MEMPHIS, Tenn. — Jennifer Pepper, CEO of a reproductive well being clinic in Memphis, tried her greatest to arrange her workers for the painful pivot coming in a post-Roe world.
For 48 years, the Selections clinic within the coronary heart of Memphis supplied abortion providers. However that ended on Wednesday, Pepper mentioned, the day earlier than Tennessee’s abortion ban took impact — making performing the process a criminal offense punishable by as much as 15 years in jail.
For months, Pepper, the CEO of Selections, has been working with the middle’s board to do two issues concurrently: shield the Memphis workers from layoffs and open a brand new clinic some three hours away, in a distinct state.
That’s meant laying the groundwork for the brand new clinic in Carbondale, Illinois, the place abortion rights seem safer. It’s additionally meant cross-training former abortion care workers in Memphis to supply different providers, together with billing Medicaid and turning into beginning assistants.
“We will definitely proceed to help our group in determining entry abortion providers,” Pepper mentioned. “We’ll promote and other people will be capable to discover our clinic in Carbondale very simply.”
Inside a month of the U.S. Supreme Court docket’s choice to overturn Roe v. Wade, greater than 40 clinics stopped offering abortions in trigger-ban states, in keeping with the most recent information accessible from the Guttmacher Institute. In Tennessee, a minimum of one clinic, situated in Knoxville, has closed for the reason that rollback of abortion rights this summer season.
The fact of the post-Roe v. Wade world has set in slowly at Selections, the place the once-bustling clinic’s ready room typically has extra empty seats than purchasers.
After the Supreme Court docket’s choice, a ban on abortions after the detection of fetal cardiac exercise (usually at about six weeks) took impact, the clinic began seeing extra sufferers that they needed to flip away.
“Are you ready for that?” Roxy Vazquez, a medical assistant, would ask sufferers. “Simply know that we’re right here.”
With that window closed on Wednesday, Vazquez mentioned she is beginning a brand new chapter. After spending almost her entire profession in abortion care — at Deliberate Parenthood earlier than Selections — Vazquez is coaching to turn into a beginning assistant with the clinic’s midwifery providers.

“We’re going to be right here,” Vazquez mentioned. “We’re nonetheless standing.”
Funded by a mixture of affected person income and greater than $1.5 million in donations final yr, Selections is staying afloat financially — for now, Pepper mentioned. Final yr the clinic supplied almost 4,000 abortions, in keeping with its annual report.
Even with out abortion providers, the clinic nonetheless presents a variety of reproductive care, together with a birthing heart that provides midwifery providers, HIV prevention, contraceptives and gender-affirming care. However its birthing heart is comparatively new, opening its doorways in 2020. Final yr, the middle’s midwifery follow assisted in about 90 births.
Selections’ clinic in Carbondale is anticipated to open on Sept. 19, Pepper mentioned.
Pepper mentioned she’s involved that Tennessee and different states banning abortion are “not creating programs that take care of pregnant and parenting folks and actually turning their again on them.”
Pregnant folks in Tennessee are among the many most weak within the nation, in keeping with information from the Facilities for Illness Management and Prevention. The state has one of many nation’s highest maternal mortality charges with almost 35 maternal deaths for each 100,000 reside births between 2018 and 2020. Black ladies had been virtually 3 times as prone to die than white ladies, in keeping with the Tennessee Division of Well being.

Dr. Terry Grebe, 76, the clinic’s president of medical providers, remembers being in coaching earlier than Roe v. Wade and seeing a affected person with a life-threatening complication after having an unlawful abortion. He just lately noticed a story a few Louisiana mom whose fetus was identified with a deadly situation, however mentioned her hospital refused to terminate her being pregnant. He worries that leaving ladies with so few choices may result in desperation, he mentioned.
“Something you may conceive about goes to occur to any person,” Grebe mentioned.