World

One Year, 61 Clinics: How Dobbs Changed the Abortion Landscape

Dozens of clinics have closed or halted abortions since the Supreme Court’s decision to overturn Roe v. Wade.

We set out to see what happened to them and the surrounding communities.

In the year since Roe fell, 20 states enacted laws banning or restricting abortion, forcing a rapid shift in the country’s patchwork of abortion access. Clinic owners scrambled to adjust, canceling appointments and helping patients travel elsewhere.

Some clinics relocated, while others stayed open to provide the services they still could. Many simply closed, leaving behind empty buildings.

In Milwaukee, this former clinic is for sale for $1 million. The real estate agent says he’s had a hard time finding buyers.

Elsewhere, patients still show up, knocking on closed doors. CeeJ, 20, who asked to be identified only by her first name, recently stopped by a shuttered Montgomery, Ala., clinic because she could not afford $50 for emergency contraception at Walmart.

Protesters come by, too. The same people who used to picket a Bristol, Tenn., abortion provider now stand outside a new clinic, less than a mile away in Bristol, Va.

At least 61 clinics, Planned Parenthood facilities and doctors’ offices stopped offering abortions in the last year.

Most were in the 14 states that banned abortion outright. But the uncertainty surrounding laws in several other states also caused providers there to shut down.

Physicians said the laws in some states were unclear. Others pointed to the possibility of criminal penalties, including prison time, making the prospect of offering abortion services risky.

About half of the clinics have shifted their focus to other services, such as birth control and prenatal care. Some see patients who have gotten abortions elsewhere for follow-ups. At least a dozen providers moved and opened new clinics in friendlier states.

A handful of the buildings, including the clinic at the center of Dobbs v. Jackson Women’s Health Organization, the case that overturned Roe, were sold and turned into something else.

Many clinic owners said they couldn’t afford to stay open without providing abortions. Instead, they decided to move.

A grid of photos of abortion clinics in nine locations. Labels indicate that four of the clinics have closed – in Dallas; Savannah, Georgia; and Fort Worth. Five of the clinics are no longer providing abortions – in Birmingham, Alabama; Charleston, West Virginia; Milwaukee; San Antonio; and Fort Worth.

Most of the movers were independent clinics, which typically have performed more than half of the country’s abortions. They usually offer financial assistance, don’t require insurance and won’t turn away patients who can’t afford the cost of the procedure — about $500 in the first trimester and $2,000 or more in the second trimester.

This clinic in Shreveport, La., closed and moved to western Florida. The director, Kathaleen Pittman, plans to open there once her license is approved, despite the state’s recent passage of a six-week abortion ban.

“It was a calculated move on our part to help as many people as possible, particularly those from Louisiana,” Ms. Pittman said.

Anti-abortion advocates said they had celebrated clinic closures in their communities, but some said that their work was far from over.

A grid of photos of abortion clinics in nine locations. Labels indicate that five of the clinics have closed – in Baton Rouge, Louisiana; New Orleans; Mt. Juliet, Tennessee; San Antonio; and Houston. Four of the clinics are no longer providing abortions – in Indianapolis; St. Louis; Oklahoma City; and Twin Falls, Idaho.

“I was hoping they’d tear it down,” Doug Lane, 71, a pastor and longtime protester, said of the clinic in Jackson. “It’s still a reminder of what they did there.”

In Huntsville, Ala., community members still gather every Thursday morning outside the Alabama Women’s Center to pray. The center hasn’t performed an abortion since last June.

“We will come until the building is torn down or someone buys it,” said Josefina Montoya, 30. “We are trying to end abortion everywhere.”

Rather than reduce abortions, the bans enacted since Roe was struck down appear largely to have pushed patients across state lines or to find pills online. Illinois, Florida and North Carolina have reported thousands more abortions compared with the months before the Supreme Court ruling.

Nationally, average monthly abortions fell by about 3 percent in the nine months after the ruling.

Even though they can no longer perform abortions, many providers have stayed put, continuing to offer other services.

A grid of photos of abortion clinics in nine locations. Labels indicate that two of the clinics have closed – in Houston; and McKinney, Texas. Seven of the clinics are no longer providing abortions – in Flagstaff, Arizona; Little Rock, Arkansas; Austin, Texas; El Paso; Houston; Waco, Texas; and West Bend, Wisconsin.

Most providers that have remained open are Planned Parenthood health centers, which have the backing of the national organization and already offered a range of other services.

Others, like Dr. Darin Weyhrich, an OB-GYN in Boise, Idaho, who had performed abortions at his private practice since 2002, have also stayed open. Dr. Weyhrich now keeps his stock of abortion pills locked in a filing cabinet.

“It’s really hard to feel that you’re not able to provide optimal care and all the services you were trained to do,” he said.

In many communities, clinics had offered the only free or low-cost access to reproductive health care. It’s one reason why some are trying to keep their doors open.

Across states with abortion bans, legislators and health care providers are preparing for more pregnancies and births.

A grid of photos of abortion clinics in nine locations. Labels indicate that three of the clinics have closed – in Little Rock, Arkansas; Tulsa, Oklahoma; and Houston. Six of the clinics are no longer providing abortions – in Meridian, Idaho; Louisville, Kentucky; Oklahoma City; Memphis; Nashville; and Houston.

Dr. Yashica Robinson and Dalton Johnson want to transform their former abortion clinic in Huntsville into one of Alabama’s first birth centers, for patients who want to deliver outside of a hospital. They are waiting for regulators to finalize licensing requirements.

They stopped performing abortions last year but continue to run two OB-GYN offices. They have seen deliveries rise 30 percent this year.

Many of their patients have little or no insurance and face high-risk pregnancies. “They can’t travel to a state to exercise other options,” Dr. Robinson said. “Instead, they start their prenatal care reluctantly.”

Some states that restricted abortion have at the same time promised to help pregnant women and new parents.

In Texas, clinics started closing even before Roe was overturned, after the state passed a restrictive six-week ban in 2021. The state has since extended Medicaid coverage to one year after birth, and gave $100 million to “alternatives to abortion” like crisis pregnancy centers, which are largely operated by faith-based groups without medical training.

Many clinics had been in their communities for decades. For their supporters, the loss is greater than a building.

A grid of photos of abortion clinics in nine locations. Labels indicate that three of the clinics have closed – in Austin, Texas; and Houston. Six of the clinics are no longer providing abortions – in Tulsa, Oklahoma; Sioux Falls, South Dakota; Memphis; Austin, Texas; San Antonio; and Madison, Wisconsin.

Bekki Vaden, 38, was a surgical assistant at a shuttered Knoxville, Tenn., clinic that had been open since 1975. She took the job after having two abortions there. “They were so good to me when I was so alone,” she said.

She now works as a truck driver and spends some of her long hours on the road crying in grief and anger, thinking about the patients she can no longer help.

“I’ve realized how quickly something can get pulled out from underneath you,” Ms. Vaden said.

In at least one case, the people who took over a former clinic said they were trying to honor the building’s history.

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