Welcome to Oklahoma, the hardest place to get an abortion in a post-Roe v Wade America

When Texas introduced its ban on abortion after six weeks, then among the strictest in the United States, new patients flooded the Tulsa Women's Clinic in Oklahoma. 

For months, the staff were greeted daily by a queue at the front door of the discrete grey building on the outskirts of town. 

By mid-morning the waiting room would be full, with patients often spilling into the corridor, sitting on the floor as they grappled in silence with the stack of state-mandated paperwork required to terminate a pregnancy. 

Now, the abortion clinic is empty, except for two nurses and a handful of visitors. 

"It's heartbreaking, honestly," said Tiffany Taylor, the clinic's senior nurse. 

"Each chair represents to me a person capable of being pregnant, somewhere in this geographical area that is no longer able to access any services. 

"So, these are people that are trying right now to figure out how they're going to go forward with their life. 

"And, quite frankly, it was really hard to get used to walking in here and having no-one here." 

The Tulsa Women's Clinic has been in stasis since Oklahoma introduced its own abortion ban, modelled on Texas's, effectively outlawing the procedure in the state from the moment of fertilisation. 

A week ago, the US Supreme Court sealed the clinic's fate by overturning Roe v Wade, the ruling that guaranteed Americans' right to abortion up to about 24 weeks.

The country has since splintered.

Nearly half of US states have moved to ban or tightly restrict abortion, redrawing the national abortion map almost overnight.

Oklahomans were already living with the reality of post-Roe America, but abortion providers, like the doctors who worked at Tulsa Women's Clinic, now face felony charges on top of the existing $US10,000 ($15,000) fine.

The ban makes no exceptions for rape or incest, and even harsher criminal penalties are expected to come into effect in August, including fines 10 times more expensive and potential prison sentences. 

The state's four abortion clinics, which have recently welcomed patients from Texas and beyond, will soon be forced to close, sending another wave of people seeking abortions across state lines. 

The Tulsa Women's Clinic stopped offering abortion services weeks ago, but protesters still gathered outside to celebrate the Supreme Court's decision. 

"I'm praising God and Donald Trump," said Tim Beach, a former school teacher who protests on the curb with a whiteboard bearing hand-written anti-abortion slogans. 

"He wouldn't have got those three Supreme Court justices in and [we] wouldn't have that ruling.

"God uses men and God used Donald Trump."

On Tuesday, Mr Beach was joined by another clinic regular, Alan Maricle, an anti-abortion preacher who labelled the clinic "the gates of hell".

"Welcome to Oklahoma," Mr Maricle said.

"These are crazy days."

The Midwestern state, which has a population of nearly 4 million, currently only allows abortion if a mother's life is at risk.

Even then, the law has had a chilling effect on the few doctors licensed to perform the procedure in the state.

How medication abortions, which are often self-managed, can be monitored remains an open question, but they are also banned.

Wendi Stearman, the Republican state politician who designed the Senate bill, said it was meant to act as a deterrent, rather than being punitive.

It was signed into law by Oklahoma's Republican Governor, Kevin Stitt, in May and deputises citizens to sue anyone who "aids or abets" pregnancy termination, skirting the protections of Roe.

Ms Stearman, a staunch abortion opponent, said she was excited when she heard the news of Roe's demise.

"It's something that has been in place since a year before I was born," she said.

With the constitutional right to abortion gone, healthcare providers, clinics and millions of Americans are grappling with a new reality. But will it mimic the time before Roe v Wade?

"And so, my whole life abortion has been taken from the states, the decision concerning that has been taken from the states, and to see it returned to the states, where it rightfully belongs is, is phenomenal.

"So many people never thought that they would live to see this happen. And now it has happened."

On June 24, when the Supreme Court handed down its ruling, Oklahoma's Attorney-General moved to adopt an additional "trigger law", which made performing a surgical abortion a felony, the same day.

It is one of 13 such laws of varying severity in states nationwide.

In August, Oklahoma will add criminal penalties for abortion providers — on top of the ban — of up to 10 years in prison or a $US100,000 ($150,000) fine.

Ms Stearman is proud of her state, which now has the strictest abortion laws in the country.

She described pregnancies resulting from rape and incest as "horrible situations" but said it was the duty of government to "protect life and liberty" as laid out in the US constitution.

She cited a mix of available public and private services, including adoption, for parents, even unexpected or unwilling ones.

"The purpose [of government] is to protect life, not to provide for citizens," she said.

"I would love for the rest of the country to follow suit."

Ms Stearman does not oppose the use of contraception, including the morning after pill, known as Plan B.

Speaking with women living in Oklahoma, the ABC encountered a range of views.

Caitlin Hendrix, a mother and mental-health worker from Claremont, a town near Tulsa, said she felt "sick to my stomach" when she read the headlines about Roe.

"It's an issue that shouldn't be boiled down to simple conversations," Ms Hendrix said.

"And this has made it seem like you can just flip a card and change an entire nation in the blink of an eye, you know? And that's scary.

"There [are] so many opposing factors right now that things just continue to be politicised that truly are personal."

Two 16-year-olds from Tulsa, Treasure Craven and Adrienne Brown, argued it was unfair to ignore the views of young people.

"We should have our right to our own bodies," Ms Craven said.

"There [are] a lot of minors out here whose voices deserve to be heard. But they're not being heard because they're just children."

Ms Brown added the Supreme Court failed to consider the impact on future generations.

"They didn't reach out to the women," she said.

"They didn't really think about the next 20 or 30 years when our generation start having kids or when our kids are having kids.

"You don't want your kids going through what you've already been through."

By throwing the power to regulate abortion back to states, the Supreme Court returned the US to a patchwork of laws, sending abortion providers scrambling to keep up.

The unprecedented move also created widespread confusion among patients, particularly those too busy working or raising kids to stay across the news.

Around lunchtime on Tuesday, a pregnant woman, who had taken an at-home test that morning, knocked on the door of the Tulsa Women's Clinic.

Her husband translated from English to Spanish, as Ms Taylor explained the law had changed and abortion was now banned in Oklahoma.

The former ER nurse couldn't offer clear guidance on what the couple should do next, for fear of being accused of helping them end their pregnancy.

Later, she reflected the hardest part of not being allowed to do her job was knowing "there are women and people capable of being pregnant right now that are sitting in a bathroom somewhere, looking at a pregnancy test that has two lines and thinking, 'Oh my god. What am I going to do?'"

Before Oklahoma's abortion ban was enacted, Ms Taylor estimates the clinic saw about 100 patients a week and did roughly 30 to 50 ultrasounds.

Recently, it has cancelled all procedures and only does one or two ultrasounds a week, mostly to determine if an abortion performed elsewhere was successful or gestational age.

New equipment, including glass jars and suction tubes, which were purchased in response to the influx of patients from Texas, now sits dormant.

"It's all equipment that only works if you can use it," Ms Taylor said.

"The silence in the clinic right now is deafening."

The hardest room for her to be in is the procedure room, which is now empty except for a surgical table.

A billboard advertising a fake abortion clinic down the street is visible through the blinds.

Ms Taylor didn't know the final procedural abortion she assisted with in the room would also be the clinic's last.

"I can remember the patient," she said.

"I can remember what we talked about."

The overwhelming feeling patients expressed leaving the room was of relief, she recalled.

"They just thanked us over and over again for what we did for helping them, for helping other women," she said.

"Something I always liked to say to my patient after it was all said and done was 'Go have a beautiful life. Just go have a beautiful life.'

"Because I felt like a lot of people when they get pregnant — and they don't want to be pregnant or they're not prepared to be pregnant — everything just stops.

"And we helped give control back to the person."

Ms Taylor described Oklahoma's decision to roll back its governing abortion legislation to laws written in 1910 as "mind-blowing".

"How do you how do you rationalise that in 2022?" she asked.

"We send billionaires to space right now for fun. But if you're pregnant in Oklahoma, you're going to have to find a way to travel to have an abortion."

The nearest abortion clinic for Oklahomans is Trust Women in Wichita, Kansas, roughly 3.5 hours' drive from Tulsa.

And there's no guarantee of getting an appointment.

"In the region of the country that we're in, we're right now on the island of abortion access in just a desert," said Zach Gingrich-Gaylord, the clinic's communications director.

"And the type of care we give has not changed, the passion for the work has not changed. But since [June 24], it is a much different vibe."

Trust Women has a sister clinic in Oklahoma City, which Mr Gingrich-Gaylord said was inundated when Texas's ban came into effect.

"And what we saw from that is the displacement of Oklahoma residents, from their own communities, and then coming visiting Kansas as well," he said.

"We see people from as far south as Galveston and Houston [in Texas], from Shreveport, Louisiana. We regularly see people from Arkansas."

Around half of all abortions performed in Kansas each year are for residents of other states, particularly neighbouring Missouri, which also banned abortion last week, further compounding the problem.

In Wichita, Trust Women has doubled its clinic days over the past 10 months, bringing on additional doctors and hiring additional staff to help accommodate all the Oklahomans displaced by Texans.

For now, Kansas remains a sanctuary state in the Midwest, but that could soon change.

On August 2, Kansans will vote on whether or not to alter its constitution, after the state Supreme Court affirmed the right to abortion in 2019.

In the suburbs, battlelines have been drawn.

Markers of both sides can be spotted along a single leafy street, with blue "hands off our rights" lawn signs, facing off against purple "vote yes!" stickers plastered on everything from barbecues to car bumpers.

Trust Women belongs to the pro-abortion coalition, Kansans for Constitutional Freedom, which is campaigning against changing the constitution, fearing it could open the doors for a total ban.

Mr Gingrich-Gaylord, who was raised in a family of feminists, said abortion access, or lack of it, affects everybody.

"We consider abortion a public good that must be protected," he said.

"Like public parks or public transit or libraries having quality, robust, comprehensive healthcare impacts our communities in positive ways."

"More personally, I've got a wife, I have a non-binary kid who was assigned female at birth.

"And this is very much foundational to my own concept of what it means to be a free person."

On the other side is Brittany Jones, a spokesperson for the Value Them Both campaign, which is backed by several anti-abortion organisations.

Ms Jones, who joined the pro-life movement in elementary school, hopes to reassure Kansans state Republicans simply want more power to regulate abortion, rather than to ban it.

"We wanted to see the ability of the people across the nation to actually have a say in the question of abortion, and that's what the [Supreme Court] did," she said.

"But the problem is, that's not true in Kansas.

"Kansans do not want to be a destination for abortion."

If the amendment passes and abortion is banned, as many fear it will be, the Midwest's abortion island will prove to be a short-term mirage, and the desert will grow to the size of France.

While the rest of the US grapples with the fall of Roe, and what comes next, Oklahomans are already living it.

The day after the Supreme Court announced its decision, Susan Braselton, who ran the group of volunteers that escorted patients in and out of the Tulsa Women's Clinic, turned her energy to organising.

"Protests are good, but we're tired of protest," she said.

"We want some action. We want to do something."

Ms Braselton is a board member of the Roe Fund, which has helped poor Oklahomans, many of whom are from marginalised communities, access and pay for abortion services for more than 20 years.

It formerly funded procedures directly but recently pivoted to offering practical support in the form of money to cover travel, childcare and accommodation costs.

In the 24 hours following the ruling, the organisation received tens of thousands of dollars in donations.

But like Ms Taylor, she is being judicious with her advice and the Roe Fund's activities are on pause as the organisation seeks legal advice.

At Tulsa's annual Pride celebrations, which were held on Saturday, June 25, Ms Braselton handed out rainbow-coloured condoms and stickers advertising Plan C, a website providing information on self-managed abortions.

"We can't do the fight from jail. I mean, I could write a bunch of postcards to my legislators, but I wouldn't be able to really do the fight as well in jail," she said.

Ms Braselton likened the vow by the Governor, Mr Stitt, to sign any and all anti-abortion legislation as a "race to the bottom", arguing if he cared about kids he would increase funding for education, healthcare and welfare.

In 2021, Oklahoma ranked in the bottom 10 states for child wellbeing, with one in five children — roughly 186,000 — living in households below the poverty line.

The state has one of the worst maternal death rates in the US, and thousands of children in foster care.

"Just banning abortion doesn't make you pro-life," she said.

"It just makes you pro-birth.

"It makes you anti-woman because you're not giving women the tools and the decisions [of] when and where they might want to have children and support them when they decide to have children."

Across the country, US states have their own choices to make: To ban, restrict or protect abortion.

And many have moved quickly to exercise that new-found power.

"Who knows where this can end? But what it means immediately, is that if you are a person capable of being pregnant in the United States of America, you need long-term contraception," Ms Taylor said.

"The other side of this movement is not stopping. They do not feel like winning Roe was the end game.

"Their end game is to make sure abortion access in the United States of America is no longer an option for any pregnant person in America."

We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work.

This service may include material from Agence France-Presse (AFP), APTN, Reuters, AAP, CNN and the BBC World Service which is copyright and cannot be reproduced.

AEST = Australian Eastern Standard Time which is 10 hours ahead of GMT (Greenwich Mean Time)