Outside are protesters, praying or proffering pamphlets with grisly photos. Inside, young women sit quietly in a room furnished with a television and a gumball machine, waiting...

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JACKSON, Miss. — Outside are protesters, praying or proffering pamphlets with grisly photos. Inside, young women sit quietly in a room furnished with a television and a gumball machine, waiting for their appointments at Mississippi’s only abortion clinic.

These are busy — but worrisome — days for the Jackson Women’s Health Organization, which has added many clients since the only other remaining clinic closed last summer. The clinic’s staff and supporters know their adversaries will try relentlessly to shut their office down, taking another step toward making legal abortions in the state virtually nonexistent.

For both sides in the national debate over abortion, Mississippi has become Exhibit A: It is widely considered the state with the most thorough arsenal of laws, policies and public pressure aimed at curtailing the procedure. There used to be seven abortion clinics in the state; now it is the most populous of a handful of states with only one.

“Mississippi is the picture of the future,” said Susan Hill, a North Carolina-based businesswoman who owns several clinics, including the one in Jackson. “It’s the perfect laboratory for any restriction; there’s no way, politically, that it won’t sail through the Legislature.”

Roy McMillan, an anti-abortion activist who has been protesting outside Mississippi clinics for 25 years, is delighted that he no longer has to ponder which clinic to target.

“Thankfully, we’ve arrived at a time I always wanted — when the women have to come through us,” said McMillan, dressed in a well-worn Santa Claus suit as he confronted clinic employees and patients on a recent weekday. “I would love our state to be the first to be abortion-free.”

Abortions reached a peak in Mississippi in 1991, when 8,814 were reported. The number dropped to 3,605 in 2002, the last year for which figures are available, producing one of the lowest abortion rates in the U.S. — less than one-third the national rate.

Many hard-to-measure factors may have contributed to the drop, such as more effective use of birth control or an upsurge of Mississippi women getting abortions in other states. But activists on both sides believe the strict laws and community pressure have had a significant impact, along with the efforts by anti-abortion groups to publicize the checkered legal backgrounds of some abortion providers.

Though many states have laws restricting abortion, Mississippi has striven to lead the pack. For example, it recently enacted the nation’s most sweeping “conscience clause,” allowing any health-care provider to refuse to provide any abortion-related service, including emergency referrals.

Mississippi is one of only two states, along with North Dakota, requiring consent of both parents before a minor can get an abortion. It is one of two states, along with Texas, requiring that women seeking abortions be told, in contradiction of National Cancer Institute findings, that abortion might increase their risk of breast cancer.

The Legislature has been so diligent that Pat Cartrette, executive director of Pro-Life Mississippi, says her group no longer has a wish list of abortion laws — all its priorities have been enacted. Her group is now targeting the Jackson Women’s Health Organization, asserting that one of the three doctors working there has vision problems.

“We don’t need to wait for the Supreme Court to outlaw abortion,” Cartrette said. “If we shine the light on the abortionists and the abortion industry, it will self-destruct, and we’re seeing that happen in Mississippi.”

Betty Thompson, longtime director of the Jackson clinic and now a consultant for it, said the allegations regarding the doctor’s eyesight had been refuted, but she expects no respite in what she and her colleagues consider systematic harassment.

“We’re just going to have to fight each time,” she said. “As long as we’re in compliance with the laws, I think we’ll be able to function.”

Thompson and her allies say the most onerous state requirement — particularly for rural residents — is that which prohibits women from having abortions until at least 24 hours after they receive mandatory counseling from a doctor on the risks of the procedure and alternatives to it. Some women must take a day off from work and spend a night in Jackson — potentially a costly burden for low-income women.

“But a young woman who’s made up her mind to have an abortion will find a way to pay for it,” Thompson said. “She’ll sell whatever she has at a pawnshop, steal, prostitute herself. She’ll run in here — not walk, but run.”

The Jackson clinic, which charges $380 for first-trimester abortions, provides the mandatory counseling in group sessions unless a woman requests a private briefing.

“They don’t hear a word you say; they don’t ask questions,” Thompson said. “They tell us, ‘We understand this already. We’re not stupid.’ ”

As with many social issues in Mississippi, racial demography surfaces in the abortion debate.

Blacks make up 37 percent of the population, yet account for 73 percent of the state’s abortions. Cartrette voices disappointment at Pro-Life Mississippi’s failure to make more headway among blacks, while McMillan — who is white — often cradles an African-American doll in his arms while protesting and hands out pamphlets depicting abortion as a form of black genocide.

Such allegations irk Dr. Helen Barnes, who in the 1960s ran a clinic in the impoverished Mississippi Delta and was one of the first black women in the state to practice as an obstetrician. Barnes delivered thousands of babies and provided birth control to women who had used lard as a contraceptive; now she opposes the state’s anti-abortion laws and says officials should do more to make birth control available.

“I do hate that we’re going backward,” she said, referring to state medical facilities that no longer perform abortions, which they did provide in the ’60s to protect women’s mental or physical health.

“If you followed the rules, it was acceptable,” said Barnes, 76. “Now they’re trying to make it a crime.”

Compared with the powerful anti-abortion camp, which includes Republican Gov. Haley Barbour, Mississippi’s abortion-rights movement is weak. Planned Parenthood monitors the state from an office in neighboring Alabama; its only health center in Mississippi does not offer abortions.

“Some Mississippi women drive across the state line to get abortions, but the poorest of the poor are either having the kids or getting a back-alley abortion,” said Larry Rodick, who heads Planned Parenthood’s Alabama office. “Some of those women probably end up getting sick and dying, though we’ll never know because they don’t put it on the death certificate.”

Hill, the clinic owner, is braced for prolonged confrontation. “The state and the protesters are determined to close us, and we’re determined to stay open,” she said. “It’s the classic fight to the finish.”