Can the Supreme Court save the South's last abortion clinics?

Yamani Hernandez, executive director of the National Network of Abortion Funds, along with  staff and volunteers from 11 abortion funds.

The United States Supreme Court will soon determine whether a Texas law known as H.B. 2 creates an undue burden for people seeking abortion care. The case, Whole Women's Health v. Hellerstedt, has implications nationwide, but will have the most impact in the South, where nine states combined have only three later-term abortion clinics.

The omnibus House Bill 2 passed by Texas conservatives in 2013 enacted a number of restrictions, including a 20-week abortion ban, limitations on medication abortion, and new requirements that have effectively shuttered numerous abortion clinics. Those requirements, which opponents call targeted regulation of abortion providers, or TRAP provisions, mandate that abortion clinics meet the same standards as ambulatory surgical centers, and that physicians obtain admitting privileges at a neighboring hospital. Unable to make the expensive changes needed to meet these requirements, many clinics have shut down.

Whole Women's Health challenges the TRAP provisions; this means the court will not be weighing in on the 20-week ban or the new restrictions to obtaining medication abortion.

While most of these states have the majority and super-majority representation to pass anti-choice bills with ease—it’s the constitutionality of these bills, which is what the Supreme Court will decide, that has advocates on both sides of the debate staying up at night.

In 2012, the Georgia legislature banned abortions after 20 weeks, but the law has been temporarily blocked after a judge argued its constitutional validity. Similarly, South Carolina is now on the verge of prohibiting abortions after 19 weeks of pregnancy. Therefore, the fate of that law and others rests on the precedent set by the Court.

So for those in the South, H.B. 2 and similar laws already shape the abortion access landscape. H.B. 2 and other legislative attacks on abortion access disproportionately affect people living in rural areas and low-income communities, where there is already a shortage of accessible abortion care.

Advocates for abortion access from across the South rallied in front of the Supreme Court on March 2, when justices heard oral arguments in the case. Oriaku Njoku was one of the hundreds of pro-choice activists present.

Njoku is the Executive Director of Access Reproductive Care - Southeast (ARC-SE), an organization that helps people pay for their abortion care.

“Similar legislation [to H.B. 2 in other states] would definitely do Georgians and Southerners a disservice by creating an unsafe environment for individuals accessing reproductive care,” Njoku said.

“Clinics in Georgia are already dealing with barriers to access in other states,” said Njoku. According to Njoku, Atlanta clinics, which face fewer restrictions than other areas, have become the epicenter for late-term abortion care in the Southeast. Just three clinics take on heavy patient loads daily to accommodate the influx of patients traveling from out of state, she said.

A 2015 study by the University of California San Francisco supports Njoku’s statements. They found that not only were people traveling from across the South, the Midwest and the Northwest for care—but that over half of patients who received later-term care in Atlanta traveled from out-of-state.

Jessica Seales of Magnolia Fund, another Georgia-based group that offers financial, transportation, and lodging support, said her fund has experienced that first-hand.

Seales, who serves as a board member and the Practical Support and Intake Manager, said Magnolia had an uptick in logistical support needs within the last year. Clients are traveling further distances to Atlanta. Call volume has tripled.

Seales recounted one particularly difficult weekend for one of her clients.

“A younger woman and her mother were originally scheduled to go to a clinic in North Carolina, but the clinic canceled. So, they prepared to travel to [an abortion clinic in Atlanta] and Magnolia provided a Greyhound bus ticket. Greyhound canceled. We rescheduled, but you can see how the costs can continue to go up.” The cost of abortion also increases depending on the length of pregnancy.

So, what would a Supreme Court win mean for abortion funds and patients?

Advocates can’t expect that a ruling that will protect abortion access in the South, especially with the slew of TRAP laws introduced in recent years. However, with the threat of sweeping clinic closures taken off of the table, abortion activists will have the opportunity to focus their attention on other laws that restrict access.

Amanda Williams, Executive Director of Texas’ Lillith Fund, is not only hopeful about the hearings, but is already visioning what advocates in the South can do afterward.

“We need to end restrictions on abortion altogether and instead pass laws that promote full-spectrum, comprehensive reproductive healthcare for all people, to include abortion care," she said. "If we really want to systematically improve our clients' ability to obtain safe abortion care and other important resources, we need to be taking action whenever we can, at all levels.”

Abortion funds across the South are helping to fill the gaps in abortion access through advocacy, direct funding, and practical support. Most funds are led by volunteers and raising large swells of money in hostile states is far from easy—but they get that much closer to paying with community support. Donate to the above funds on the front lines of this attack on abortion access. Check out the National Network of Abortion Funds’ website to find a fund near you and offer support as a clinic escort, fundraiser, or helpline volunteer. Fund abortion. Build power.

The authors work for the National Network of Abortion Funds.