There had never been an abortion clinic in the quiet college town of Carbondale, Ill. So when its first clinic opened this fall, it revealed tensions between residents that had largely been hidden.
Regine Garmon, a Carbondale resident who works at the clinic, was standing on the sidelines of her son’s basketball game when she overheard a group of parents discussing the clinic’s opening. One mother wondered aloud if the clinic’s employees would encourage local teenagers to be sexually irresponsible.
“It’s very frustrating to think that this is what some people think of us,” Ms. Garmon said, “but we’re providing health care, we’re doing a good thing.”
Mark Surburg, a pastor from the neighboring town of Marion, joined an early protest, watching workers arrive at the clinic. “It was a shock to realize that this is happening in our own backyard,” he said.
Carbondale sits in the southernmost corner of Illinois, a place where most residents have largely avoided talking about abortion. But after the Supreme Court overturned Roe v. Wade, the town found itself in a prime location for abortion clinics looking to serve patients traveling from states where the procedure is now banned, including Tennessee, Arkansas and Missouri. Carbondale now has two abortion clinics, including Ms. Garmon’s employer, Choices.
A new exterior sign was installed outside Choices.
The town is a study in contradictions, not quite conservative or liberal. There is a L.G.B.T.Q. community center down the road from a Southern Baptist church and a recreational marijuana dispensary next to a turn-of-the-century train depot. Representative Mike Bost, a reliable ally of former President Donald J. Trump, has an office in Carbondale, yet the town voted Democrat in the past two presidential elections. Locals say Southern Illinois University has brought a more diverse population to the city, which is still more than 60 percent white.
Choices opened in Memphis nearly half a century ago, but as the specter of Roe ending loomed in recent years, Jennifer Pepper, the clinic’s chief executive, said she knew the clinic would need a new location from which to offer abortion services. When Ms. Pepper and her team settled on Carbondale, they began tapping local community leaders to help smooth the transition.
“You come into somebody’s house, you need to introduce yourself, break bread with people,” Ms. Pepper said.
Chastity Mays, a mother of three who has lived in Carbondale since 1994, helped make introductions. Ms. Mays, who works as a doula, coaching pregnant women through childbirth, set up lunches between Ms. Pepper’s team and Carbondale leaders like the police chief and city counselors.
The clinic’s staff said that some Carbondale residents had offered small tokens of support, bringing baked goods and encouraging notes to the clinic.
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“That’s just the way Carbondale is,” Ms. Mays said, hailing the community as a place where residents readily offer each other help.
But at a Carbondale City Council meeting in May, abortion opponents urged town leaders to prevent Choices, and any other abortion provider, from opening.
The room was so packed with local residents and people from surrounding towns that a second room was needed.
At the start of the meeting, the Council gave the public a chance to speak on any town issue. Jared Sparks, a Baptist pastor in Carbondale, was first to approach the microphone.
“Abortion is murder — those who do it are in violation of God’s law,” he said. The room erupted in applause as Mr. Sparks told the city councilors that they were “complicit in violence against, and the murder of, little boys and girls.”
While he spoke, a line of people formed behind him. For nearly an hour, the Council heard comments from men and women, many of them passionately voicing concerns similar to Mr. Sparks’s. Many of the people seated behind the speakers nodded in agreement.
A few attendees, including Ms. Mays, spoke in favor of the clinic.
While she waited for her turn, Ms. Mays said she was surprised to watch people she’s know for years — faces she had seen at school pickup lines, at the grocery store — speaking out against abortion.
“It was this moment of, ‘Oh, you’re here?’ — people that I see day to day,” she said. “But the next day, we all went back to normal.”
As the clinic’s opening day neared, there was more evidence of the tensions brewing in town. A few companies refused to do business with Choices. A spokesman for Ms. Pepper said a local electric company had asked the clinic to find a new utilities provider because it said it had received harassing online messages and phone calls from abortion opponents.
Still, the clinic opened last month, and patients have been making hourslong drives to Carbondale, underscoring the demand from around the region.
At the end of October, Miracle, who asked to be identified only by her first name because of a fear of harassment, drove three and a half hours to Carbondale from Arkansas with her infant daughter to get an abortion. She said she had an intrauterine device, or IUD, inserted shortly after she gave birth to her daughter, but, less than a year later, her IUD failed and she was pregnant again. Like a majority of women who seek abortions, many of the clinic’s patients are already mothers.
When Miracle asked her doctor about her options, she said the doctor told her to pray about it.
She was thankful that she could afford to take time off work to make the drive across state lines, in large part because she owns her own business and does not have to request time off.
Anti-abortion groups from other states have also turned their attention to the Carbondale clinic. After abortion was banned in Missouri, Churches for Life, an organization based in St. Louis, began focusing on nearby states. The group is in contact with Mr. Surburg, the pastor from Marion, Ill.
In the 16 years that Mr. Surburg and his family have lived in southern Illinois, he says he has felt insulated from the abortion debate. He was concerned to learn that another abortion provider, the Alamo Women’s Clinic, had recently opened, moving to Carbondale from Texas.
“There are a lot of churches that are concerned but are doing things in their own little silo,” Mr. Surburg said. He praised Churches for Life for coordinating protests against Choices, which have dwindled in size since the clinic first opened.
James Price, who has lived in southern Illinois for two decades, said he had been meeting with Mr. Surburg and other local Christians who oppose abortion.
“I’ve never gotten as engaged with it until it came to my hometown,” said Mr. Price about the abortion debate.
Mr. Price and Mr. Surburg said they hoped to build a network of abortion opponents in southern Illinois. Mr. Price also said they were committed to peaceful protest.
“We absolutely disagree with any approach that brings harm to workers or brings harm to the facility,” he said.
Ms. Garmon, who left a remote job at an insurance company to join the clinic’s staff, said she was still acclimating to the irregular protests.
“Sometimes they’ll just stay on the sidewalk,” she said, “but the bold ones will come right up to the edge of the parking lot, right up there in front of your car.”
In response to the protesters, the clinic’s staff was given several directives during a safety training session in September: Don’t engage with protesters, change into your scrubs once you arrive in the office and don’t wear your Choices T-shirt in public, to avoid revealing where you work.
But much of that advice does not translate to a place like Carbondale, where the close-knit community makes anonymity difficult. Workers at the clinic said having conversations about their work with their close friends and family was a necessity in a small town where it would be tough to hide their affiliation.
Stacy, a nurse at the clinic who asked to be identified only by her first name because she worried about the reaction from her church community, said she was relieved when her grandmother supported her new job. She and her family attend Sunday services every week, and she said she has struggled to reconcile abortion with her Christian faith.
“Me taking this job took a whole lot of prayer,” she said. She was against abortion, she said, until she became pregnant at 18, “and I considered it.”
Stacy said she did not have an abortion, and does not regret her decision, but the fear she felt softened her view of the issue.
“It’s a scary decision to make,” she said, “and you just don’t know how you’ll feel until you’re faced with that choice yourself.”
She says she tries to remember that fear when she meets patients at the clinic, who often arrive exhausted after long drives.
Alyssa, who asked to be identified only by her first name for fear of how her community would respond, arrived at Choices last month after a five-and-a-half-hour drive from her home in Mississippi. She has two young children, one of whom is an infant, so when she recently found out she was pregnant, she said she knew she could not afford to care for a third child.
Alyssa said she spent every cent of her savings to travel to Carbondale, the closest clinic, and made the drive alone. Anxious about her ability to have the procedure, she said she hadn’t been able to sleep for a few nights. When she arrived at the clinic, she told the staff that she was worried about being able to afford gas to return home.
Ms. Garmon helped gather enough money to cover Alyssa’s abortion, leaving her enough money for fuel for the long ride home.