By Aria Bendix - NBC News
Steps taken by North Carolina and South Carolina to impose new restrictions on abortion are increasingly limiting the options for residents in the South to terminate their pregnancies.
On July 1, the ban on abortion after week 12 will take effect in North Carolina, after the state Assembly led by the Republican Party overrode last Tuesday the veto that had imposed on the legislation by Democratic Governor Roy Cooper.
Abortion rights supporters demonstrate outside the North Carolina Legislative Building in Raleigh, May 13, 2023.Hannah Schoenbaum/AP file
That same day, the South Carolina House of Representatives passed a bill to ban abortion beyond week six, which is now in the hands of the state Senate.
The moves come a month after Florida Gov. Ron DeSantis, a Republican, signed into law a bill banning most abortions after six weeks gestation. The law will take effect if the state Supreme Court maintains its current 15-week limit, in an ongoing legal challenge.
We're going to see a lot of people forced to continue pregnancies against their will," said Amy Hagstrom Miller, founder and CEO of Whole Woman's Health, which operates two abortion clinics in Virginia, and has others in Indiana, Maryland, Minnesota and New Mexico.
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Miller said she is preparing for a possible increase in the number of women who will travel to Virginia for abortions in the coming months, because the state will surely soon become the last in the South without restrictions on terminating pregnancies.
North Carolina's ban provides exceptions for rape, incest and fetal anomalies that limit viability. Proponents of the law argue that it offers a compromise on abortion.
"The elements of this bill are not obstacles to abortion. They are safeguards. We seek a balance between protecting unborn babies and safely caring for mothers," North Carolina House Speaker Sarah Stevens, R-R., said Tuesday.
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Even before North Carolina's 12-week ban was passed, Miller said his Virginia clinics were taking in patients from all over the South. Since January, its call center has received more than 6,000 calls from out-of-state people seeking care in Virginia, he said.
Not all of those people make it to her clinics: Miller, every day a patient cancels an appointment, often after multiple attempts to reschedule it, due to factors that prevent her from traveling, such as a child's illness or inability to make the trip.
"They tell us, 'It's going to be easier for me to have a baby. I don't know how to get there,'" he said.
The time it takes to make an appointment and arrange travel also forces some patients to delay the procedure until the second trimester. On average, women find out they are pregnant at weeks five or six of gestation. In many cases, that will mean a surgical abortion, since abortion pills are only authorized until week 10.
The ban in North Carolina could exacerbate these problems, Miller warned.
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It's going to have devastating effects throughout the South."
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Amber Gavin, vice president of advocacy and operations for A Woman's Choice, which operates three abortion clinics in North Carolina, said her centers have begun recording wait times of about 10 days. "It adds more administrative tasks than necessary for our doctors and health personnel," he said.
Her North Carolina clinics, she said, frequently serve women from Alabama, Florida, Georgia, Louisiana, Mississippi, South Carolina and Texas. On July 1, clinics will begin referring pregnant women older than 12 weeks to clinics in Virginia, Maryland, Illinois and Washington, D.C., she said. "It's going to have devastating effects throughout the south," Gavin said.
One option women will still be able to turn to is The Brigid Alliance, a service that provides travel, food, lodging, childcare and other logistical support to those seeking abortions across the United States.
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Clinics and providers can refer to this service, which receives funding from private donors. The average patient prototype travels more than 1,300 miles round trip, and has travel expenses of nearly $1,400.
"Many of our customers haven't even left their county," says Serra Sippel, interim executive director of the alliance. "Many have never been on a plane."
In the longer term, medical experts and political leaders also fear an exodus of specialists from states that ban abortion, which could limit access to both abortions and maternal health care in general in the South.
"North Carolina's ban will harm patients and threaten physicians for providing essential care," White House spokeswoman Karine Jean-Pierre said in a statement Tuesday.
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Dr. Catherine Kuhn, associate dean of graduate medical education at Duke University School of Medicine in North Carolina, said residents who are training in obstetrics, gynecology or family medicine will likely have to travel to other states to learn how to perform abortions after 12 weeks.
North Carolina could also struggle to attract new medical talent if the state is seen as hostile to reproductive health care, Kuhn added. A survey of medical students released this week found nearly 60% said they were unlikely or very unlikely to apply for a single residency program in a state with abortion restrictions.
"I'm concerned that, particularly in the area of women's health and reproductive health, requests and interest are declining," Kuhn said.