When the Planned Parenthood in Marquette, Michigan, closed last spring, it left a 500-mile stretch with no in-person abortion care. The clinic had provided roughly 1,100 annual visits for cancer screenings, IUD insertions and medication abortions. In response, Marquette Medical Urgent Care—run by Dr. Shawn Brown—began offering medication abortion with mifepristone and misoprostol, a service Brown likens clinically to first-trimester miscarriage management.
Brown, who calls herself “individually pro-life,” said the decision grew out of community need. Urgent care clinics already see acute reproductive issues, accept walk-ins, and are set up for same-day care. Viktoria Koskenoja, an emergency physician who had worked at the closed Planned Parenthood, organized a community meeting to identify options after the shutdown. With family medicine and OB-GYN practices strained or unwilling to provide abortions, urgent care emerged as a practical alternative.
Patients have responded. One patient, identified only as A, drove more than an hour on snowy backroads with her children in daycare to be seen in person; she said she preferred a clinician she could meet and trust rather than pills mailed from afar. Some people arrive after ordering pills online but feeling too nervous to use them alone; others need confirmation via ultrasound or have medical issues that require in-person assessment.
At Marquette Medical, clinicians take time for counseling and evaluation. They assess patients’ confidence in their decision, offer an ultrasound to confirm gestational age and rule out ectopic pregnancy, discuss contraception and family-planning options, and provide a “comfort bag” containing medications, pain relief, a heating pad and instructions. Since launching last July, the clinic has averaged about four medication abortions per week, including some patients who travel long distances.
Community support helped make the service feasible: a local donor purchased an ultrasound machine, and a nonprofit was formed to subsidize medication and staffing, cutting patient costs from roughly $450 to an average sliding-scale fee of about $225.
Setting up the service revealed logistical and regulatory hurdles. Brown said obtaining malpractice coverage was initially difficult: an insurer demanded extensive documentation, extra training and quoted an annual premium near $60,000—about three times the clinic’s usual insurance costs. After pushback from the clinic’s broker and presentation of data on limited added liability, the insurer lowered the additional premium to roughly $6,000 per year.
Marquette’s move comes amid broader disruptions to abortion access. Tracking group I Need an A reported at least 38 abortion clinics closed last year in states where abortion remains legal. Since the Supreme Court’s 2022 decision overturning Roe v. Wade, clinics have shuttered for a mix of reasons—financial strain, shifting policies, and the expanded use of telehealth and mail-order pills. The #WeCount reporting project found telehealth abortions rose from about 5% of all abortions to roughly 25% by the end of 2024.
Some advocates view urgent care–based medication abortion as an underused option. Kimi Chernoby of FemInEM called the idea exciting, and some academic medical centers have signaled interest in offering medication abortion at urgent care sites. But legal and practical pitfalls remain: state laws vary widely (some impose waiting periods, counseling or facility standards), and mifepristone remains subject to federal requirements, including certification processes. David Cohen, a law professor studying abortion access, warned that the regulatory environment is “very particular,” and providers must consider whether they want to be listed among potentially scrutinized or legally vulnerable clinics.
The rise of telehealth and mail-order pills—driven in part by clinic closures—has expanded options for many, but opponents are increasingly targeting pills-by-mail. That prospect has made in-person sites more critical for people who need or prefer face-to-face care or who live where remote options may be restricted.
Marquette’s experience highlights both the promise and complexity of urgent care as a partial stopgap: urgent cares are widely distributed and accustomed to managing acute reproductive health issues, and they can offer in-person services when telehealth or mail options aren’t suitable. At the same time, regulatory compliance, insurance costs and mission alignment present real barriers. Replicating the model more broadly will likely require coordinated planning, legal guidance and community funding.
For now, in places like Marquette, urgent care clinics have become an immediate, community-built response—providing counseling, diagnostics and in-person medication abortion where no clinic otherwise exists.