Pregnant immigrants in Minnesota have been postponing their abortions, skipping aftercare, and delaying birth control visits and urgent cancer screening follow-ups to avoid coming in contact with federal immigration agents. 

Medical providers say the federal operation — which the Department of Homeland Security has called its largest-ever immigration enforcement raid — has cut off access to time-sensitive reproductive health care, delays that can result in more complicated and expensive care. Border czar Tom Homan announced Thursday that the operation — now in its third month — is coming to a close, saying that only a “small footprint” will remain in the state. 

Since December 1, Planned Parenthood clinics in Minnesota have seen their no-show rate increase by about 8.2 percent, a notable increase that the organization attributes to the prolonged federal offensive, said Ruth Richardson, CEO of Planned Parenthood North Central States, which operates health centers in Minnesota, Iowa, South Dakota and Nebraska. 

“There is just a tremendous sense of fear in this moment,” Richardson said. Planned Parenthood staff said it was the largest no-show spike they could identify in recent years.

Disproportionately, patients who have skipped or canceled appointments are those scheduled for family planning services, an umbrella category including contraception, wellness visits, cancer screening and testing for sexually transmitted infections, per data shared by Planned Parenthood.

But increased cancellations are happening across the board — including with some patients in their first trimester of pregnancy, said Dr. Sarah Traxler, the organization’s chief medical officer. Though abortion is safe, it becomes more complicated — and more expensive — as a pregnancy progresses, particularly through the second trimester.

“It’s always best if someone knows they want an abortion to come in and do it when they’re ready,” Traxler said. “The longer they delay, the harder the procedure will be for them.”

The Trump administration has rescinded a Biden-era policy that barred immigration officials from targeting health care providers, opening the door to raids conducted at or near medical centers. Immigration agents have been in “close proximity” to Planned Parenthood affiliates and have briefly come to one of the organization’s health centers, Richardson said. Whole Woman’s Health, another abortion provider, has not seen immigration agents on site, but is located near apartment buildings that have been targeted by federal officials. 

“Everyone is concerned. Our patients are concerned. Our staff is also concerned,” Richardson said. 

Patients at Planned Parenthood, which has clinics in Minneapolis and St. Paul, have also been nervous about coming in for follow-up visits after their abortions, Traxler said, including visits to confirm the abortion was successful. 

Complications from abortion are very rare, and the failure rate is low. But patients who receive medication abortions can experience excessive bleeding or infection, the latter of which can be caused when the body fails to expel all parts of an embryo or fetus.

“Those usually can be treated on an outpatient basis, but if the treatment is prolonged, they can become life-threatening,” Traxler said.

Another Minnesota organization has noticed a possible decline in who is seeking abortions. Our Justice, a local abortion fund, has received fewer requests for funding, a change that leaders attribute to the climate of fear sparked by the federal operation, said executive director Shayla Walker. This January, 82 people requested money to help cover the costs of abortion, she said. That number was 131 in January 2025. 

Abortion providers in the area have emphasized medical options that don’t require people to leave their homes. Planned Parenthood and Whole Woman’s Health, another abortion provider, are both highlighting telehealth abortion. Patients in their first trimester can have abortion medications mailed to them, which they can safely take from home. Whole Woman’s Health is sharing information about mail-delivery options for abortion pills, contraception and pregnancy tests through local mutual aid websites, which have also been used in the Twin Cities to coordinate services such as food donations, legal assistance and rental support.

“That is a really safe option for people who are homebound,” said Amy Hagstrom Miller, who runs Whole Woman’s Health. “People don’t always know it’s an option.” 

Still, it’s not a viable alternative for everyone. People in the second trimester of pregnancy require an in-person procedure if they want to terminate their pregnancies. The medication option resembles the experience of a miscarriage, and some patients may feel more comfortable ending their pregnancies with an in-person procedure. For people who want to keep their abortions private, or who aren’t safe telling their partners they are seeking an abortion, receiving pills in the mail to take from home can pose a safety risk.

Traxler also pointed to other time-sensitive reproductive services Planned Parenthood provides — specifically, cervical cancer screenings — that can’t be done at home.

She described two patients in need of cervical cancer follow-ups have been unwilling to come in for care, citing concerns about ICE. Both had “high grade abnormalities” after diagnostic screenings, results that suggest a serious risk of cancer, and that require a detailed, in-person evaluation.

“This is not something that waits for ICE,” she said. “Usually we don’t have a lot of urgency around cervical cancer screening, but with these patients it’s pretty critical, and we cannot get them to come in.”

Clinic escorts — the volunteers who guide patients from their cars to the clinic, shielding them from anti-abortion protesters — have received training in how to protect patients from immigration agents, including when to involve the organization’s legal team, and how to recognize a proper search warrant.

With fewer people seeking abortions, the abortion fund Our Justice has shifted to emphasize other offerings. That has included raising funds to distribute menstrual pads and diapers, coordinating rent support for people who feel unsafe going into work, and in one case, trying to cover medical expenses for a pregnant client who delayed prenatal care because she was worried about encountering immigration officials, and who then required an emergency room visit.

“We’ve always been trying to figure out ways to respond to the needs of the community,” Walker said.