women don't know they're pregnant before the six-week statutory deadline that would take effect in Georgia.
That's prompted many advocates to shift their attention toward abortion funds, which raise money to pay for the procedure, travel and child care for needy patients.
One of the only funds based in Georgia is Access Reproductive Care-Southeast, which focuses on helping women in six Southern states.
Since its founding in 2016, the group has contended with soaring demand, especially after Texas' abortion law was implemented last fall, said Oriaku Njoku, ARC's co-founder and executive director.
"Every month since then, we have had to close our helpline early because the demand is so great," and the monthly funding sometimes runs out, said Njoku.
Within 24 hours of the Alito draft being leaked, Njoku said ARC saw a spike in donations from furious onlookers.
"The idea of crossing county lines, crossing state lines, that has already been happening," said Njoku. "But now we're talking about folks having to leave our region. That means going all the way up as far as New York, as west as California, Illinois."
Should Georgia's abortion law be implemented, some abortion providers are likely to redirect their efforts on early pregnancy testing and encouraging birth control. It's partially a matter of financial survival.
"It would just be a matter of expanding the other areas of our practice," said Megan Gordon-Kane, a lobbyist and spokeswoman for the Atlanta-based Feminist Women's Health Center.
Abortion by pill — no different under the law than a surgical abortion — would also change. A doctor's prescription is required for the pills, so those doctors would have to stop prescribing for patients more than six weeks pregnant. Pharmacists can't hand over the pills without a prescription.
If Texas is any guide for Georgia, some will still try to get around the state ban.
Texans have increasingly sought out online abortion doctor consultations offered by the overseas organization Aid Access, according to its Dutch founder, Dr. Rebecca Gomperts. Speaking in an interview for Ms. magazine in February, Gomperts said that her group will provide abortion pills by mail from a pharmacy in India to patients in all 50 states.
But for many providers in Georgia, working outside the law is a line they say they won't cross.
"Health care providers want to provide care within the law and not put their licenses at risk, not go to prison," said Lorie Chaiten, a longtime American Civil Liberties Union attorney who has defended use of the abortion pill. "I can assure you that providing medication abortion is considered an abortion in every state."
A metro Atlanta OB-GYN who provides abortions said that, if the procedure is severely restricted in Georgia, she will likely pivot her practice.
"For me, it's going to be a lot more education and advocacy," said the doctor, who requested anonymity out of fear for her family's safety.
She predicted that abortions would continue no matter what, even if women have to travel or look to the internet for do-it-yourself methods.
Dr. Cary Perry, president of the Georgia Obstetrical and Gynecological Society, does not perform abortions. But she is concerned that different types of care for women will now be disrupted if the treatment impacts tissue in the uterus, such as chemotherapy.
And she's concerned that medical care that is sometimes needed to help a woman in the midst of a miscarriage — for example, a dilation and curettage, a procedure commonly known as a D&C, in which tissue is removed from the uterus — could be confused with illegal abortion.
"Are we going to have innocent, sad women presenting at eight weeks, bleeding from their miscarriage, have a D&C and get accused of having an (illegal) abortion, thereby criminalizing the provider?" asked Perry, who emphasized that she is speaking for herself as a physician.
Dr. Mimi Zieman, an Atlanta OB-GYN, worries that such a landscape could prompt an exodus of health care workers from Georgia if doctors fear they could be prosecuted or handcuffed in their work. Georgia already has an OB-GYN shortage — at last count there were nearly three-dozen counties currently without one.
Fewer doctors, Zieman said, "will have grave consequences for all women seeking GYN care for everything from fertility treatments to thyroids, menopause or bleeding issues."
Abortion opponents, meanwhile, say they don't plan to sit back, even if justices ultimately pare back Roe.
For many, the priority will be ensuring that Georgia's 2019 abortion law is speedily upheld in court. Others are zeroing in on this year's elections.
"We have the opportunity to elect people who can better decide than ever before, because they're empowered to do so, how we protect life in our state," said Cole Muzio, who runs the conservative Norcross-based Frontline Policy Action.
There are other issues on the wish lists of anti-abortion activists.
That includes passing a "personhood" amendment to the state's constitution and reviving Senate Bill 456, which failed to pass in the legislature last year and would have banned women from receiving the abortion pill through the mail.
Dr. Jeffrey Harris runs an OB-GYN clinic in Jesup, roughly 40 miles northwest of Brunswick. He doesn't encounter many women seeking abortions, and, having been born to a 15-year-old mother in the days before Roe, said he won't be heartbroken if the law falls.
If it does, Harris thinks the state needs to do more to help rural health care practices that have been stretched thin for years.
"I think, if we make this commitment that more people are going to keep their babies, we should try to put more of an emphasis on contraception so they don't get pregnant, and if they do, on education and support of the basic need-type stuff," he said.
