By Drew Griffin and Kira Kay
CNN

SIOUX FALLS, South Dakota (CNN) -- Not a single doctor in South Dakota will perform an abortion, which is why Dr. Miriam McCreary has come out of retirement.

Once or twice a month, the 70-year-old grandmother takes a 45-minute flight from Minneapolis, Minnesota, to Sioux Falls, South Dakota, to perform abortions at the last clinic in the state willing to offer the procedure.

Dr. Miriam McCreary or one of her colleagues flies into South Dakota once a week to perform abortions.

South Dakota is the focal point of the nation's debate over abortion. Backed by a strong Christian movement, Gov. Mike Rounds signed into law last month a bill that will make performing abortions a felony -- except to save the life of the mother. If unchallenged, it would go into effect this summer.

But most observers believe it will be challenged and will go before the U.S. Supreme Court. Both supporters and critics of the ban say they believe the time is ripe for a new legal examination of the abortion debate.

Planned Parenthood CEO Sarah Stoesz says her group plans to hold up enactment of the law with a lawsuit.

But some South Dakotans, like parishioners at Church of the Holy Spirit, pray the state's abortion ban will hold. "I think that the time is right to bring the subject again to the Supreme Court, and I guess we had leadership here that felt strong enough about it to push this through our legislature," one congregation member told CNN.

On the morning CNN traveled with McCreary, we arrived to a full parking lot at South Dakota's only abortion clinic. Abortions are performed only one day a week by McCreary and three other out-of-state physicians who rotate through the duty.

On this day, there were no protesters. Still, the doctor entered through a back door. Inside, she donned a white lab coat and got to work. A medical staff has completed most of the medical screening.

The patients have been counseled and have waited at least the mandatory 24 hours to think it through.

"We always worry about people who are ambivalent and they're not sure they want to do this," McCreary said, "and sometimes I'll say, 'don't do this. You don't want to do this today. Please go home and think about this and come back if you want.'"

She said patients are told in counseling of the alternatives to abortion, but that not many choose these options.

"Adoption is a wonderful thing, and they are always given the option to have the pregnancy and have children placed in adoption. And I admire those who do, but not many do," she said.

South Dakota covers 77,000 square miles. One patient drove more than four hours to get here. The patients can sit several more hours waiting for the five- to 10-minute procedure.

South Dakota requires every woman who has an abortion here to fill out a reporting sheet that includes details about her life and her decision to have an abortion.

From these public forms, CNN was able to learn a little about the 16 women who were at the clinic to have abortions. Asked why they were having an abortion, six said they "could not afford the child." Seven others checked the box saying "the mother did not desire to have the child."

McCreary said she rarely knows much about the women on whom she performs abortions. Her job, she said, is to provide safe procedures. "The only doubt I have is that I want the patient to be really sure that she wants that. That's the only doubt. Other than that, I just feel I am giving good health care."

At almost 6 p.m., McCreary has completed the last of the day's abortions and feels a sense of accomplishment at the end of her long day. "I've helped them out of a predicament that they were not happy to be in," she said, "and if I wasn't here to do it, you know, maybe no one else would do it."

McCreary has been making this trip for seven years. At age 70, she wants doctors in South Dakota to take her place.

But so far no one has stepped forward. So she said she will keep coming back.

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