Health CareNews & Opinion

Providers Prepare for 12-Week Abortion Ban To Take Effect in NC

New law begins one week after one-year anniversary of the Supreme Court’s decision to overturn Roe v. Wade

Clinic volunteers stand outside Planned Parenthood with pink umbrellas
A Planned Parenthood clinic in Charlotte’s Cherry neighborhood. (Photo by Justin LaFrancois)

Speaking over the phone from A Preferred Women’s Health Center (APWHC) on June 23, clinic owner Calla Hales still wasn’t sure where she’d be the next day — the one-year anniversary of the Supreme Court’s decision to overturn Roe v. Wade, ending federal protections for abortion across the country. She did know, however, that she would be wherever the vice president was.

VP Kamala Harris was scheduled to fly into Charlotte on the morning of June 24 to address local leaders in a speech about reproductive rights, and as Hales waited to hear where exactly she would need to go to hear said speech, she didn’t harbor much optimism for what would come from the next morning’s events.

Having already convened with Harris about a month after the Supreme Court decision in 2022, Hales was having trouble envisioning any true progress coming from another speech.

“I recognize that I could never be a politician and I don’t want to be, and it is a very hard job to manage all these different expectations and different priorities — because I know where mine are,” said Hales, who on top of her work as an independent owner of multiple abortion clinics spread throughout North Carolina and Georgia has long been active in public advocacy for reproductive rights.

“But it’s definitely a very weird place to be because, for as much as you push and you try, there’s still that aspect of screaming into the void a little bit — not even a little bit, a lot,” Hales continued. “Kind of being trotted out for photo ops and proof that folks truly care about an issue, it’s a weird little place to be. I’m not exactly the most hopeful human being anymore.”

Hales wasn’t so concerned with the one-year anniversary of Roe’s overturning as she was with another date: July 1, 2023. That’s when North Carolina’s 12-week abortion ban — voted into law despite the governor’s veto in May — officially takes effect.

On top of restricting access to abortion for patients past the first trimester of their pregnancy, Senate Bill 20 also implements stricter licensing requirements on clinics statewide and stricter mandates on doctor visits before receiving an abortion.

Though Hales and her staff had already begun the slow process of scaling services back to first-trimester patients before the bill was even introduced — a time-saving response to an overwhelming increase in demand from out-of-state patients whose health care options have been restricted in their home states — the bill will cut her staff off from even seeing patients past that point so they can help with referrals and other care.

According to Molly Rivera, spokesperson at Planned Parenthood South Atlantic (PPSAT) — which oversees Planned Parenthood services in North Carolina as well as Virginia, West Virginia and South Carolina — while supporters of Senate Bill 20 point to data showing that a vast majority of abortions already occur in the first 12 weeks, that data is only available through 2021. It has not yet been made available for 2022, so as to track the effects of Roe v. Wade’s overturning.

“What we know about abortion bans and restrictions is that it pushes people further into their pregnancy,” Rivera told Queen City Nerve.

Abortion bans or near-bans in surrounding states like Georgia and West Virginia have led residents of those states to look elsewhere, creating longer wait times in states such as North Carolina.

“Because of all these additional barriers and wait times at clinics, people are being delayed care weeks from the time they make their decision,” Rivera said. “So we do anticipate that over the last year, people have been forced to get an abortion later in pregnancy, not because they hadn’t made up their mind, but because of these barriers.”

Data provided to Queen City Nerve by APWHC shows just how this has played out at the company’s Charlotte clinic. Through May, the clinic has seen a 74% increase in customers compared to the same time in 2022, before Roe v. Wade was overturned, thanks in large part to a more than 217% increase in out-of-state patients.

“I think we’re all really exhausted,” said Hales.

Three woman stand together, with Calla Hales on the left
Calla Hales (left) stands with other abortion activists. (Courtesy of Calla Hales)

Along with cutting back on which patients are eligible for treatment, Hales has increased staffing at her North Carolina centers.

Elsewhere in the country, Planned Parenthood has gone the opposite direction, announcing layoffs in May that began early in June.

Rivera said there have not yet been any layoffs at PPSAT thus far, however, as the team needs all hands on deck in the South especially.

“The environment is incredibly volatile,” said Rivera. “It is a challenging time to be an abortion provider, but it has always been challenging to be an abortion provider, especially in a state like North Carolina. This is not the first time we’ve seen extreme restrictions on this care. It’s certainly gotten worse than it has in maybe 50 years, but we are accustomed to providing health care in a hostile environment.

“That being said, the situation is incredibly bleak,” she continued. “The restrictions are serious, the penalties on health care providers are serious, and even more cultural experiences like protesters in front of clinics, that has only gotten worse.”

Even for patients who fall into the narrow exceptions written into Senate Bill 20 for sexual assault survivors, incest, fetal abnormalities or folks suffering from some life-threatening condition due to pregnancy, the implications of the new law could still be dire, Rivera warned.

Such patients must go to a hospital for such care rather than a provider such as Planned Parenthood or APWHC. Many rural counties do not have hospitals, or if they do, the hospitals do not provide abortion care. If they can find such care, the patient will likely be burdened with a large medical bill, whereas organizations like Planned Parenthood could have offered them financial assistance.

“If the anti-abortion movement and anti-abortion politicians continue in the way that they have done over the last year, we actually know that this is just the beginning and things will get worse,” Rivera said.

That’s why it’s been important for folks in North Carolina’s reproductive health care industry to work together in the years leading up to and following the Supreme Court ruling that overturned Roe v. Wade.

While a recent New Yorker article published in May painted a picture of independent abortion clinics around the country feuding with the larger Planned Parenthood organization, by all accounts that hasn’t been the case in North Carolina.

Hales says that, while she has had a contentious relationship with Planned Parenthood chapters in places like Georgia, where her company runs two clinics, she has enjoyed a continuing collaboration with PPSAT in North Carolina.

Because her clinic offers a specific type of abortion care as compared to Planned Parenthood’s full spectrum of reproductive health care services, the two are often trading referrals and communicating about available grants, among other things.

“It is incredibly important that all health care providers work together in this movement and in this landscape, because just in the United States, and especially in a state like North Carolina, people struggle to access basic health care, never mind reproductive health care,” Rivera said. “And so when you get to more specialized care like abortion care, the landscape is incredibly challenging.”

She pointed out that there are only 14 abortion clinics in all of North Carolina, concentrated in nine counties.

“It’s an incredibly vulnerable ecosystem and the only way to provide care to patients is by working together,” she continued, adding that PPSAT also works closely with Carolina Abortion Fund to help provide financial assistance to those who need it.

Learn more: Carolina Abortion Fund Does More Than Help Patients Pay for Procedures

“There is not one organization that can do this on our own. I think the North Carolina coalition of health care providers and advocates are really tight-knit and strong. And we’ve been working in a hostile environment together for a long time. Call it shared trauma, perhaps.”

Hales agreed.

“Some independent providers in the country do feel like Planned Parenthood is like the boogeyman out to get them out of business, that’s not a false statement,” she said. “But with [PPSAT] and North Carolina I do not feel that way. Here in Charlotte, specifically, it’s been really, really, lovely. It’s a nice little thing to say because I quite frankly have never experienced that before.”

It’s just the type of coalition building that, more than any visit from a national dignitary, can give someone who describes herself as “not a hopeful human anymore” something to hold on to.

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