Around two days a week, Natalee Hartwig leaves her home in Madison, Wisconsin, before her son wakes up to travel across the border into Illinois.
"Luckily it's summer," said Hartwig, a nurse midwife at Planned Parenthood of Wisconsin. "For now, he can sleep in. But any getting ready that has to happen will be on my spouse."
She drives at least two hours each way, immersed in audiobooks and podcasts as she heads back and forth from a clinic in this northern Illinois suburb. She spends her days in the recovery room, caring for patients who have had abortions and checking their vitals before they go home. She is also licensed in Illinois and trained to provide medication abortion, something she'll be able to do virtually through telehealth with patients across Illinois.
Hartwig is essentially working part time in Illinois because when Roe v. Wade was overturned in June, a state law immediately took effect that bans nearly all abortions in Wisconsin, except to save the life of the pregnant person. Wisconsin providers want to preserve access for patients, while those in Illinois — long an oasis for abortion rights — need more staff to help treat a surge of people arriving from across the U.S.
The Waukegan clinic is Planned Parenthood of Illinois' busiest for out-of-state abortion patients. After Roe fell, 60% of patients came to this clinic from outside the state — mostly from Wisconsin. In fact, the organization opened in Waukegan two years ago with Wisconsin in mind, knowing that if Roe v. Wade did fall, access to abortion in that state would greatly diminish.
After Roe was struck down, Planned Parenthood organizations in both states announced their partnership. More than a dozen employees from Wisconsin — including doctors, nurses, and medical assistants — now commute to Waukegan to help provide care.
"It really required this perfect pairing of supply and demand," said Kristen Schultz, Planned Parenthood of Illinois' chief strategy and operations officer. "They had capacity without local demand, and we had the opposite."
In the month after the U.S. Supreme Court overturned the federal landmark decision, Illinois became even more of an oasis for people seeking abortions. Dozens of clinics closed across the nation as 11 states in the South and Midwest implemented bans, according to the Guttmacher Institute, a nonprofit that supports abortion rights and tracks the issue.
The influx of patients into Illinois has had another effect. For years, abortion providers have been traveling once or twice a month to other states like Kansas, Mississippi, and Oklahoma, where their help was badly needed.
Dr. Laura Laursen, an OB-GYN in Chicago, was one of them.
"Now the script is totally flipped," said Laursen, a fellow with Physicians for Reproductive Health. "This is where you are needed more than anywhere else."
Anti-abortion groups oppose the Planned Parenthood partnership and are preparing for a marathon effort to restrict abortion rights in Illinois. In a statement after the organization's announcement, Amy Gehrke, executive director of Illinois Right to Life, called it "particularly tragic."
Some of the Wisconsin providers commute to Waukegan a few times a week; others a few days a month.
For Hartwig, associate director of clinical services at Planned Parenthood of Wisconsin, she's able to do more in Illinois for patients than she could back home. Even as a nurse with an advanced degree, she wasn't allowed to provide medication abortions in Wisconsin. But she can in Illinois, according to the state Department of Financial and Professional Regulation.
"This was really just what I was always supposed to do," Hartwig said. "There's nothing that's going to keep me from helping our patients."
Dr. Kathy King, Planned Parenthood of Wisconsin's medical director, said that while her staff is dedicated to providing these services, it comes at a cost.
"It is a burden on our clinicians and nurses and medical assistants who have young children at home," King said. "It sounds great. Sure, we'll all just travel down to Waukegan five days a week. But the logistics of that and the sacrifice of doing that on just people's day-to-day lives takes a toll."
Still, this sacrifice has helped. With staff from Wisconsin, the Waukegan clinic has doubled the number of abortion appointments available, and it is still ramping up. The support frees up other staffers to treat patients with different needs, like birth control and cancer screenings.
There has been a surge of patients from Wisconsin for abortion appointments at all Planned Parenthood of Illinois clinics — a tenfold increase in the month after Roe was overturned, from about 35 patients a month to 350, King said. That doesn't include Wisconsin residents who might have sought abortions with other providers.
The partnership at the Waukegan clinic has ignited interest from abortion providers in other nearby states. Planned Parenthood of Illinois is fielding calls from Indiana, Kentucky, and Ohio, for example, Schultz said.
What Illinois needs is more staff to treat more patients. The commute from Wisconsin to Waukegan is relatively short compared with abortion providers in Ohio, for example, who'd have to cross Indiana to help relieve the staffing need.
Across the nation, other conversations are happening among providers. The National Abortion Federation, which has about 500 facility members including independent abortion clinics and hospitals, is pairing up people looking for jobs at clinics with those that need workers, said Melissa Fowler, chief program officer at the federation.
Still, she acknowledged moving isn't a realistic option for everyone.
"People have lives," Fowler said. "They have families. They're deeply rooted in their communities. … And so a situation like you're seeing in Illinois and Wisconsin is great because people are able to stay connected to their community, not have to move their family, and still be able to provide care."
This story is part of a partnership that includes WBEZ Chicago, NPR, and KHN.
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.