SIOUX FALLS, S.D. -- To know what's at stake in the Supreme Court confirmation hearings, it's best to travel 1,200 miles west from the paneled Senate room to a small nondescript clinic in a Great Plains state.
It's best to turn from the blue-and-white charts brandished by senators to the parking lot filled with cars from places as far away as Rapid City, S.D., or even Wyoming.
It's best to turn from the buzz about precedents and privacy to the quiet of a waiting room.
Here, late in the afternoon, the clinic is still full. There's a soldier who will make a 700-mile round trip from the western part of the state. There's a teenager slouching beside a tense mother. There's a rancher, a mother of two high-schoolers and pregnant after having an IUD removed.
This is the only clinic in the state, and this is the only day in the week when a woman can get an abortion in South Dakota. Today, they'll be treated by one of four doctors flown in from Minneapolis because it's impossible to recruit locally. Today's doctor is Miriam McCreary, a mother of four and grandmother of nine, who graduated from medical school in 1958. At 70, she still knows "how desperate women are to end their pregnancies."
One clinic, one day, one doctor. This is what it's like in South Dakota under Roe v. Wade. It's also like this in North Dakota and Mississippi, and not very different in Arkansas or a dozen other states.
Anti-abortion lobbyists here boast that South Dakota is the legislative laboratory for testing and imposing state restrictions. Last year, five new restrictions passed, including one, now being challenged, to force doctors to recite a state-written speech saying that abortion ends the life of "a whole, separate, unique living human being." This year, the legislature, which just opened its 35-day session, is being pressed by a state task force to add more misinformed consent, more delays, more expensive barriers.
South Dakota is one of seven states with a "trigger law" ready to ban abortion if Roe is overturned. But it's possible to add so many burdens onto the back of Roe that it collapses without ever being overturned.
Kate Looby, the state director for Planned Parenthood, puts it simply: Even if Roe is saved, "we'll end up living in a country in which women theoretically have legalized, safe abortion. But for the women of South Dakota, that won't mean anything." She has had to imagine moving this last clinic over the state line to Minnesota.
Back in Washington, supporters create charts that compare Judge Samuel A. Alito Jr. to Sandra Day O'Connor, "model justice." If Justice O'Connor was a moderate, they protest smugly, so is Judge Alito.
Indeed, Justice O'Connor's decision in Casey v. Planned Parenthood ruled that states can regulate abortion as long as they don't impose an "undue burden" on the right.
Twenty years ago, Justice Alito believed that the Constitution doesn't protect abortion rights. He doesn't disavow that. He laid out a strategy on how to eat away at abortion without a frontal assault on Roe. It was a blueprint abortion opponents have followed, one regulation at a time. Later, as a judge, he said the state could order a woman to notify her husband before she could get an abortion. Justice O'Connor strongly disagreed.
That moderate "model justice" Judge Alito would replace also wrote this: "The ability of women to participate equally in the economic and social life of the nation has been facilitated by their ability to control their reproductive lives." Does Justice Alito agree?
More than 30 million women in America have had abortions since Roe in 1973. Seventy percent of Americans say Judge Alito shouldn't be confirmed if he would end Roe. In the hearings, even anti-abortion senators insist, ironically and disingenuously, that Judge Alito has an "open mind."
But the question is not just whether he would overturn Roe. It's whether he would let it be crushed. In 10 years, more than 400 state regulations have been added, and more are coming. When do burdens that force women to state-shop for their rights become "undue"?
Ellen Goodman is a columnist for The Boston Globe. Her column appears Mondays in The Sun. Her e-mail is firstname.lastname@example.org.