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Eight patients were in the waiting room of the Little Rock Family Planning Services clinic on the morning in June 2022 that Roe v Wade died. Until that moment, the clinic was the only place where women in Arkansas, a deeply red state, could get surgical abortions.

Natalie Tvedten, who helped found the clinic and provided counseling to patients, remembers huddling in a back room with a visiting doctor from Los Angeles after they heard the news.

Usually, patients would undergo a two-day procedure. But the doctor working that day made the call that they could not start any terminations. He was beside himself, Tvedten said.

“He broke down. I am talking broke down,” she said. “We pulled the patients back and started explaining to them that it was no longer legal to give them abortions in Arkansas and that we would find them care elsewhere.” Their best options involved travel to Kansas, New Mexico or Illinois.

The Guardian on Tuesday published an investigation about how rightwing forces successfully blocked a ballot measure that would have rolled back the Arkansas abortion ban ushered in by Roe’s demise. Alongside that story, we are also publishing this story about Little Rock Family Planning Services, and accounts from women who were served there.

Tvedten has never talked about that day, but agreed to share her memories with the Guardian. She was sometimes overcome by emotion describing how events unfolded, and how it abruptly brought to an end the work she said the clinic did over decades to empower women to make their own reproductive choices.

“It was a horrifying day. I am still not over it. A lot of these women have spouses or partners that are just not supportive. For some of these women, it is the first time it has been acknowledged they exist,” she said.

Three patients did not want to leave, she said. Some had already traveled from out of state, including Texas, Florida and Tennessee. There were 16 others who were on their way in. Some were begging, she said, for doctors to perform the abortions anyway. Staff explained that they could not break the law. “A lot of women said, ‘I am going to get this done,’” Tvedten said.

Karen Musick, an escort who worked at the clinic, helping women walk through the throng of ever-present protesters outside its doors, said one protester with a bullhorn started reading the supreme court ruling – known as the Dobbs decision – out loud.

Karen Musick. Photograph: Stephanie Kirchgaessner/The Guardian

Dobbs triggered a total abortion ban in Arkansas. It was shocking but not surprising. A draft of the ruling had already leaked in the media, and the clinic staff ramped up in anticipation of the decision, trying to treat as many women as possible.

“We were on a marathon, we were going to try to do 200 abortions by the end of June,” Tvedten said.

The clinic still exists but the protesters have left. It no longer offers abortions. But the remade facility, called the You Center, offers women resources if they need abortions: including sharing a phone number they can call to have abortion medication shipped to them from out-of-state providers, and helping them find financial support to leave the state for the procedure. Recently, two 13-year-old girls came to the clinic for help and were able to travel out of state for their abortions.

Musick – the one-time abortion escort – is now co-founder of the Arkansas Abortion Support Network, which runs the You Center. On its website, the AASN offers practical advice, including how visitors to the website can clear their browser and search history.

“Most people in Arkansas are going to Illinois and a lot of them are going to Kansas. We want people to get care where they are most comfortable getting it,” said Musick.

Now the clinic is facing a new problem, and it’s one that has hit similar centers in red states where abortions have been banned: money is running out.

Initially, the AASN benefited from what Musick calls “rage giving”. When the Dobbs draft leaked, the organization raised $100,000 – more than it ever had before. When the opinion officially came out, it raised another $100,000, and by the end of the year it had taken in $780,000. In 2023, that figure sharply dropped to just under $400,000.

The AASN pays for patients’ out-of-state care – sometimes up to 70% or the whole cost, if needed. It also has to pay for staff salaries.

But the need for spending has continued to increase, and donations have not kept up. Musick said her group mostly takes in smaller donations from individuals – the average is $18 – but large donations are starting to dry up nationally.

The journal in which patients recorded their experiences. Photograph: Stephanie Kirchgaessner

“I think a lot of big-dollar donors thought we would be a lot closer to normal by now, but we’re not. I think most people understand that it’s not sustainable to have to send people from south Texas to Colorado, but they didn’t see or understand how deeply abortion is embedded in politics,” Musick said.

Among the relics of the abortion clinic is a journal that used to be kept in the waiting room. It was a place where patients could tell their stories and read those of others. Sometimes women left encouraging notes for one another.

Now it reads like notes from a bygone era. The Guardian read dozens of journal entries provided by the clinic’s former staff, who redacted any identifying details. The accounts differ dramatically: women sharing painful stories about abusive boyfriends and husbands; others who said they could not take on the responsibility and financial burden of a child; those who said they were just getting their life in order or are going to school; and some who were devastated after receiving news that their pregnancies were not viable because of fetal anomalies.

The women are now bound together by one fact: none could have had an abortion in Arkansas today.

Illustration: Guardian Design

“I just had a child a few months ago after missing birth control. Pregnancy was a nightmare. It was honestly worse than I expected. I have never been so mentally & physically ruined. I’m doing this for numerous reasons but your reason is just as important!” wrote one woman.

Another said: “I’m 18, and am 13 weeks & 2 days today. In fear of not being the person I want to be. I am giving my baby to the Lord. Knowing not having the right parents can affect you forever. I feel it is only fair to you to give you a life & love one day but this is not the right time. I have to learn to love me first so I don’t mess up with you, baby.”

Another wrote: “I use to be against abortions but until you get in that seat you just have to do what is best for your life. I’m still learning how to be a mom to my 3 yr old.”

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