Shannon Brewer has called the Jackson Womens Health Organization in Mississippi a sort of second home since she began working there as a sterilization technician in 2001. Fast forward 20 years and Brewer is now the director of JWHO, the last abortion clinic in Mississippi, and shes headed to the Supreme Court in Washington to take on the fight of her life.

On Wednesday, the high court is scheduled to hear oral arguments in Dobbs v. Jackson Womens Health Organization, which centers on a 2018 Mississippi law that seeks to ban abortion after 15 weeks of pregnancy. The law directly contradicts Roe v. Wade , the 1973 Supreme Court decision that protects the right to abortion. Roe made it a constitutional right to access safe and legal abortion until a fetus viability, which is around 24 weeks. The Mississippi law cuts that almost in half with a 15-week restriction.

Since JWHO is the only abortion clinic left in the Southern state, the law directly targets Brewer and her staff. And they have a heavy burden to bear. Not only will the case decide the fate of abortion rights in Mississippi, it will also determine if abortion access will remain legal across the country.

Ive been asked a lot of times if this is a scary thing thats going on, just like all of the other cases weve done over the years, Brewer said on a call with reporters earlier this month. This case has worried me more than any other one, because I know this is going to be detrimental to women not only here in Mississippi, but in so many states. Because, believe me, if [the Supreme Court] decides to do it, most of the other Southern states are going to ban abortion immediately.

The Supreme Court could strike down the Mississippi law, which would mean Roe remains the law of the land. Or the court could uphold the law whether banning abortion outright or tinkering with the gestational limit which would effectively overturn Roe and allow states to set their own standards. If that happens, it would trigger bans or constitutional amendments in several states that would immediately outlaw abortion.

The Supreme Court isnt expected to decide the Mississippi case until June. If the state law is upheld, it will be the beginning of a nationwide battle in a post-Roe world. But for people in Mississippi, where abortion rights have been under attack for years and reproductive choice already badly restricted, it would be a final blow.

A 25-Year Campaign To Eliminate The Constitutional Right To Abortion

Its no mistake that the last battle in a decadeslong war over abortion rights has come to a head in the state of Mississippi. Mississippi is one of the states with the greatest number of abortion restrictions and the worst access to abortion care, with 88% of women of childbearing age living in counties with no abortion provider.

Mississippi has always been a market leader in anti-abortion laws, so Im not surprised its come to this, said Jenny Ma, a senior staff attorney for the Center for Reproductive Rights working on the Dobbs v. JWHO case. The 15-week ban is part of a 25-year campaign to eliminate the constitutional right to abortion. This has been a very targeted, intentional approach by anti-abortion legislators in Mississippi.

Anti-abortion organizations and lawmakers have been successful in their campaign against abortion access. There are currently a dozen abortion restrictions in Mississippi, with several others caught up in court challenges.

And lawmakers in the state have not been shy about their ultimate goal: to make Mississippi abortion-free.

Theres only one abortion clinic in Mississippi. I hope this measure shuts that down, Republican state Sen. Merle Flowers said in 2012 while pushing for a restriction requiring people to undergo an ultrasound test before getting an abortion.

Another lawmaker, GOP state Rep. Sam Mims, at the time said that Mississippi is historically one of the strongest pro-life states in the nation. Legislators backing the abortion restriction, he said, aimed to cause fewer abortions, so if the clinic in Jackson had to shut down, then I think it is a positive day for the unborn.

After voicing support for a particularly draconian abortion restriction, then-Gov. Phil Bryant (R) famously said: As governor, I will continue to work to make Mississippi abortion-free.

Those officials and others are absolutely in conversation with anti-abortion organizations, said Ma. The anti-abortion group Americans United for Life has applauded Mississippi legislators for closing six out of the states seven clinics in the last decade. The group has drafted legislation for abortion restrictions that anti-choice lawmakers have introduced.

Two Decades Of Abortion Restrictions At The Pink House

JWHO, fondly referred to as the Pink House for its bright pink exterior, first opened its doors in 1995 and provides care to around 3,000 patients a year. The majority are Black women, poor women and teenagers. Although the state currently allows abortions up to 20 weeks, JWHO only has the resources to provide abortions up to 16 weeks. Anything beyond that requires a dilation and evacuation procedure, known as D&E, which brings more costs and paperwork that the clinic simply doesnt have the resources for.

Brewer said the 15-week limit would have severe consequences for patients. JWHO sees about 15 or 20 people a month who are 15 weeks pregnant or more, she said. And any other clinic that would open in Mississippi in the future would lose a five-week window to perform the procedure.

In 1992, Mississippi had eight abortion facilities. One by one, seven of them closed after the 1992 Supreme Court decision in Planned Parenthood v. Casey, which ruled states were legally allowed to restrict abortion access as long as it did not impose an undue burden on patients. Using the Casey decision, Mississippi abortion opponents and lawmakers pushed targeted regulation of abortion providers, or TRAP laws, under the guise of protecting womens health.

The ruling gave anti-abortion advocates the tool they had been looking for to shut down access to abortion care. And it worked. By 2014, Mississippi had two abortion facilities and one clinic. Today, theres just the Pink House.

These TRAP laws are designed to shut clinics down and, unfortunately, in states like Mississippi, they have been successful, said Ma. These laws have made it impossible to sustain a clinic and for patients to access care.