MINNEAPOLIS—There is a nearly 1,200-mile-wide desert of abortion providers stretching from the western border of Idaho to the eastern borders of North and South Dakota. Across this five-state expanse, the total number of cities that offer any form of abortion access can be counted on just two hands. Montana used to be an oasis in that abortion desert, with four clinics in four different cities offering both surgical and medication abortion options, but not anymore.

Last month, an apparent pro-life vandal destroyed the abortion clinic in Kalispell, Montana. Now, the state has just two clinics providing surgical abortions, in Billings and Missoula. This crisis of access affects not just Montana residents but thousands of women in neighboring states, too.

Vandalism or Terrorism?

Susan Cahill, a physician’s assistant, provided abortions in Montana for decades, through fire-bombings and lawsuits, but is now no longer practicing. After learning that the building that housed her clinic had been bought and her lease was not being renewed, Cahill moved to a new building this February. Three weeks later, that new clinic was broken into and vandalized beyond repair.

Michelle Reimer, executive director of Hope Pregnancy Ministries, a local crisis pregnancy center, was soon revealed as the owner who forced Cahill out of her old office. Reimer makes no bones about the fact that her intention was to stop Cahill from performing abortions in the city, telling Democracy Now: “We made a stand for the pro-life position in a legal, peaceful and non-confrontational way, purchasing the building in order to advance the cause of life.”

The vandalism, on the other hand, was a destructive act of aggression and malice, according to those who saw the clinic after the attack. Maggie Moran, executive director of NARAL Pro-Choice Montana told the Billings Gazette, “Equipment, records, the plumbing and heating system—all destroyed. And all of her personal things were maliciously torn and stabbed.”

The suspect in the case, Zachary Jordan Klundt, is the son of Twyla Klundt, a board member of Hope Pregnancy Ministries. Klundt has pled not guilty, although documents from the office were found in his home and his shoe treads match those found at the scene. His mother, meanwhile, resigned from the board.

Eliminating Choice

Whether the destruction of the clinic is confirmed as a deliberate attempt to stop abortion in Kalispell or simply a random act of violence, the result is the same. In just under one year, Montana has gone from a state with four non-medication abortion providers to a state with only two. Dr. Susan Wicklund, a long-time champion of abortion rights and access, retired and closed her Livingston clinic in the fall of 2013. Meanwhile, its ability to offer medication abortions in a few other clinics is completely dependent on the day of the week and the availability of a provider to administer the medication.

Closing abortion clinics has become a primary goal for anti-abortion activists, who have used bills requiring expensive clinic renovations or medically unnecessary transfer agreements to force clinics that can’t meet requirements to shut their doors. The reasoning is simple: If abortion can’t be outlawed, closing off clinics is the next best thing.

The gambit has been highly successful: between 2010 and 2013, one in 10 clinics closed across the country—and that was before Texas’s HB 2 began to go into effect, which will close another 20. For states like Alabama, Mississippi, and Wisconsin, the only thing standing between losing most or all of their clinics are court orders blocking bills from being enforced.

Planned Parenthood in Billings and Blue Mountain Clinic Family Practice in Missoula have become the primary locations for abortions. Billings, in central Montana, is often the nearest location for pregnant people in western North and South Dakota or much of Wyoming, three states that not only have just one provider each but, in some cases have waiting periods ranging from 24 to 72 hours.

For Blue Mountain, the situation is a reminder of why they started. “Blue Mountain Clinic was founded as a response to this lack of providers in the West,” said Emily Likins, the clinic’s communications director. “We’ve always had patients who have been coming to us from far away. I have been a counselor at the clinic for two years, and not a week has gone by that I haven’t had a patient who has traveled 12 hours to get to us here.”

“We are busy here, and so overbooked,” said Likins. “We are short on equipment, short on space, short on providers and short on nurses.”

Being overbooked also means prioritizing patients, which Likins regrets. “We hate having to tell women that we can’t get them in this week. ‘We’re sorry, but we can’t get you in this week, and you’re only 9 weeks so we can wait until you are 10.’ We hate doing that. We don’t want to force people to walk around pregnant when they don’t want to be.”

Desperate Measures?

While more than 100 bills limiting access to abortion providers have passed in multiple states since 2011 Montana has been an exception: it’s only legislative move was to try to increase parental consent.

With legislators doing little to stop access in the state, could frustrated anti-abortion activists have taken matters into their own hands to force a clinic closure in Kalispell? Likins of Blue Mountain believes so.

“This wasn’t a random act of violence,” she said. “This wasn’t just one nut job going in and destroying a clinic. This was a calculated, specific act of terrorism where an entire group of people repeatedly pushed an abortion provider out of a place where she had been working for decades. When people get desperate, they get violent.”

The situation in Montana is a reminder that in the abortion provider desert you are just one retirement or one clinic closure away from a state with no legal abortion whatsoever. “When you live in such a small state and there are so few providers, each individual story becomes a much bigger one, especially when it comes to providers,” said NARAL’s Maggie Moran. “With the retirement of Wicklund, and then the clinic destruction in Kalispell, two completely unrelated incidents have now had a massive impact on our state.”

Now, the question becomes how to reverse this trend and bring more care and choices back to the state. For advocates like Likins, the question isn’t will Montana have more access, just how soon it will come about.

“We’ll get a new clinic open,” vowed Likins. “It will happen. It’s only a matter of time. We will have a new clinic in Montana.”