When Planned Parenthood’s clinic in Marquette, Michigan, closed last spring, Shawn Brown found herself offering a service she never expected to provide: medication abortion. Her Marquette Medical Urgent Care now keeps mifepristone and misoprostol on hand and provides first‑trimester medication abortions alongside routine urgent‑care visits — from kids with the flu to skiers with broken bones.
The local Planned Parenthood had served roughly 1,100 patients a year for services including cancer screening, IUDs and medication abortion. After it shut, Brown described a 500‑mile stretch with no access to in‑person abortion care. Though she calls herself “individually pro‑life,” she saw the medical overlap between miscarriage management and early medication abortion and responded to patient needs.
Marquette’s shift reflects a broader pattern: at least 38 abortion clinics closed last year in states where abortion remains legal, according to I Need an A. Even in states that have protected abortion in their constitutions, like Michigan, closures and reductions in pregnancy‑care capacity continue in the wake of the U.S. Supreme Court’s 2022 Dobbs decision. Rural hospital cutbacks in labor and delivery have compounded those access gaps.
Some providers and advocates view urgent care as a plausible patch. Urgent‑care centers are built for walk‑ins and quick access, and many emergency‑medicine clinicians are familiar with the medication regimen used for early abortion — a single dose of mifepristone followed by misoprostol 24 to 48 hours later — which parallels miscarriage treatment protocols. Kimi Chernoby of FemInEM, a nonprofit for women’s emergency medicine, calls the idea of urgent cares filling local abortion gaps “exciting.”
But scaling that model has obstacles. Insurers and regulators can push back. Brown said insurers initially requested extensive documentation and training and quoted a roughly $60,000 annual malpractice premium to cover medication abortion — about three times the cost of insuring her whole urgent care. After her broker challenged that estimate with data showing the practice added little extra liability, the carrier agreed to an approximately $6,000 annual premium. A local donor provided an ultrasound machine, and community supporters formed a nonprofit to subsidize medications and staffing, trimming patient costs from about $450 to an average sliding‑scale fee near $225.
Marquette’s urgent care now sees about four medication‑abortion patients a week, approaching the volume the local Planned Parenthood had seen. People travel long distances for in‑person care; Brown said some patients have come from as far away as Louisiana. For many, visiting a clinic feels more secure than ordering pills online or using telehealth, especially when patients want an ultrasound to confirm gestational age or to rule out an ectopic pregnancy, or simply want face‑to‑face counseling.
Viktoria Koskenoja, an emergency‑medicine physician who previously worked at Planned Parenthood, helped organize the community response after the clinic closed and now performs medication abortions at the urgent care. She describes clinical visits as a mix of confirmation, counseling, and practical support: clinicians verify the patient’s decision, offer an ultrasound, discuss contraception, provide medications and arrange follow‑up. Koskenoja and local volunteers even assembled handsewn “comfort bags” with pills, instructions, pain relievers, a heating pad and notes from supporters.
Telehealth and mail‑order abortion pills have grown rapidly since Dobbs and have helped plug some gaps: telehealth accounted for about 5% of abortions before Dobbs and rose to roughly 25% of abortions by the end of 2024, according to the reporting project #WeCount. Planned Parenthood of Michigan reported a 13% increase in telehealth appointments for Upper Peninsula patients after the Marquette clinic closed. Still, as pills‑by‑mail draw political and legal challenges, advocates say more local, in‑person options will remain important.
Legal and regulatory complexity is a major barrier to wider adoption of urgent‑care abortion services. State laws vary widely and may impose waiting periods, mandatory counseling, facility requirements or parental‑consent rules. Federally, the Food and Drug Administration requires prescribers of mifepristone to be certified by distributors and to obtain signed patient agreements. David Cohen, a law professor who studies abortion access, warns that the regulatory environment around medication abortion is “very particular” and could deter organizations whose main mission does not center on reproductive care.
Some larger health systems are watching the Marquette experiment. Brown said a major academic medical center has asked questions and plans to offer medication abortion at some of its urgent‑care sites later in the year.
For patients in rural areas who prefer or need in‑person care, urgent cares can provide counseling, ultrasound confirmation, medication and human contact. Marquette’s experience shows that community support, adaptable clinicians and pragmatic problem‑solving can reestablish local access after a clinic closure. Whether urgent care becomes a widespread safety net will depend on insurance practices, legal rules and the political climate surrounding abortion care.