“I began thinking of how it could be legal because of those casino ships on the Mississippi,” said Meg Autry, a San Francisco–based obstetrician and gynecologist
Ozark’s Missouri Belle Casino in Stone Mountain, Georgia. Photo: Derek Storm/Everett Collection/Alamy For people seeking abortion care in Mississippi, Alabama, Louisiana, and Texas — four Gulf Coast states staring down the country’s “most restrictive” post-Roe policies — the options are bleak: a daylong drive with astronomical gas prices or flights in and out of small airports requiring two connections or more.
There is a long history of providing emergency health care aboard boats, on which vessels are quickly deployed for military actions or disaster-relief efforts. In the early days of the pandemic, hospital ships like the Navy’s 1,000-bed Mercy docked in the harbors of U.S. cities in which emergency rooms were overwhelmed with patients. But Autry’s inspiration actually came from quite a different source: the Missouri gambling empire featured in the Netflix series Ozark.
The media attention Autry has received in the past week led to an outpouring of suggestions, from the helpful to the fanciful . But she also knows that the spectacle around the project carries risks. Before practicing in San Francisco, Autry was an abortion provider in Wisconsin, where she was the subject of attacks. “My house was picketed. My family was accosted at the zoo,” she says. “I know what that’s like.
Autry’s vision echoes recent calls from congressional leaders such as Elizabeth Warren and Alexandria Ocasio-Cortez to use federal lands for abortion care, taking advantage of legal gray areas with proposals that match the audacious actions of the anti-abortion movement, which has utilized land-use and zoning laws to successfully block or limit access to reproductive-health care for decades. Expanding the concept to federal waters may offer even more opportunities.
Abortion-access groups on the Gulf Coast have long been discussing the possibility of floating clinics, says Morgan N. Moone, strategic-data and advocacy manager for ReJAC in New Orleans. But the strategy is also a reflection of how bad things have gotten and the stakes of the fight ahead, she says: “We shouldn’t need to flee to the middle of the sea for health care.”
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