JACKSON, Miss. - Outside are protesters, praying or proffering pamphlets with grisly photos. Inside, young women sit quietly in a room furnished with a TV set and a gumball machine, waiting for their appointments at Mississippi's only abortion clinic.
These are busy - but worrisome - days for the Jackson Women's Health Organization, which has added many clients since the other remaining clinic closed last summer. The clinic's staff and supporters know their adversaries will try relentlessly to shut their office down, taking another step toward making legal abortions in the state virtuallynonexistent.
For both sides in the national debate over abortion, Mississippi has become Exhibit A: It is widely considered the state with the most thorough arsenal of laws, policies and public pressure aimed at curtailing the procedure. There used to be seven abortion clinics in the state; now it is the most populous of a handful of states with only one.
"Mississippi is the picture of the future," said Susan Hill, a North Carolina-based businesswoman who owns several clinics, including the one in Jackson. "It's the perfect laboratory for any restriction - there's no way, politically, that it won't sail through the legislature."
Roy McMillan, an antiabortion activist who has been protesting outside Mississippi clinics for 25 years, is delighted that he no longer has to ponder which clinic to target.
"Thankfully, we've arrived at a time I always wanted - when the women have to come through us," said McMillan, dressed in a Santa Claus suit as he confronted clinic employees and patients on a recent weekday.
"I would love our state to be the first to be abortion-free," McMillan said.
Abortions reached a peak in Mississippi in 1991, when 8,814 were reported. The number dropped to 3,605 in 2002, the last year for which figures are available, producing one of the lowest abortion rates in the country - less than one-third the national rate.
Many hard-to-measure factors may have contributed to the drop, such as more effective use of birth control or an upsurge of Mississippi women getting abortions in other states. But activists on both sides believe the strict laws and community pressure have had a significant impact, along with the efforts by antiabortion groups to publicize the checkered legal backgrounds of some abortion providers.
Mississippi recently enacted the nation's most sweeping conscience clause - allowing any health care provider to refuse to provide any abortion-related service, including emergency referrals.
Mississippi is one of only two states, along with North Dakota, requiring consent of both parents before a minor can get an abortion. It is one of two states, along with Texas, requiring that women seeking abortions be told, in contradiction of National Cancer Institute findings, that abortion might increase their risk of breast cancer.
The legislature has been so diligent that Pat Cartrette, executive director of Pro-Life Mississippi, says her group no longer has a wish list of abortion laws - all its priorities have been enacted. Her group is now targeting the Jackson Women's Health Organization, asserting that one of the three doctors working there has vision problems.
"We don't need to wait for the Supreme Court to outlaw abortion," Cartrette said. "If we shine the light on the abortionists and the abortion industry, it will self-destruct, and we're seeing that happen in Mississippi."
Betty Thompson, longtime director of the Jackson clinic and now a consultant for it, said the allegations regarding the doctor's eyesight had been refuted, but she expects no respite in what she and her colleagues consider systematic harassment.
"We're just going to have to fight each time," she said. "As long as we're in compliance with the laws, I think we'll be able to function."
Thompson and her allies say the most onerous state requirement - particularly for rural residents - prohibits women from having abortions until at least 24 hours after they receive mandatory counseling from a doctor on the risks of the procedure and alternatives to it. The requirement forces some women to take a day off from work and spend a night in Jackson - potentially a costly burden for low-income women.
"But a young woman who's made up her mind to have an abortion will find a way to pay for it," Thompson said. "She'll sell whatever she has at a pawn shop, steal, prostitute herself. She'll run in here - not walk, but run."
Some Mississippi women travel to Tennessee, which has no waiting period for abortions, or to Alabama and Louisiana, where clinics are more plentiful.
Clinic owner Susan Hill is braced for prolonged confrontation. "The state and the protesters are determined to close us and we're determined to stay open," she said. "It's the classic fight to the finish."