The Political Scene | The New Yorker

Episode: A Year of Change for a North Dakota Abortion Clinic
Date: June 26, 2023
Host: David Remnick
Guests: Emily Witt (The New Yorker staff writer), Tammy Kromenaker (Director, Red River Women’s Clinic)

Episode Overview

This episode revisits the journey of the Red River Women’s Clinic, formerly the only abortion provider in North Dakota, in the wake of the Supreme Court’s Dobbs decision, which overturned Roe v. Wade. Through reporting by Emily Witt and an in-depth conversation with clinic director Tammy Kromenaker, the episode explores the clinic’s strategic relocation across state lines, the challenges faced during this transition, ongoing legal battles, and the shifting landscape of abortion access in America. The program provides a firsthand account of how the clinic and its staff responded to legal setbacks and adapted to continue providing care, as well as insights into broader trends affecting abortion providers nationwide.

Key Discussion Points & Insights

1. Context: Post-Dobbs Legal Landscape

(01:17 – 03:18)

• The Red River Women’s Clinic was North Dakota’s only abortion provider.
• After the Supreme Court overturned Roe v. Wade, North Dakota (and 13 other states) implemented bans on abortion.
• The clinic’s solution: relocate just a few blocks east, across the Red River and state border to Moorhead, Minnesota, where abortion remains legal.

Quote:
"The Red river isn't wide here, but it now forms a border, a distinct border between starkly different realities for women. On the one side, North Dakota, which has banned abortion, and on the other, Minnesota, where Democrats are in power and they've expanded abortion access."
— David Remnick (02:55)

2. Moving the Clinic: Planning, Secrecy, and Execution

(03:31 – 07:14)

• Clinic director Tammy Kromenaker foresaw the need for relocation as early as Fall 2021, as legal threats mounted.
• The new clinic was purchased on June 23, 2022—less than 24 hours before Roe was overturned.
• Secrecy was paramount: Kromenaker describes moving incognito to keep the location private initially.

Quote:
"I was wearing a hat and glasses and a mask and coming in the back utility door, you know, because we had to keep the location secret and secure."
— Tammy Kromenaker (04:58)

• Intensive renovation and setup ensued, described as a community effort involving staff and volunteers.
• The first patients were seen August 10, 2022, only 47 days post-purchase.

Memorable Moment:
"People were running to the hardware store and picking stuff up. But this was the Tuesday. So this is what the room looked like then. This is 10 o’ clock at night. We threw the flooring down… Oh my gosh… 12:39am."
— Tammy Kromenaker (06:29)

3. Emotional Toll and Resilience

(07:14 – 07:58)

• Staff felt a blend of exhaustion, exhilaration, and anxiety.
• Despite losing the battle for abortion access in North Dakota, Kromenaker found a “silver lining”: a better facility and a less hostile political environment.

Quote:
"I played… Sia, 'I'm unstoppable,' because I just needed like an anthem."
— Tammy Kromenaker (07:14)

4. Clinic Operations in Minnesota: New Challenges and Patient Fears

(08:10 – 13:18)

• The new location’s security and setting have made patient experiences significantly less stressful.
• The clinic only serves up to 16 weeks’ gestation due to part-time availability of their doctor and regulatory constraints.
• Staff must frequently address patient misconceptions and fears, particularly around legality, safety, and anonymity when crossing state lines.

Quote:
"Patients demeanors when they arrive in the building is so different… when they used to come in, their adrenaline was pumping, they were crying, they were upset… but it’s not every patient every time [now]."
— Tammy Kromenaker (10:13)

• Adjustments in treatment protocols have been made to reduce legal risks to patients returning to states with abortion bans.

Quote:
"We don’t want patients to go back into those hostile states… So the second medicine in the medication abortion regimen, they insert while they're still here in the clinic, into their vagina. So they're not taking a bottle… that are specifically for abortion back into those host[ile states]."
— Tammy Kromenaker (11:57)

5. Legal Battles and Broader Advocacy

(12:35 – 14:13)

• Despite the move, the clinic remains a North Dakota corporation and continues to challenge restrictive laws in court.
• Persistent rumors about potential laws prohibiting travel for abortion care are addressed; as of the episode's recording, crossing state lines for abortion remains legal.

Quote:
"There's at least three bridges over the river from Fargo to Moorhead… What are they going to have, you know, National Guard stationed on the… the bridge? And a person who appears female and of reproductive age has to, you know, submit to a pregnancy test? I mean, come on, let’s get real about this."
— Tammy Kromenaker (13:24)

6. Impact on Other Providers and Emotional Fallout

(14:13 – 16:09)

• Kromenaker reflects on the challenges faced by clinics in regions without a nearby safe state.
• Many have had to transition into support organizations or close altogether.
• Survivors’ guilt and professional isolation among remaining providers are significant.

Quote:
“I, too, at a point, I was having some survivor’s guilt… really it was a victory of what happened for us, and… other people had to shutter their clinics… especially in the South. The whole South is a hot mess.”
— Tammy Kromenaker (14:28)

Notable Quotes & Timestamps

• "The Red river isn't wide here, but it now forms a border, a distinct border between starkly different realities for women."
  — David Remnick (02:55)

• "I was wearing a hat and glasses and a mask and coming in the back utility door… because we had to keep the location secret and secure."
  — Tammy Kromenaker (04:58)

• "Oh, my gosh, yes. But also like exhilarated and nervous and scared and all of those things. I played… Sia, 'I'm unstoppable,' because I just needed like an anthem."
  — Tammy Kromenaker (07:14)

• "Patients demeanors when they arrive in the building is so different… now."
  — Tammy Kromenaker (10:13)

• "We’ve changed some of our medication abortion administration, because we don’t want patients to go back into those hostile states… So the second medicine… they insert while they’re still here in the clinic."
  — Tammy Kromenaker (11:57)

• "We still are a North Dakota corporation, and just because we… moved five minutes across the river doesn’t mean we’re abandoning North Dakota…"
  — Tammy Kromenaker (12:59)

• "There’s at least three bridges over the river from Fargo to Moorhead… What are they going to have, you know, National Guard stationed on the… the bridge?"
  — Tammy Kromenaker (13:24)

• “Especially in the South. The whole South is a hot mess. You know, there was no easy place for them to go to.”
  — Tammy Kromenaker (14:28)

Important Segments & Timestamps

• Dobbs aftermath, context for move: 01:17 – 03:31
• Clinic relocation planning and secrecy: 03:31 – 05:20
• Clinic renovation and emotional journey: 05:20 – 07:14
• Opening and adjusting to the new facility: 07:14 – 08:10
• Patient care and new protocols: 08:10 – 12:35
• Legal challenges, cross-border fears: 12:35 – 14:13
• Reflection on loss, survivor’s guilt, and the wider impact: 14:13 – 16:09

Summary & Takeaways

Amid an increasingly restrictive landscape for abortion access in North Dakota and surrounding states, the Red River Women’s Clinic serves as a poignant example of perseverance, rapid adaptation, and the new realities facing reproductive health providers. With patient anecdotes, operational details, and heartfelt observations, the episode offers a clear-eyed view of both the personal and political stakes. The conversation underscores broader questions about access, the consequences of legal shifts, and the resourcefulness and vulnerability of providers at this historic crossroads.