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'A greater sense of urgency': 12-week abortion ban inhibits, exhausts healthcare providers


Since the implementation of Senate Bill 20, Dr. Robin Wallace has to travel to Virginia to provide abortion care for patients who are more than 12 weeks pregnant.

One of the first patients she saw after the implementation of the bill was someone who lives less than 20 minutes away from her in the Triangle. She said they both made the two and a half hour drive to Virginia in order for the patient to receive care. 

S.B. 20, which went into effect on July 1, bans most abortions in North Carolina after 12 weeks of pregnancy and requires patients to attend an in-person appointment at least 72 hours before receiving an abortion.

According to the Guttmacher Institute, the number of abortions in the state decreased 31 percent between June and July this year.

Wallace said that since S.B. 20 has been in effect, she sees more patients coming in to receive abortion care earlier in pregnancy. 

“My personal take on that is there is a greater sense of urgency than ever before because there is this very sobering check on what we have access to legally,” she said. 

Calla Hales is the executive director of A Preferred Women’s Health Center, an abortion clinic with locations in Charlotte and Raleigh. She said her clinics have had to increase capacity and staff as well as make changes to the practical flow of clinic procedures.

Before July 1, counseling was required for abortion patients at least 72 hours before their procedure, but that counseling could be done over the phone, Hales said.

Now, individuals seeking abortion care must visit the clinic for an in-person consultation and return another day for their abortion procedure. The law also requires that medical professionals perform an ultrasound at least four hours before an abortion is performed. 

Hales said the in-person consultation has created a strain on staff because it doubles the amount of appointments and reduces the number of patients.

“You wonder if the intent was to not only decrease the amount of procedures but also to burn out providers to the limit of no return,” she said. 

Molly Rivera, the communications director for Planned Parenthood South Atlantic, said that though Planned Parenthood staff is familiar with attacks on the services they provide, it can be difficult to stay resilient. 

Rivera said Planned Parenthood South Atlantic clinic staff have been working hard to help patients understand the additional in-person appointments and increased paperwork. The organization's teams of “patient navigators,” who work with patients one-on-one, were added in preparation of the overturning of Roe v. Wade, and have been expanded over the last year, she said.

She said people are more familiar with the 12-week ban than the new appointment requirements.

“We hear from a lot of frustrated and, frankly, angry patients that have to dramatically reconfigure their life in order to make these appointments and make them on time before the 12-week cut off,” she said. 

Rivera also said some patients have said the in-person counseling requirement is too significant a barrier and that they may choose to travel out of state to avoid having to go multiple times in person. 

Some clinics in North Carolina are attempting to accommodate patients from other states, which means longer wait times for patients who want to receive abortion care before 12 weeks of pregnancy, Hales said. She said this is not only a burden on patients but also providers. 

“It's really like trial by fire. It's very much hit or miss. It's very much fake it 'til you make it and figure out the best way possible,” she said. 

She added that now, at the end of the year, her clinics have been able to find good rhythms and a solid workflow after the state's policy changes. 

Wallace said reproductive healthcare’s restrictive environment is a stark contrast to other areas of medicine. She said a large part of the national community has begun to understand that abortion is necessary healthcare and she remains hopeful. 

“There's so much work to be done, and we really need not just the entire medical community, but folks across the state to really stand up and advocate for that, because we have a long road ahead of us to regain these losses,” she said. 

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Lucy Marques

Lucy Marques is a 2023-24 assistant city & state editor at The Daily Tar Heel. She was previously a city & state senior writer. Lucy is a junior pursuing a double major in political science and Hispanic literatures and cultures.

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