In the South, abortion access is a shifting landscape. Roe v. Wade was overturned this week last year, freeing up states to limit or ban the procedure.
In Tennessee, a narrow exemption to the state’s current criminal abortion ban went into effect in the spring. Previously, the law required doctors to prove why an abortion was medically necessary in court.
The law now allows doctors to use their “reasonable medical judgment” to determine whether an abortion is needed to save a mother’s life or prevent a major injury. It also allows doctors to perform abortion services for ectopic pregnancies and miscarriages. There is still no exception for fetal anomalies or victims of rape and incest.
Corrine Rovetti was co-director and a nurse practitioner at Knoxville Center for Reproductive Health, which provided medication abortions and abortion procedures — as well as gynecological and family planning services — before its closure in 2022. She said the law is still too restrictive.
“We're hearing story after story from OBGYNs about women having to actually sit in parking lots in emergency rooms before coming in for care or being told to go back outside and sit in the parking lot,” Rovetti said. “Because even though they're bleeding heavily, and there's a threat for their life, it's not serious enough. And so, they sit outside until their condition worsens. And then they're readmitted so that they can be seen.”
The newly amended law also requires the Tennessee Health Department to report quarterly on any abortions performed in the state to the governor and other state officials.
Since the Tennessee abortion ban took effect last August, patients are seeking care in states where access is still available.
North Carolina has become a safe haven for those seeking abortion care.
However, in North Carolina, abortion restriction laws will move from a ban on abortions after 20 weeks — with some exceptions — to a ban on abortions after 12 weeks (with some exceptions) on July 1.
There are currently 14 abortion clinics located in 9 different counties in the state. In the state’s 18 westernmost counties — home to about a million people — there is only one clinic located in Asheville.
Dr. Julia Oat-Judge is a family practice doctor at Planned Parenthood in Asheville. She says the office had to quadruple the number of appointments for abortion care at their location to deal with demand from other states.
“It's been a huge surprise to suddenly be taking care of patients from Alabama, for example, places that are an incredibly long drive,” she said.
Oat-Judge worries about access under the latest law.
“It’s really scary to contemplate the changes that are coming July 1 because they are really going to impact the health of patients in western North Carolina and the surrounding area,” she said.
The new abortion restrictions allow exceptions including sexual assault and medical emergencies, but patients are required to attend an in-person visit more than 72 hours before their appointment at a hospital.
Virginia will soon take on an emerging migration of people seeking access to abortion in the south, but Oat-Judge said Illinois, D.C., Maryland might be easier to get to for some.
At Whole Woman’s Health in Charlottesville, birds sing outside the window of the recovery room where patients who have just had an abortion can lounge in a recliner and drink tea.
Avantae Logan, a former patient, has worked at the clinic for just over a year.
“We had a patient drive at 3 a.m. to 10 a.m. just to get to their appointment,” she said. “It breaks my heart.”
She says people coming from out of state are often exhausted and full of questions.
“They are stressed about what happens if something goes wrong,” Logan said. “And the biggest question, the biggest concern is: ‘Will I get caught?’”
Logan assures them that most procedures are uneventful, and that the abortions they’re receiving are legal. In fact, Virginia’s abortion laws have gotten more permissive in recent years.
“It wasn’t that long ago that people had to come twice in Virginia,” said Amy Hagstrom Miller, President of Whole Woman’s Health Alliance. “There was a two-visit requirement, a 24-hour waiting period, a what we call ‘forced ultrasound,’ where everybody had to have an ultrasound at least 24 hours before they had the procedure, and we just knocked those restrictions down in 2020.”
In 2021, Virginia joined more than 20 other states that allow patients to access abortion medication through telehealth visits.
“What you’re seeing here is some best practices, which was hard fought, and I think is one of the reasons why Virginia is a real bright light in this part of the country,” Miller said.
Democrats have a slim majority in the Virginia Senate and Republicans control the House — a balance that, so far, has warded off any significant changes to the state’s abortion laws.
But this November’s elections could unsettle that balance. All 140 state legislative seats are up for election this year.
Editor's note: This report featured a collaboration with fellow public media stations WUOT in Knoxville and Blue Ridge Public Radio in Asheville.