Abortion Providers Stand on Unstable Ground Three Years After ‘Dobbs’

Shannon Bauerle was at A Preferred Women’s Health Center (APWHC) in southeast Charlotte on June 24, 2022 when the landmark decision to overturn the constitutional right abortion established in the 1973 Roe v. Wade case was announced.

APWHC operates as an abortion clinic six days a week, providing services to folks throughout the Southeast. Within 30 minutes of the decision, there were at least five or six news crews in front of the abortion clinic.

“I had to yell at them because they were blocking the road,” Bauerle said, adding that they were more obstructive than the anti-abortion protesters who mill around the clinic on a daily basis.

The Supreme Court’s decision to overturn the Roe v. Wade case came in a ruling for the Dobbs v. Jackson Women’s Health Organization case, drawing national attention toward the abortion clinics that the decision affected.

Within 30 days of the Dobbs decision, 43 clinics in 11 states stopped providing abortion care, according to the Guttmaker Institute, a research and policy organization fighting for reproductive rights.

By 100 days post-Dobbs, the number increased to 66 clinics across 15 states with no abortion-providing facilities operating in the 14 states enforcing total abortion bans.

Three years post-Roe, the reproductive care world is seeing more of a negative impact than right after the Dobbs decision was made, Bauerle said.

Though the Dobbs decision was the cause for national abortion bans, the aftermath of it sparked a wave of bad bills, protester aggression and funding deficits.

”It’s kind of like [the media is] coming and then getting what they need out of it and we’re still here and it’s still getting worse,” Bauerle said.

Abortion access in NC today

Currently in North Carolina, a person is able to access abortion care up to 12 weeks and 6 days of a pregnancy, whether through medication abortion or an in-office abortion, which is also known as a surgical abortion, though the procedure does not require surgery.

Before a person is able to get an abortion, they must first complete two in-person visits. The first visit is a state-mandated counseling session performed by a professional with a certain set of certifications. Then, the patient must wait at least 72 hours before they can return for the actual procedure.

“[The waiting period] has been a very large hurdle to navigate for a lot of patents and it does prevent a lot of patients from getting the access they need,” said APWHC founder Calla Hales. “But I would say that a lot of folks underestimate how willing to meet the occasion North Carolina providers are.”

Read More: Providers Prepare for 12-Week Abortion Ban To Take Effect in NC (2023)

“This is a particularly resilient group of providers in the state and [they are] really dedicated to the work,” Hales continued. “I don’t mean it just in my clinics, I mean across the state, I mean at different hospitals, different clinics … and Planned Parenthoods. There are a lot of very keen, caring providers that want to help and they want to make sure that the access is there. So I think it’s really important that people know that and not assume that they’re never going to get in.”

Hales credits these assumptions about limited abortion access in part to the continuously changing legislative landscape surrounding abortion care. She noticed that anytime an abortion ban is proposed in North Carolina or surrounding states, there is a drop in patient numbers as residents are unsure about what is and is not legal.

In October, South Carolina introduced the Equal Protection Act, or the Unborn Protection Act, which would have banned abortion with few exceptions, restrict birth control access and in vitro fertilization, and charge anyone who receives or aids in an abortion with up to 30 years in prison, equating the procedure to homicide.

Following the act’s introduction, APWHC saw a decrease in South Carolina patients in October that is only now beginning to return to normal levels.

Though the act didn’t pass committee, Hales said there is talk that it could come back into the discussion. If that occurs, not only will it impact South Carolinians but those traveling from out of state to access abortion care, those volunteering for clinics and those performing the procedures.

When one state passes — or even proposes — stricter abortion regulations, it affects all of the surrounding states, Bauerle said.

While medication abortion by mail is legal in some states, Hales said there is a real possibility that it will end, and probably much sooner than we think. That would also severely impact the reproductive care landscape.

“This whiplash of thoughts, it makes it very hard to navigate as a human, let alone as someone who is trying to still provide services that are highly politicized and are in desperate need in the South,” Hales said. “I know more about laws than I ever wanted to and, quite frankly, probably more than most people should have to know.”

What’s happened since the ‘Dobbs’ decision

Though the Dobbs decision was a play to strip the constitutional right to abortion, it did not stop them. In fact, total abortions have increased in the U.S. since the decision in 2022, with the monthly average of abortions rising each year since, according to the #WeCount project.

While quarter four of 2024 saw one in four abortions provided via telehealth, which involves mailing medication abortion pills and consulting virtually with a doctor, the majority of abortions are still provided in-person.

About a third of patients at APWHC’s Charlotte clinic are from North Carolina, another from Georgia, and the remainder from South Carolina, Texas, Alabama, Mississippi and Florida, Hales told Queen City Nerve.

Nearly one in five patients were forced to cross state lines in the first half of 2023 in order to access reproductive care, according to the Guttmaker Institute.

After the wave of clinic closures that followed Dobbs, the precautions put in place to protect the existing abortion clinics in states where abortion remains legal are shifting.

The Freedom of Access to Clinic Entrances, or FACE Act, was implemented in 1994 and made it a federal crime to use force, the threat of force or physically obstruct individuals from obtaining or providing reproductive health care services, according to the National Abortion Federation (NAF).

The act also authorizes abortion health care providers, the state attorney general and/or the federal government to bring civil lawsuits to get injunctions against these activities.

After the Trump administration took office, the new Department of Justice’s leaders issued a memorandum calling the FACE Act “a weaponization of the federal government” and law enforcement.

The memo stated that all future abortion-related FACE Act prosecutions and civil actions will only be permitted in extraordinary circumstances or in cases that involve death, serious bodily harm or serious property damage.

The cases that do not present these aggravating factors must be addressed under state or local law and no new abortion-related FACE Act actions are permitted without authorization from the assistant attorney general for the Civil Rights Division.

In July 2024, APWHC received a bomb threat from a person in Georgia. As one of the last FACE Act cases reported under the Biden administration before Trump took office in January, the case was quickly denied by Trump’s Department of Justice and sent back down to the state level.

“It went radio silent for a very long time after that, to the point where I genuinely thought that it had just disappeared,” Hales said. “North Carolina and local cops had known nothing about it. It wasn’t referred to Charlotte and it wasn’t referred to North Carolina.”

Read More: Anti-Abortion Protesters Allegedly Harass, Assault UNC Charlotte Students

Because the person who made the threat resided in Georgia, the case was redirected to the state’s local law enforcement. Within these past two months, Hales was finally informed that law enforcement was filing for an indictment.

However, the case has been completely restructured from a FACE Act violation and is now listed under making terroristic threats, which Hales has two minds about.

“I guess, in the grand scheme of things, of all of the shit we’ve dealt with over the years, it’s probably the furthest we’ve gotten in terms of charges being filed and some type of justice being found,” she said. “[But] this feels like this is entirely shifted from something that the clinic … was hoping for a resolution on to something that has been modified to exclude the clinic.”

The abortion knowledge gap

The decision to shift the responsibility of monitoring abortion clinics onto local law enforcement also serves to widen the knowledge gap between the law and those who are meant to uphold them.

Many law enforcement officers do not know what the FACE Act is and when it can be applied, Hales said. This creates a dangerous reality at a time when aggression from anti-abortion protesters is on the rise.

The NAF released its Violence & Disruption report in April, including data from 2023 and 2024. The report documented sustained and consistent harassment and violence against abortion providers, even as clinics closed following Dobbs and abortion became harder to access in banned states.

Read More: Reproductive Rights Coalition Wants to Answer Your Questions on Abortion

Harassing behavior included obstruction, trespassing and picketing while violent actions included threats of death and harm, arson, assault and battery, bomb threats, stalking, and more.

Obstruction, trespassing and picketing are everyday occurrences for AWPHC staff and volunteers.

“We’re one of, if not the busiest clinic in the Southeast,” Bauerle said, “as well as the most protested.”

Most abortion clinics deal with somewhere between five and 20 protesters, Hales said. APWHC regularly sees about 150 on its slowest Saturdays.

After the majority Democratic wins in recent local elections, the protesting numbers increased. Anti-abortion organization Love Life recently held its last parade of its annual 40-week campaign of “prayer walks” that aims to “result in an end to abortion and the orphan crisis,” according to its website.

Around 700 anti-abortion marchers gathered in front of the clinic before walking around the block on Latrobe Drive in east Charlotte. It was the largest march Hales has seen in years, she said.

“[We] hadn’t had numbers that high in a while, and police were not fucking prepared, and there’s a lot more aggression,” he said.

People were stopping cars in the clinic’s driveway and letting their children walk in front of the driveway to impede cars.

“It had been a while since I had seen bullshit like that,” Hales said.

Read More: A Movement Grows Outside of East Charlotte Abortion Clinic

Bauerle, the clinic’s executive director, said the protesters have become more emboldened, even resorting to physical violence. One protester has been convicted of assault on a clinic volunteer while another court case is pending in an assault on a different volunteer, she explained.

When Queen City Nerve visited the clinic in November, Bauerle pointed out the additional cameras staff had added to monitor the protesters’ behavior following the two assaults. Each volunteer also wears a camera around their neck and carries walkie talkies during each shift, a new precaution that resulted from the assaults.

Flip Benham, a local pastor who spent years protesting in front of AWPHC, was charged with assault against a clinic volunteer in January. He has not returned since, though he does protest in front of the Planned Parenthood on Torrence Street in Midtown, Hales said.

While trespassing laws and sound ordinances should be cut-and-dry surrounding a private property like the clinic, CMPD maintains that abortion protesters have a right to enter the property until the clinic officially bans them and files the ban with CMPD.

Hales said this creates a cat-and-mouse dynamic in which the clinic calls the cops to have someone banned but the trespasser runs off before they can properly file.

“It becomes a sick game, so you give up,” she said. “It’s so energy- and time-consuming.”

Read More: Opinion: Anti-Abortion Protesters Are Not Counselers and Not Essential

It becomes more complicated when the law enforcement officers that respond to a clinic call do not keep a list of those who have been banned from the property. Staff then has to depend on other officers to have filed the bans correctly, which became a problem earlier this year when CMPD’s system wiped each banned name prior to 2021.

Hales still doesn’t know if the full list of banned individuals has been recovered. She highlights the need for cultural literacy around reproductive rights and laws.

“Every officer does not walk around knowing every law they’re supposed to be upholding,” Hales said. “They have a general rule of thumb, but with that general rule of thumb you are also being influenced by your personal biases, and that really makes a difference.”

Moving forward with abortion care in NC

An influx of fundraising for abortion clinics followed the Dobbs decision, but that enthusiasm has died off, Hales said.

Advocates have gotten some good news. On Dec. 2, US District Judge Indira Talwani blocked a provision barring Medicaid funding for Planned Parenthood and other nonprofit reproductive care providers in 22 states that sued the government in July.

While Planned Parenthood performs around 30 abortions per week, it also offers HIV services, STD testing, gender-affirming care and other wellness and preventative services. Talwani ruled that federal Medicaid funding will continue to go to Planned Parenthood clinics in the states involved in the lawsuit while the case progresses.

As an independent clinic, AWPHC wasn’t affected by the federal funding cuts included in President Trump’s so-called Big, Beautiful Bill Act. Instead, the company is seeing the funding impact in the amount of patients that can get to them.

At one point, AWPHC was able to obtain an Abortion Fund Grant, which allowed it to provide free care for patients coming to North Carolina from a banned state for abortion care. The grant only lasted 14 months, however, and Hales said the clinic burned through every bit of it.

Following that grant’s expiration, the clinic saw a drop off in patient numbers because they could no longer afford to get there.

“It is sometimes a truly unbearable weight to try to figure out how to stay open, how to abide by all the laws as they change so rapidly, how to help patients navigate all of the … continually heightening burdens that they’re having to face and jump through,” Hales said.

Money, support and correct information is needed more so than ever, Bauerle said. The Carolina Abortion Fund, a part of the National Network of Abortion Funds, works with clinics in the Carolinas to provide grants and help patients pay for their procedures.

APWHC’s monetary donations don’t just go toward abortion procedures but practical support, Bauerle said, including travel expenses, food and child care and Plan B contraception, which the clinic distributes across the Southeast.

Read More: Charlotteans React as 12-Week Abortion Ban Moves Through General Assembly

“After Dobbs… we amped up very hard, very fast, and I will forever be proud of what we were able to do to meet the need and really get accomplished at that time,” she added. “But there is a real reality that when you have burned full force 24/7 for going on six years now … burnout is real and I think that’s a lot of reasons why much is … sliding through the cracks right now is because people really don’t have the capacity to fight one more thing.”

Despite the setbacks, Hales stays optimistic by focusing on one thought through it all: “How lucky am I that so many people say every day, they want to do something that makes a difference, and they want to help people, and I actually really get to do that. That’s really fucking cool.”