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Minnesota is now an island for legal abortion access in the Upper Midwest after the U.S. Supreme Court ruled Friday to overturn Roe v. Wade.

From health care providers to activists to elected officials, the ruling set in motion what's expected to be a tumultuous fight to either permanently protect abortion access in Minnesota or ban it altogether. For those who've sought to keep abortion legal and accessible, it was a day marked by anger, grief and anxiety over what might come next.

"An absolutely horrible, devastating day," said Sarah Stoesz, CEO of Planned Parenthood North Central States.

"The Supreme Court has taken an absolute knife to Roe and our protections, the protections that we have relied on, that so many of us — including myself — have used to organize and plan our lives for the last 50 years, those protections have now evaporated," Stoesz said at a virtual news conference. "The overturn of Roe represents a clear and present danger to women's health and lives in this country and nothing will be the same for many, many years to come."

For the minority of Minnesotans who oppose legal abortion, it was a triumphant culmination of the decades-long fight to undo the 1973 ruling that concluded the Constitution protected a woman's right to an abortion.

Cathy Blaeser, a board member with Minnesota Citizens Concerned for Life (MCCL), said the high court's decision in Dobbs v. Jackson Women's Health Organization is the result of nearly half a century of work by "pro-life women and men across Minnesota and across the country."

"We rejoice in the Dobbs v. Jackson decision while recognizing that, in many ways, our work to protect life is just beginning," she said in a statement Friday.

Minnesota is flanked by states that immediately outlawed abortion when the Dobbs ruling came down, either through so-called "trigger bans" or by reverting to legislation pre-dating Roe. The handful of providers based in Minnesota had already experienced an uptick in patient demand as states across the country restricted abortion in recent months. On Friday, providers pledged to continue their work at a time when demand here is only expected to rise.

"We will do everything we can to help obtain safe, timely, affordable care for those whose rights and access to safe and legal abortion services have been cruelly and unjustly revoked," Amy Hagstrom Miller, Whole Woman's Health president and CEO, said in a statement. "And we will keep fighting like hell against the anti-liberty, anti-family, anti-rights extremists responsible for this monstrous attack on the people, families and communities we serve until their full rights and access to the care they need have been completely restored."

Sarah Traxler, chief medical officer with Planned Parenthood North Central States, said the organization has been preparing for months for an influx of patients. It has launched a direct-to-consumer program for Minnesotans to access medication abortions, expanded telemedicine services and is hiring more physicians and other staff, she said.

"We'll need increasing support and resources for patients as they move around the country in our region finding the care that they need," Traxler said.

Abortion is constitutionally protected in Minnesota under the 1995 state Supreme Court decision in Doe v. Gomez, though the state also has laws that restrict the procedure, including a 24-hour waiting period, mandated counseling and a requirement that minors notify both parents. Efforts by DFL legislators to codify the right in state law have been unsuccessful and, like Roe at the national level, Doe could be overturned by a future Minnesota Supreme Court.

Minnesota's state and federal elected officials reacted to the Dobbs ruling along party lines. U.S. Sen. Amy Klobuchar was prominent among the Democrats who rebuked the ruling, saying that "women are going to have less rights than their mom and their grandmas across the country."

"It's not just taking us back to the 1950s," Klobuchar said in an interview. "It's taking us back to the 1850s."

Republicans applauded the high court's decision and said they're committed to working toward further restrictions.

"Today life prevailed with a decision that will save countless unborn lives," Minnesota House Minority Leader Kurt Daudt, R-Crown, said in a statement. "While there is no immediate impact here in Minnesota, this is an important step toward building a nation that values and recognizes life as a gift that should be protected."

At the state Capitol, DFL lawmakers and abortion rights advocates held a news conference urging the Legislature to expand abortion access for Minnesotans. They called for the state to codify abortion rights in law and pass protections for people who come here from other states to get an abortion. They also want to protect Minnesota providers who perform the procedure on out-of-state patients.

"Today, my daughters woke up with less rights than they had yesterday," said state Sen. Lindsey Port, DFL-Burnsville. "I am committed and I know that our caucus is committed to fighting, to not standing by and accepting that this is the reality for women."

At a later news conference, House Speaker Melissa Hortman, DFL-Brooklyn Park, called on Minnesotans "to make sure that their voices are heard in this year's election."

"What we're seeing in other states — we see today, today abortion is illegal in the state of Wisconsin — and Minnesota could go that direction as well unless voters show up and make their voices heard and keep Minnesota in the hands of a pro-choice government," she said.

As is typical for the party that controls the White House, Democrats are expected to face a tough midterm election. First-term DFL Gov. Tim Walz and all 201 legislative seats are on the Minnesota ballot in November, and abortion is already a top campaign issue. Walz's main challenger, former GOP state Sen. Scott Jensen, has said he would seek to ban abortion if elected governor.

Hundreds of people took to the streets in Minneapolis on Friday evening — as in cities across the country — to protest the court's decision. A smaller group of about 100 people celebrated the decision in St. Paul.

At a vigil outside the Federal Courthouse in Minneapolis, the screams of about 500 people rang throughout downtown. Some wore red dresses and white bonnets in reference to Margaret Atwood's dystopian novel, "The Handmaid's Tale."

"What I want to invite us to do in our rage and our grief, is to yell out, is to have a big rageful primal scream," said the Rev. Kelli Clement. "We do not scream alone. We do it together."

Staff writers Jessie Van Berkel, Ryan Faircloth and Hunter Woodall, Alex Chhith and Katelyn Vue contributed to this report.