“The day it actually happened was a difficult day, just to feel unsafe in our country,” recalled Briggs, the executive director of the WE Health Clinic, an abortion provider in the northern Minnesota city of Duluth.

“Just knowing the impact that would have on patients across the country was really heartbreaking to think about.”

A copy of Justice Samuel Alito’s draft majority opinion overturning the landmark 1973 Roe v Wade abortion decision was leaked to the press a month before the Supreme Court’s ruling – in a Mississippi case known as Dobbs – was formally released on June 24, 2022.

That was when clinics across Minnesota – a US state surrounded by others that, like many Republican-led areas across the US, either banned abortion outright or imposed strict limits on the procedure after Roe fell – began bracing for an influx of patients.

In the year since, Minnesota abortion providers have said they have seen a marked increase in patients, as well as public and legislative support.

Briggs told Al Jazeera that across Minnesota, providers anticipated that appointments would increase by 25 percent. At We Health, the clinic provided 568 abortions in 2022 compared with 462 in 2021 – a nearly 23 percent jump.

“A bit less expected is where those patients were coming from,” she said.

“Even pre-Dobbs, we were the only abortion provider for hundreds of miles in any direction for northern Minnesota, northern Wisconsin, and the upper peninsula of Michigan. That didn’t change after Dobbs, but what did change was patients travelling from the Twin Cities [of Minneapolis and Saint Paul, Minnesota].”

Staffing shortages contributed to week-long waits for appointments at clinics across the Twin Cities metro area – home to a population of nearly three million people spread across seven counties – and drove patients north to access care.

Briggs also said donations and applications for employment and volunteer opportunities were “higher than ever” last year, which was “really nice to see”, but that a core group of anti-abortion rights protesters that regularly picketed outside the clinic seemed more emboldened after Dobbs.

“They’ve just gotten louder, more physically aggressive with both our patients and our clinic escorts. We had one incident of some anti-abortion people who had travelled from a rural area of Minnesota to come to our clinic and attempted to enter the clinic,” Briggs said.

“That was intense for us. That’s not something we typically deal with here.”

Bolstering protections

Minnesota, where both chambers of the state legislature and the governor’s office are led by Democrats, has produced some of the most robust abortion protections in the country since Roe fell last year. The 2022 elections resulting in the so-called Democratic “trifecta” was driven by support for abortion rights, advocates have said.

A 2022 poll by UnRestrict Minnesota, a reproductive justice organisation, found that 65 percent of Minnesota voters wanted laws that support abortion rights and access; 68 percent supported repealing laws that restricted abortion access; 75 percent supported protecting providers from lawsuits, and 74 percent supported protections for those travelling to Minnesota for abortion care.

And in late January, Minnesota Governor Tim Walz signed the so-called PRO Act into law, enshrining access to abortion and reproductive health care into state law.

The measure affirms “that every Minnesotan has a fundamental right to make decisions about their own reproductive health, including the right to use or refuse reproductive health care, to continue a pregnancy and give birth, and to obtain an abortion”, Walz said in a statement at the time.

“A nice surprise for us was having the first pro-choice [pro-abortion rights], majority trifecta that really catapulted us to be able to pass strong policies that continue to make Minnesota the beacon for hope and expanded access,” Abena Abraham, campaign director for UnRestrict Minnesota, told Al Jazeera.

That protection of abortion access has drawn providers to the state, as well.

The Red River Women’s Clinic, previously the only abortion provider in North Dakota for more than 20 years, moved across the river from Fargo, North Dakota to Moorhead, Minnesota in the wake of the Supreme Court’s Dobbs decision.

Tammi Kromenaker, the clinic’s director, said that besides escaping North Dakota’s long-restrictive abortion laws, the clinic also has enjoyed a reprieve from protesters thanks to its new space.

The Fargo location was on a city street with a front door that opened to a public sidewalk, and “patients had to literally walk a gauntlet of protesters,”, Kromenaker told Al Jazeera. “Patients would enter the building crying and upset, with their adrenaline pumping.”

In Minnesota, the new clinic is only accessible via a private parking lot that “nobody can enter unless they’re an escort [of patients] or have a scheduled appointment”, she said. “The ability to get into the building without being harassed or bullied has made a huge difference.”

While the building has brought positive changes, Kromenaker said it was still an unnecessary burden. “Having to locate a building, move, retrofit the space, all the planning and inspections — it’s been an enormous undertaking,” she said.

But it is one that Kromenaker said is evidence of her independent clinic’s commitment to their services and their patients, of whom they have seen an estimated 10 to 15 percent increase over the last year.

“We’ve seen a handful of patients from Texas, we saw patients from Nebraska recently. But I suspect that there are more patients from out of state who may just not be telling us where they’re coming from.”

‘A lot of work ahead’

Meanwhile, abortion rights advocates in the state said that while many of their priorities have become law, their fight is far from over. Abraham at UnRestrict Minnesota said the group was now honing in on the affordability and continued accessibility of both abortion and pregnancy care.

“We want to be able to make sure that folks have access to free pregnancy tests and ultrasounds and go after the fake abortion clinics known as CPCs”, or crisis pregnancy centres, she said.

There are an estimated 90 CPCs across Minnesota, many of them in rural areas, compared with nine abortion providers.

“There’s still a lot of work ahead to make sure Minnesota continues to be that leader,” Abraham said. “We want to make sure that we’re also expanding funding for pregnancy support and that folks can get medically accurate, unbiased information and support that isn’t wrapped in religious rhetoric that’s shameful and full of harassment.”