Antony Hare

Once a month, Carol Ball’s trip to work begins early in the morning at the airport when she catches a flight in St. Paul. She completes her journey 200 miles away, in Sioux Falls, at South Dakota’s only abortion clinic. Since 2004, Planned Parenthood has been unable to find a South Dakota doctor willing to work at the clinic, so Ball and three other traveling doctors have stepped in. Among the states hostile to abortion providers, South Dakota ranks at the very top, which means Ball has to take certain precautions. She now gets picked up from the airport in South Dakota by a security guard instead of clinic staff.

Ever since Roe v. Wade, the pro-choice movement has dreamed of a world where abortion services are inconspicuous, integrated into a woman’s routine health care, and provided by her chosen doctor. But nearly 40 years on, some places are as resistant to this notion as ever. So the movement has had to rely on a handful of pioneers, such as Ball, for whom the culture war is hardly an abstract metaphor. They fly or drive for hours, into states or pockets within states (in North Dakota, Nevada, California, for example) where no local doctors are willing to do the work. They almost always face a line of protesters on their way to work, some of whom hold posters with the doctor’s name and face on them. In those communities, they are pariahs, but to the pro-choice movement they are heroes.

Ball didn’t pursue the job at first. For years, she had been doing abortions in a Minnesota hospital. But there she also delivered babies and provided women with other family-planning services, whereas at the Sioux Falls clinic, she would be much more conspicuously an abortion doctor. She also had young children and felt it was important to be able to explain her work to them. But several years later, Planned Parenthood was still looking for someone to serve Sioux Falls, so she accepted. At that point, she explains, her twins were 9, old enough to grasp why she did what she did. “If someone should show up at your school with a sign that says baby killer,” she told them (it’s happened elsewhere), “I want you to know that I believe in a woman’s right to have children when and if she wants to.”

As Ball is driven to the clinic, she passes a line of protesters—thicker during election season or contentious abortion debates in the state legislature. Last year, a bill was crafted specifically to target her and her colleagues, requiring a doctor to be on hand for the 24 hours leading up to any abortion, should the woman decide she wants to have a consultation (scheduled or not) before her procedure. This would prevent doctors from flying in and out in a day.

Eight abortion-clinic staffers have been murdered since the 1980s, but on her 34-minute plane ride, Ball isn’t consumed by that. “I don’t have a daily feeling that this could be my last day on Earth,” she says. “If I did, I couldn’t do this.”