Reclaiming access
Potential new Four Corners clinic could better serve rural reproductive care needs

It just so happened that Colorado author Pam Houston’s reproductive life coincided almost precisely with the 49 years, five months and two days that the U.S. Supreme Court protected a woman’s right to an abortion. Last week, Houston told a squeezed-in crowd at Maria’s Bookshop that she started her period in January 1973, and went into menopause at the time Roe v. Wade was reversed in June 2022, ending the constitutional right to abortion.

A body in sync with the progress, then decline of reproductive rights. 

Houston, in Durango to promote her latest book, “Without Exception: Reclaiming Abortion, Personhood and Freedom,” has always opened doors wide to her inner life, whether characters are fictional or all too real.

With 60 chapters – one to match each year of her life – “Without Exception” is ambitious, moving among facts and laws to impressions and personal stories, from sickening to uplifting. It’s brave, uncomfortable and necessary.

Houston skillfully makes connections, for example, between acts of government interference and grievous nonchalance, from enacting control over women’s bodies to companies not held responsible for toxic spills that poisoned the soil of the Navajo Nation.

“Same machine,” she said. 

Houston’s book is all over the place – but in a good way with good reason. Because conversations about abortion must cover much ground. From the sweeping to the visceral, every detail matters in underlining demands for body sovereignty, safe reproductive health care and, ultimately, freedom to live as we wish.

Equally important to rights is actual access. Especially in remote, rural areas. 

Houston’s talk was more timely than she may have realized. Afterward, as chairs were put away, a few in the know spoke within small groups about the potential for a new local clinic – now in its exploratory phase – that could replace the nonprofit Planned Parenthood that recently closed in Durango. Ideally, the new clinic would serve Southwest residents even better, along with increased numbers of travelers requiring care.

Dedicated supporters approached a nonprofit specializing in reproductive health care clinics in underserved and rural areas. Together, they are considering feasibility, working through processes of everything involved, punching numbers and, generally, getting the lay of the land. 

A force within this group – a changer, a believer – is registered nurse Ginny Laidler, who worked at Durango’s Planned Parenthood for 18 years. Laidler has done everything from performing ultrasounds, assisting surgeries, managing the clinic and holding hands of patients.

She has lived the inverse dynamics across health care: increased workloads, fewer staff members and decreased support, especially after the pandemic.

And who better to lead the charge than a frontline nurse?

“I needed to do whatever I could to open a clinic,” Laidler said. “Locally controlled, locally run with no call center, tailored to the needs of our community.”

Emphasis on the call center. Scheduling at Planned Parenthood was centralized, far from Durango, and, oftentimes, a nightmare. Nonmedical personnel, often unaware of the time needed for procedures, lab work, explanations and more, decided appointment slots. And day-in, day-out long-distance scheduling upsets contributed to employee burnout. 

Sure, the clinic had a rhythm with routine care for its regulars. But abortion care was less reliable. Who would show up on any given day?

Let’s be clear, Planned Parenthood does a lot of things very well. In particular, it attracts compassionate, committed providers. Young people, especially, respond to them. But its model was urban and didn’t meet unique rural needs.

Twenty states ban or restrict abortions. Since the fall of Roe, Durango’s place on the map attracts interstate patients, notably from Texas. In fact, Colorado Department of Public Health and the Environment data show that nearly one in five abortions performed in our state last year were on Texas residents. In 2023, 2,846 Texans terminated pregnancies in Colorado, up from 400 in 2021.  

With this reality, a new clinic’s vision would expand to manage the needs of these patients who, for example, miscarried or had nonviable pregnancies and can’t receive treatment in their home states. Without that care, women risk excessive bleeding or even death. 

Laidler has witnessed these anomalies. 

In 2023, Yale Medicine reported the effectiveness of medical abortions from mifepristone and misoprostol pills between 92% and 99.7%. Pretty good odds, except for those who fall between those percentages with incomplete abortions.

Medical school curriculums in states with draconian abortion laws are being affected, too. Students and residents won’t experience full-scope reproductive care, won’t learn all they need to know. A dearth of professional knowledge isn’t a far-off scenario. 

For all the reasons, all the people, Laidler will do everything possible to help create a reproductive health clinic in the Four Corners. “I cannot let this go,” she said.

Ann Marie Swan is a former opinion editor at The Durango Herald and The Journal in Cortez. She’s worked in newsrooms at the Rocky Mountain News, the Honolulu Star-Bulletin and Pacific Stars and Stripes in Tokyo.