In the months since the Supreme Court overturned the constitutional right to abortion, Pennsylvania clinics have hired more doctors, extended their hours, and hustled to get time-sensitive care to an influx of out-of-state patients.

Right after the court’s ruling, providers anticipated a 25% increase in out-of-state patients — roughly 8,500 more people — as some of Pennsylvania’s closest neighbors became the first to restrict the procedure. Ohio, for instance, prohibited abortion after the sixth week of pregnancy, though a judge has temporarily blocked the law.

Twenty-six states have or are expected to restrict abortion access, according to the Guttmacher Institute, leaving some 40 million people living in states without an abortion provider.

That leaves Pennsylvania in a unique position: Despite limited resources, it is the closest abortion care option for growing numbers of people.

“We actually are a keystone state,” said Susan Frietsche, a lawyer and the Western Pennsylvania director for the Women’s Law Project, which advocates for women’s health issues, including abortion rights. “The degree to which Pennsylvania protects abortion rights here is important for the whole region.”

Since well before the court ruling, Pennsylvania has limited access by requiring parental consent for minors, mandating a consultation followed by a 24-hour waiting period, and imposing regulations on abortion clinics that health experts say are not truly necessary.

“The infrastructure has already been eroded,” said Alexis McGill Johnson, CEO of Planned Parenthood Federation of America, at a roundtable in Philadelphia on Sept. 12. “I don’t know what the tipping point is.”

Limited access in high demand

In the 1970s, Pennsylvania had more than 100 abortion clinics, but today, there are only 17, most clustered in the Philadelphia area. There are none between Pittsburgh and Harrisburg.

And while Harrisburg-area patients can turn to clinics in Allentown, York, or Philadelphia, the Pittsburgh clinics have long been the closest option for a broad area that stretches beyond Western Pennsylvania into Central Pennsylvania, Ohio, and West Virginia.

Demand has increased since the Supreme Court’s decision, with people traveling from other states, even as far as Texas, for care.

“It is so painful to think we are an access state” because resources are also restricted here, said Sydney Etheredge, CEO of Planned Parenthood Western Pennsylvania, which operates in the Pittsburgh area. She said calls tripled almost immediately after the ruling, with people “trying to find out if they can get this care safely and legally in our state.”

Allegheny Reproductive Health has been planning for two years to meet the demand. It now has 10 abortion providers, up from two a couple years ago.

To make more space for them, the clinic moved administrative staff to the basement and scaled back non-abortion services that are available elsewhere, such as obstetrics.

The clinic can typically schedule patients for an abortion within one to two weeks, critical because Pennsylvania allows the procedure through the 23rd week of pregnancy.

Traveling across Pa. for abortion

From Pittsburgh, the next closest clinic in Pennsylvania is in Harrisburg.

Planned Parenthood’s Allentown clinic is seeing the biggest influx so far, despite being at least an hour farther than Harrisburg for people driving from Ohio.

Procedures at Planned Parenthood Keystone clinics are up 26%, in part because hours were expanded due to high demand.

Currently, the Keystone clinics can provide abortion through the 13th week of pregnancy but will soon expand care through the 15th week, encompassing the vast majority of abortions sought in Pennsylvania. Though abortion is legal through the 23rd week of pregnancy in Pennsylvania, later procedures are riskier and may require a hospital visit.

Philadelphia anticipating a patient influx

Eastern Pennsylvania’s neighbors — New Jersey, New York, Delaware, and Maryland — all allow abortion. Some out-of-state patients, such as those coming to Philadelphia from Ohio or West Virginia, are driving past closer clinics that are booked up — or they’re flying to get here, said Dayle Steinberg, CEO of Planned Parenthood Southeastern Pennsylvania.

She expects to see more out-of-state patients because Philadelphia has a major airport or because they can stay with nearby friends or family.

Still, Planned Parenthood’s Philadelphia-area clinics are busier than usual, likely because Western Pennsylvania clinic appointments are filling up more quickly.

The three regional Planned Parenthood executives recently joined the national organization’s CEO, McGill Johnson, at a roundtable discussion in Philadelphia where they warned of increasing strain on Pennsylvania’s resources — and the consequences for millions of people if abortion rights are restricted here.

“Pennsylvania is a critical state in the provision of abortion care in our nation,” Reed said.