In the rugged landscape of Michigan’s Upper Peninsula, a shift in the delivery of reproductive healthcare is taking place within the walls of a standard urgent care center. As traditional reproductive health clinics face increasing instability, a new model of care is emerging in Marquette, where medication abortion services are being integrated into a facility that typically treats sports injuries and the seasonal flu.
The initiative comes as a response to a tightening healthcare landscape. Following the 2022 Supreme Court decision to overturn Roe v. Wade, reproductive health access has grow fragmented. Even in states where abortion remains legal, the infrastructure is fragile. Last year, more than 30 abortion clinics closed across the U.S., including the only Planned Parenthood facility in Michigan’s Upper Peninsula.
This closure left a critical void in the region, creating what local providers described as a 500-mile stretch without clinical abortion access. For residents in rural areas, the loss of a brick-and-mortar clinic means choosing between long-distance travel or relying on telehealth and mail-order medications—options that do not all patients find secure or sufficient.
Integrating Reproductive Care into Urgent Care
The transition to an urgent care model was born from a partnership between Dr. Shawn Brown, the owner of Marquette Med Urgent Care, and Dr. Viktoria Koskenoja, an emergency medicine physician and former Planned Parenthood employee. The two recognized that the urgent care setting possessed the necessary infrastructure to fill the gap: existing medical malpractice insurance and a system designed for walk-in patients.
The clinical nature of the service is focused on the first trimester, utilizing a two-pill medication regimen to expel a pregnancy. Dr. Brown noted that from a clinical perspective, the process is akin to first-trimester miscarriage management, making it a manageable addition to an urgent care workflow.
The program’s expansion has been supported by funding from FemInEM, a national emergency medicine group dedicated to reducing health disparities for female patients and supporting women in emergency medicine. According to Dr. Kimi Chernoby, the group’s chief operating officer, the Marquette program is the first of its kind to offer medication abortion services within an urgent care setting.
Addressing the Rural Telehealth Gap
Even as telehealth has expanded rapidly, providing a vital lifeline for many, it has not replaced the necessitate for in-person clinical care. In rural communities, the “digital divide” is not just about internet access, but about the desire for human interaction and clinical verification during a sensitive medical event.
Dr. Koskenoja has observed that some patients arrive at the clinic with pills they ordered online, feeling uncertain about the authenticity of the medication or the safety of the process. In-person visits allow for critical medical screenings, such as ultrasounds to confirm the gestational age of the pregnancy and to rule out an ectopic pregnancy, which can be life-threatening if left untreated.
The demand for this integrated model has grown steadily since its rollout in July. Initially seeing about four patients per month, the clinic now sees at least four patients per week, drawing people from across the region and even from states where abortion is restricted, such as Louisiana.
The Human Impact of Clinical Access
For patients, the difference between a mailed prescription and a clinic visit is often a matter of psychological security. One patient, identified only as “A,” traveled over an hour through snow to reach the Marquette facility. Despite the availability of telehealth, she expressed a preference for in-person care, stating she felt more secure seeing a provider she could look in the eye.
The Marquette model emphasizes a holistic approach to patient care that extends beyond the medication. In addition to the clinical protocol, local volunteers provide “care bags” containing pain medication, heating pads, socks, and handwritten notes of support. This combination of medical oversight and community support aims to mitigate the isolation often felt by rural patients.
The flexibility of the urgent care model also allows for nuanced counseling. Patients have the opportunity to discuss options, motherhood, and future birth control methods in a setting that is less specialized than a dedicated abortion clinic but more personal than a remote screen.
A Potential Blueprint for Other States
The success in Marquette suggests that the “urgent care model” could be scaled or adapted in other legal jurisdictions. By moving medication abortion into primary care clinics, emergency departments, or urgent care centers, the healthcare system can increase the number of touchpoints where patients can access safe, legal care.
| Metric | Initial Phase (July) | Current Status |
|---|---|---|
| Patient Volume | ~4 patients per month | ~4+ patients per week |
| Geographic Reach | Local/Regional | Interstate (e.g., Louisiana) |
| Service Type | Medication Abortion | Clinical Screening + Medication |
But, the scalability of this model depends heavily on the legal environment of the state. In states with restrictive “trigger laws” or bans, the integration of these services into general practice would be illegal. In legal states, the primary hurdles remain funding and the willingness of private practice owners to provide these services.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Please consult a licensed healthcare provider for medical concerns.
As reproductive health landscapes continue to shift, the focus now turns to how these alternative models of care will be funded and integrated into broader state health strategies. Further updates on the viability of the urgent care model will likely emerge as more clinics in legal states report on patient volume and clinical outcomes over the next fiscal year.
We invite readers to share their perspectives on the evolution of rural healthcare in the comments below.
