Dr. Katie McHugh doesn't sleep much these days.
After working 12-hour shifts at several abortion clinics in Indiana, McHugh, an OB/GYN, doesn't collapse into bed. Thoughts of her patients keep her up at night: the pregnant woman who drove 20 hours to the clinic, scared and desperate to receive an abortion; the families dodging anti-abortion protestors shouting threats at them through a bullhorn in clinic parking lots; the patients she couldn't help.
Before the overturn of Roe v. Wade in June, which ended nearly 50 years of federal abortion rights, McHugh, 42, estimates that she saw between 15 and 20 patients for abortion-related appointments each day.
Since the Supreme Court's decision, there are now days where she performs 50 abortions.
McHugh and other doctors across the state have been sprinting to help patients access abortion before Sept. 15, when Indiana's abortion ban is set to take effect. The ban includes exceptions for rape, incest, fatal fetal abnormalities, and to protect the life and health of the mother.
The ban will cut off abortion access to people in Indiana's neighboring states, including Ohio, Kentucky, and Tennessee, who have depended on clinics in the state when their own states enacted stricter bans or made the procedure illegal.
"It's devastating," McHugh tells CNBC Make It. "There are some days where it feels like we are drowning in despair at the loss of [abortion] rights. There are some days where we are just so overwhelmed."
Abortion is banned in at least 12 states with limited exceptions, the New York Times reports, and more states are expected to enact bans or other limits on the procedure in the coming months.
For the past three months, doctors like McHugh have had to navigate the chaos and confusion following Roe's demise. For some, the court's decision spurred a sudden change in career plans, while for others, it has meant a more frightening, unstable work environment.
"You can't even identify any real emotion," McHugh says. "We feel almost numb to how many patients will suffer, how many patients will be forced to continue pregnancies that they did not consent to, or that they don't have the means to support."
'We aren't used to debating whether we're breaking the law'
Dr. Allie Linton considers her job as Planned Parenthood of Wisconsin's associate medical director a calling, a core component of what she is meant to do as a doctor.
That mission has become complicated in a post-Roe Wisconsin, as the state reverted to an 1849 law that prohibits doctors from performing abortions, except to save a mother's life, as soon as the landmark decision was struck down.
Before Roe was overturned, Linton, 37, provided abortion care to patients in Wisconsin 3 to 4 days per week; in a typical week, she and her colleagues would perform 30 to 50 abortions. Now, that number is close to zero, save for the patients who meet the narrow life exemption.
Linton, who is based in Milwaukee, instead drives an hour to Waukegan, Illinois, twice a month to a Planned Parenthood center there to perform abortions.
"It's been a pretty dramatic shift in my day-to-day schedule," says Linton, who has worked in abortion care for 11 years.
Wisconsin's abortion ban has brought in a "vague, confusing, non-medical component" to providers' jobs "that should really not exist between me and my patient," Linton says.
"All of a sudden, we have this very looming threat of a felony charge of being persecuted," she adds. "We aren't used to debating whether we're breaking the law [at our jobs]. We usually are able to just focus on our oath to do no harm and focus on the patient in front of us."
Many of Linton's Wisconsin patients aren't able to travel to Illinois for an abortion because their job won't give them the time off, or because they can't afford the child-care or transportation costs.
"For a lot of patients, it is just overwhelming, confusing and frustrating to even try to navigate the system," Linton explains. "We do our best, but we've had a lot of patients that are just in tears and feel like accessing a safe abortion is insurmountable …. It's heartbreaking, because restricting access is going to push people to make incredibly dangerous medical decisions."
'I'm re-evaluating what my career looks like'
Dr. DeShawn Taylor isn't sure what her job will look like in a week.
Taylor, 47, is the founder and CEO of Desert Star Family Planning in Phoenix, one of the few health-care centers in Arizona still providing abortions.
The fate of abortion in the state — and Taylor's ability to perform the procedure — rests with a court ruling that is expected to come next week. A case in Pima County will determine whether or not to lift an injunction on Arizona's abortion ban. If the court order is lifted, all abortions would become illegal, except to save the mother's life.
Taylor has not performed a surgical abortion since June because of staffing shortages that have been driven, in part, by the overturn of Roe.
"People are hesitant to work here or refuse to help with abortion care because they think all abortion is already illegal in Arizona," Taylor explains. "I'm like, 'Do you think I want to go to jail? Do you think I would really put you in harm's way?' But that's the power of the spread of misinformation."
In the meantime, she's provided medication abortions for patients up to 11 weeks pregnant, but her patient count has also decreased.
In August, Taylor performed 35 abortions, a number much smaller than previous months. Some patients show up to her office with out-of-state appointments booked, just in case.
Operating in such a high-stress environment has led Taylor to question if she will continue this work.
"I'm re-evaluating what my career looks like," she says. "Nobody in abortion care expected to work under these horrendous circumstances, where you have to be on guard at all times, worrying about your safety and the legality of your job …. That's not normal."
She adds: "I'll always support abortion rights but whether I'll be the one showing up to the clinic every day providing this care is something I'll have to think about."
When the court announces its ruling on Arizona's abortion ban, Taylor is taking a week off from work to rest, regardless of the decision.
She hopes that conversations about abortion access in the U.S. don't fade from public interest, and that people won't forget about the doctors working overtime and putting themselves at risk to provide abortion care. That extends to the other workers helping patients, as well, including the people answering the phone, taking patients' vital signs, driving them to the clinic and sterilizing instruments.
"Some of these people have had abortions themselves, and some of them have fought extreme odds to continue to show up at work. … We all matter," she says. "We are all human beings and we are all feeling the pain from this decision."
Check out:
34% of younger workers are thinking of switching jobs due to company's stance on abortion, post Roe
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