Illustration by Alex Nabaum
This article appears as part of a special issue of The American Prospect magazine on state policy divergence and aggression. Subscribe here.
Danville, Illinois, has all the trappings of Midwestern postindustrial decline: brick buildings, old Victorian houses, and a downtown that has seen better days. At the turn of the 20th century, the city was a major coal mining, manufacturing, and rail hub. By the beginning of the 21st, most of the mines had been transformed into lakes and the manufacturing plants shuttered. Today, 1 in 4 of Danville’s 30,000 residents live in poverty. Now, the city is working to rebuild and revitalize by attracting tourists to the area’s museums, parks, and recreational offerings, along with new tax incentives encouraging businesses to set up shop downtown.
Last May, the Danville City Council considered an ordinance that would declare the community a “sanctuary city for the unborn” and ban abortion care within the city’s borders. It included a ban on the shipping and mailing of abortion pills to and within the city. At the time, access to the abortion pill mifepristone was on shaky ground after a series of contradictory rulings from U.S. district court judges across the country. After an hours-long discussion and strongly worded letters from the state and the ACLU of Illinois, the council defied them both and passed the ordinance with a tie-breaking vote from Mayor Rickey Williams, who’s served since 2018.
If Danville had been in one of the neighboring red states—Missouri, Iowa, Kentucky, or Indiana—where abortion is effectively banned, the decision would not have been unexpected. In 2020, President Biden won the city but not overwhelmingly, with 51 percent of the vote to Trump’s 47 percent. But abortion has been legal in Illinois since 1973. The state enshrined the right to abortion in state law in 2019 and has gone even further, enacting shield laws to protect abortion providers who perform treatments on out-of-state patients.
Abortion care providers like LaDonna Prince, the owner of Indianapolis’s Clinic for Women, the 46-year-old facility that closed last year, planned to step in to provide care in Illinois for women traveling from prohibition states like Indiana. She had scouted out Danville as a potential location for her new clinic. Prince told Illinois Public Media that she was specifically interested in Danville due to its proximity to Indiana. “We do want to be able to continue to serve women of Indiana, if and when we lose the right to perform abortions here,” she said in 2023.
Danville, however, also happens to be just five miles from Indiana, where abortion is effectively banned. The state legislature was the first to pass new legislation to prohibit abortion after the high court struck down Roe v. Wade. The ban contains limited exceptions with strict provisions that make care all but inaccessible: Abortions may only be provided in a hospital setting, and if there is a serious risk to the health or life of the pregnant person, a diagnosis of a “lethal fetal anomaly,” or rape and incest, before 12 weeks of pregnancy.
A week after the state ban went into effect, the courts blocked it while a lawsuit was being considered. In June 2023, the Indiana Supreme Court allowed the ban to stand once again. In April 2024, the ACLU of Indiana brought another lawsuit against the state, claiming that the ban violates the state’s Religious Freedom Restoration Act; however, as of now abortion is still illegal.
Health care providers in blue states have tried to fill the gaps left by extreme anti-abortion policymakers in neighboring states. But Prince and other reproductive rights advocates hadn’t reckoned with landing in the middle of the post-Roe minefield: blue-state, pro-life supporters embracing aggressive red-state tactics designed to prevent interstate abortion access.
WHEN THE DOBBS DECISION CAME DOWN, trigger laws immediately came into effect in 13 states to place restrictions on abortion care, prompting a surge in interstate travel for abortion care. Today, 13 states have total abortion bans and 27 states have abortion bans based on gestational duration.
Illinois—which borders one state (Iowa) with a six-week ban and three states (Indiana, Kentucky, and Missouri) with total abortion bans—has seen the largest increase in out-of-state patients seeking abortion care in the country. In the first six months of 2023, just under 19,000 of those patients obtained care in the state. That’s an increase of 13,300 out-of-state patients since 2020.
This massive surge is also a result of the state’s years-long effort to become an island of reproductive freedom in the Midwest. Christina Chang, executive director of the Reproductive Freedom Alliance, a coalition of 23 pro-choice governors, explains that since the group has limited means to challenge anti-abortion legislation in right-wing states, local activists, abortion funds, and legal organizations in red areas must take up the fight against restrictive policies instead. “But what we can do,” Chang says, “is think about what the implications are [for] people who might be seeking care in alliance states.” Those efforts include shield laws that protect providers, patients, and groups that help facilitate abortion travel, as well as data protection regulations that guard the personal information of everyone involved in abortion care.
Red states export tactics to blue states, which in turn try to fill care gaps left by red-state bans.
Shield laws provide legal protections against the threat of extradition, but they have not been tested in the courts yet—and those challenges are likely on tap. Connecticut’s shield law, for example, which is one of the strongest in the nation, doesn’t require extradition requests to provide a detailed description of the alleged illegal conduct, thus making it difficult to know whether the shield law actually applies to the circumstances at hand.
Midwest Access Coalition (MAC) coordinates a practical support fund that helps provide funding for costs like travel, lodging, food, and child care that could otherwise be barriers to abortion access for patients in the region. MAC’s director of strategic partnerships, Alison Dreith, says that in the wake of Dobbs, pro-choice policymakers and grassroots groups have learned to exist symbiotically: “I trust policymakers to know … their constituents, their fellow lawmakers, their process better than I know it, and it’s my job to know what abortion seekers need and what’s going to help clinics succeed in supporting those health care patients,” she says.
This convoluted situation originated with red-state anti-choice activists and legal advocates who have promoted cross-state restrictions to stir up more opposition. In 2021, Senate Bill 8 went into effect in Texas. Also known as the Texas Heartbeat Act, the law prohibits physicians from performing abortions after a “fetal heartbeat” has been detected (unless it is a medical emergency). The restriction is not shocking, when compared to similar draconian anti-choice measures across the country.
What is uniquely dangerous about SB 8, though, is a provision that allows regular citizens to file civil lawsuits against anyone who performs or “aids and abets” an abortion in violation of the law. The law doesn’t specify what constitutes aiding or abetting, leaving interpretations up to the courts. However, the provision has been used against abortion and practical support funds, which has a chilling effect on donors and recipients of those funds. Already precarious relationships can also take on chilling new dimensions. In one Texas case, an abusive husband attempted to sue his wife’s friends for allegedly helping her seek an abortion.
In his Dobbs concurrence, conservative Supreme Court Justice Brett Kavanaugh surmised that laws restricting interstate travel for abortion would likely be unconstitutional, arguing that the Constitution carves out a fundamental right to free movement across state lines.
DESPITE KAVANAUGH’S SIGNAL, ABORTION TRAVEL BANS have been enacted in states across the country. After passing a near-total ban on abortions, Idaho also passed HB 242, which restricts out-of-state travel for abortion care by criminalizing planning actions within state lines before the travel occurs.
In 2023, Alabama Attorney General Steve Marshall threatened health care providers, telling them that they could face felony charges for supporting patients who sought out-of-state care in states where abortion is legal. A group of health care providers filed suit, and in November 2023, the Justice Department filed a statement of interest in the case, explaining that the Constitution protects the right to travel across state lines and that states cannot prevent anyone, including health care workers, from helping others exercise that right.
In Texas, two extreme anti-abortion activists—pastor and anti-abortion activist Mark Lee Dickson and former Solicitor General of Texas Jonathan Mitchell—brought the abortion travel fight to municipalities. The effort started in four Texas counties: Goliad, Mitchell, Cochran, and Lubbock. In each county, commissioners voted for ordinances that would bar pregnant Texans from traveling through the counties to seek abortions in another state. The ordinances are only enforceable with the legal power of SB 8 that allows individual citizens to act as vigilantes.
Dickson had come up with another nefarious strategy that goes hand in hand with travel bans: the so-called “sanctuary cities for the unborn” movement. Texas Monthly reported that he first met with Mitchell on a conference call to seek guidance for his plans. In June 2019, Dickson and Mitchell’s sanctuary cities strategy earned its first success in Waskom, Texas, a city of fewer than 2,000 residents with an all-male city council. As of September, there are 69 cities and eight counties that have passed sanctuary cities–style ordinances attempting to outlaw abortions and related care within their borders.
Danville city councilors signed off on an ordinance that conflicted with Illinois law.
According to the ACLU of Illinois, these sanctuary city ordinances often operate by attempting to restrict the availability of medications necessary for abortion care, block the functioning of local abortion clinics, and restrict abortion-related travel in or through the community.
The strategy is a clear example of interstate aggression. The cities that have been targets of these anti-abortion legal offensives are often border cities that see a high volume of interstate travel for reproductive health treatments, such as picking up pills in a pharmacy or receiving care in a brick-and-mortar clinic.
Chang argues that the expansion of anti-abortion policies across state lines is a strategy as old as the anti-abortion movement itself. “They’re sharing that language, and this bounty hunter law in Texas is no different,” she explains, citing SB 8. After a policy success in one state, anti-abortion activists “replicate that in all these other states,” Chang adds. SB 8 opened the floodgates for travel bans that have spread to cities thousands of miles away—like Danville.
FROM THE MOMENT THE DANVILLE CITY COUNCILORS signed off on the ordinance on May 2, 2023, it conflicted with the Illinois Reproductive Health Act, which Gov. JB Pritzker had signed into law in 2019. The law states that reproductive health care, including abortion care, is a fundamental right and ensures that local governments cannot infringe on those rights.
City officials, of course, had been warned. The day before the vote, Illinois Attorney General Kwame Raoul sent a letter to Danville Mayor Williams, reminding him that the ordinance would be in direct violation of the Reproductive Health Act and that his office “stands ready to take appropriate action to ensure that Danville and its elected officials adhere to Illinois law, including the Reproductive Health Act.” The ACLU of Illinois also sent a letter to members of the Danville City Council’s public services committee, urging them to vote down the ordinance: “Voting yes on the proposed ordinance will only cause confusion and fear in our communities, all while exposing Danville to significant legal liability,” the organization wrote.
The legal threats from the attorney general and the ACLU of Illinois had a chilling effect on the city councilors. They backed down and amended the ordinance, adding that it would take effect only “when the city of Danville obtains a declaratory judgment from a court that it may enact and enforce” the ordinance. Until that day, the ordinance is not in effect, and Danville is not a “sanctuary city for the unborn.”
Some weeks after the Danville city councilors passed their muzzled anti-abortion ordinance, an anti-abortion extremist named Philip Buyno drove to Affirmative Care Solutions, Prince’s new clinic in Danville. When he arrived at the yet-to-be-opened facility, he rammed his maroon Volkswagen Passat into the building, attempting to set fire to the clinic. FBI agents later found gasoline, road flares, tires, a pack of matches, and a hatchet in the car.
At Buyno’s criminal hearing, Prince testified that the violence would significantly delay the clinic’s opening. “This terrorist attack was intentionally timed to prohibit us from opening our doors,” she told the court. “It delayed our opening by at least a year, perhaps more.”
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RANDY VON LISKI
Danville and Quincy, Illinois, have been caught up in the national debate after Dobbs, despite the state’s abortion protections.
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DAVID WILSON/Creative Commons
Danville and Quincy, Illinois, have been caught up in the national debate after Dobbs, despite the state’s abortion protections.
THREE MONTHS AFTER THE VOTE IN DANVILLE, Carrie Bross, an organizer with the pro-choice group Voices for Choice and a resident of Quincy, Illinois, caught wind of an abortion-related issue on the city council’s agenda. Much like Danville, Quincy is a border city of 40,000 that sits just across the Mississippi River from Missouri. Two bridges, one sleek and modern built in 1987 and the other approaching the century mark, connect the two states.
Quincy has straddled the country’s political divisions for centuries. In 1833, the abolitionist Richard Eells moved to the town and turned his new home into a stop on the Underground Railroad, providing safe passage for enslaved people fleeing Missouri and the Deep South.
Bross discovered that some city council members in Quincy wanted to go down Danville’s path and implement a “sanctuary city for the unborn” ordinance, but had kept the plan under wraps. “There wasn’t anything that was showing up on the city council agenda,” she told the Prospect. “There were really not a lot of indications that this was going on.”
When Bross stepped up to make her first public statement about the ordinance at the September 25, 2023, city council meeting, she took off her cardigan and scarf to reveal a “Pro Roe 1973” T-shirt. She argued that Quincy needed to focus on other pressing issues like public works projects instead of passing a measure that would be at odds with Illinois law from day one and require the city to channel its limited resources into defending its case.
“We kind of forced the council’s hand to discuss it sooner than they intended, because we chose to bring it to them before it even showed up on an agenda,” Bross says.
The city council set October 10 for the vote. Over the next two weeks, Bross and other local state political activists set up an informal anti–sanctuary city coalition. With the support of the state ACLU chapter, Planned Parenthood, and Personal PAC, a pro-choice group, they organized protests and phone banks, wrote letters to the editor, and reached out to residents on social media. According to Bross, about 300 people signed a petition opposing the ordinance.
“I don’t think [the city council] expected how many people would turn out in opposition to the ordinance, because the area we live in is a very conservative area,” Bross says. In 2020, Adams County—Quincy is the county seat—voted overwhelmingly for Trump, who garnered 72 percent of the vote.
The same lawyers and politicians who helped kneecap the Danville ordinance came out in full force to support Quincy. Liza Roberson-Young, then the senior supervising policy counsel at the ACLU of Illinois, traveled to Quincy for the October council vote to warn the city council against passing the ordinance. “The state of Illinois has adopted a policy assuring that every person in our state can make reproductive health care decisions without government interference. Quincy—nor any other community—cannot carve themselves out of this state law,” she said.
On the night of the vote, residents packed the small city council meeting: 27 others expressed their support while 29 people spoke out against the ordinance, with some residents commenting that if the ban passed they would leave Quincy.
The council voted 7-to-5 against the ordinance.
Muddy Rivers News reported that Mayor Mike Troup said after the meeting that had there been a tie vote he would have voted no to defeat the ordinance. “Personally, am I pro-life? Yes,” he said. “But is this something the City Council should be dealing with? That’s where, I think, the no votes came in. I don’t know that there’s really anyone on the City Council who’s not pro-life.”
Two city council members, Greg Fletcher and Jake Reed, both Republicans, got in a back-and-forth about their pro-life credentials, with Fletcher arguing that the ordinance wasn’t appropriate for a city council to decide and Reed firing back. “Take this fight to Springfield. Not here,” Fletcher said, according to the local news report.
“What happened in Quincy and Danville is a good example of how, even in a state like Illinois, where we have great policy and great protections coming from the state level, you can never let your guard down,” says Ameri Klafeta, director of the Women’s and Reproductive Rights Project at the ACLU of Illinois.
Neither Danville nor Quincy had the power to contravene Illinois law. In that sense, the anti-abortion activists behind the sanctuary cities movement failed to change local policies in a deep-blue state. But there are more fights ahead in a divided post-Roe America. Extremists like Dickson and Mitchell in Texas show no sign of stopping their sanctuary city crusade. Moreover, the increasing tensions could lead to new interstate legal conflicts over shield laws—and more violence. Dreith of the Midwest Access Coalition summed up the mood in regional pro-choice circles this way: “I think we are all doomsday preppers at MAC, basically,” she says. “We don’t have a lot of hope for the future right now.”
Pro-choice organizers, from governors to individual activists, have built strong interstate networks capable of withstanding threats like the sanctuary city ordinances. But anti-abortion activists are building the same coalitions from the grassroots to the Supreme Court. These volatile pathways are not sustainable. The debates in Danville and Quincy point to the need for a national solution, otherwise the contradictions and legal battles will only multiply in number and intensity. If abortion is indeed in the hands of states—for now—then reproductive rights supporters, especially in Republican strongholds, will have to work to pass legislation affirming the right to abortion care—one state at a time.
