In-clinic abortion care has returned to Columbia after a long hiatus. KBIA's Rebecca Smith takes us on a tour behind the scenes of central Missouri's Planned Parenthood health clinic.

The divisiveness surrounding abortion is very clear on the morning of Monday, March 3, 2025.

The Columbia Planned Parenthood clinic has opened for the day, and for the first time since 2018, doctors there are performing in-clinic abortions.

Clinic escorts stand outside using umbrellas to block views of faces - theirs and their patients'.

While about a dozen protesters stand just beyond a tall black fence shouting things, such as "I'll pray for you" to the people passing by on the sidewalk.

The protestors hold up anti-abortion signs, as a car drives by and the driver shouts, "Get off the f---ing sidewalk and get yourself a job."

And just moments later another driver honks in support of the protest.

Walking into the clinic -- it's just another medical office. Except for the escorts from the parking lot to the door, the security guard who stands by the door to welcome people in and the security system that watches the entire property.

"It's nothing that is unusual. It's just the scary word of 'abortion' that people don't like," Krissy Lincoln said. She's the health center manager at the Columbia clinic. "I think a lot of people just don't understand the steps that go into it."

Emily Wales is the CEO and President of Planned Parenthood Great Plains, which operates the Columbia clinic. She said after patients check in for their in-clinic abortion appointments, they meet with a reproductive health assistant who takes their background information and answers questions.

"Sometimes patients -- because they do feel that the care is stigmatized, or they've waited a long time to get care -- they're really hesitant to ask questions," Wales said. "We try to make them feel at ease, and also to let them know, like we have time to sit with you and answer questions."

She said patients then have an ultrasound to determine the point of pregnancy and watch a series of videos that go through their options -- adoption, abortion and raising a child.

If the patient then makes the decision to proceed with an in-clinic abortion, there's another video they watch that explains the procedure in detail, including sedation options and recovery timeline.

The in-clinic procedure is called a dilation and curettage, or a D&C. It's used to terminate a pregnancy in its early stages or after naturally occurring miscarriages.

Essentially, a doctor dilates the cervix and then uses a vacuum suction device to remove tissue from the uterus.

"(The) procedure generally lasts only a few minutes, and then (you) spend some time in recovery, where we have nursing staff that monitor patients for any potential complications."

Just down the sage green hall from the procedure room is the recovery suite where music fills the air, and two blue vinyl-covered recliners sit waiting for patients.

Macy Thompson, a nurse at the Overland Park, Kansas, Planned Parenthood clinic, volunteered to come down to the Columbia clinic and work with patients while the Columbia staff gets retrained on abortion care.

She said patients spend 15 to 30 minutes recovering, as she tells them about what they can expect over the next few days.

Thompson also gives them information about when they should seek out follow up care and provides them with an after hours nurse line they can call once they leave the office.

"It's not the fanciest setup, but we try to do a lot for comfort," Thompson said. "I've got heat packs, blankets. We do Sprite, we do snacks. We provide some toiletry products to send home with the patient, goodie bags that they'll go home with, pads, underwear, a heat pack, and then -- classic Planned Parenthood -- a big handful of condoms just in case."

She said majority of her time is spent listening because every patient's circumstances are different. Some want to share what they've been through and some just want to sit in silence and head home.

"I think nursing, a lot of times, we are the like receivers of narratives," Thompson said. "So you want to make sure that with every patient you meet, you're open to hearing whatever their process is or the reason for their abortion."

She said that before patients leave the office, she offers them what she calls the final step of the abortion process: a hug or a high five as they head back home.

In-clinic abortions are now available by appointment at the Columbia clinic and occur as doctors' schedules allow. Planned Parenthood Great Plains hopes to offer the procedure a couple days a week in Columbia.