OThe Supreme Court made an announcement that its decision was overturned at 9:30 AM. Roe v. WadeThere were 21 people waiting in our lobby for an abortion. They cried when we forced them to leave. As they realized that the same medical procedure was not available, they cried. But the reality was that each of those people represented a potential felony for my staff—and up to 99 years in prison. In fact, the decision was taken within hours. Dobbs v. Jackson Women’s Health Organization,The injunction against a 2019 law was removed and abortion has been made illegal in nearly all cases in Alabama.
Before the ruling, 95% of the patients we saw at West Alabama Women’s Center in Tuscaloosa were terminating pregnancies. We were treating patients from Texas, Louisiana and Mississippi on a daily basis. Some even traveled as far as 600 miles to receive our treatment, as there weren’t any closer appointments. In an attempt to satisfy the overflowing patient population, we gave medical abortions to 67 patients the day before. These services were now illegal, even though they would be more needed.
Tina Collins (office manager) and Gail Latham (administrative assistant), at the clinic July 11. The photograph was partially obscured in order to preserve privacy.
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The clinic’s relaunch is noted on a calendar located in the office.
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Ramona Wallace is a medical assistant. She embraces Gail Latham. July 11, 2011.
Lucy Garrett for TIME
Within days we were warned by legal advisers that assisting the more than 100 patients who had completed “first day” appointments—an ultrasound, counseling, and a state-mandated information packet that must be provided 48 hours before a patient can return to a clinic for an abortion—may be seen as “conspiracy” under the new law. But we couldn’t abandon our patients. They were given the contact information for a nearby clinic and financial assistance to enable them to make that trip. To leave them with no idea of where to go next or how to get there wasn’t just morally wrong, it was medically wrong too.
First, do no harm.
At the same time that we were finishing assisting our now former patients, we fielded phone calls from other people who didn’t believe the ban was actually in place, or who hoped their case could be an exception. Fearing legal reprisals we decided not to inform them about open clinics and financial aid. We couldn’t tell who really needed the help. Or who were abortion opponents trying to get us to break a vague, new law. Patients who came to our doors without a cancellation notice or patients that were just desperate to try it, we turned them away. Being pregnant is a difficult thing.
Nurse Francia Webb
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Dr. Leah Torres, director of patient care and programs at West Alabama Women’s Center
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On July 22, Dr. Leah Torres set up an ultrasound machine to treat an inpatient.
Lucy Garrett for TIME
These are the first posts-Roe days, our voices echoed through the building’s two lobbies, chairs empty for the first time since our patient numbers began swelling at the beginning of 2022, when the Louisiana abortion seekers started showing up regularly, and then the Texans followed soon after. Our patients were seeing up to 30 people a day and five days per week without any rest. We knew that we had nothing to offer and were exhausted. There was no medical attention. No financial support. Even basic public information is not available.
There are many abortion providersSince the closing of the U.S. Embassy, many businesses have been closed. Dobbs decision. Others are moving to more liberal states to support patients who seek abortion care. In New Mexico, the executive director and owner of the clinic that was in the middle of the Supreme Court Case in Mississippi has sold the property. The owners are facing opposition from abortion advocates, while an anti-abortion organisation has purchased the next-door space. This proves that certain battles will never be lost. Whole Woman’s Health, the provider involved in the Supreme Court case that reaffirmed RoeIt announced in 2016 that its entire Texas chain of clinics would be closing. While it, too, will open a new center in New Mexico, the hole it’ll leave behind will be impossible to fill. It will be the only North Dakota abortion center that moves a short distance across the Mississippi to Minnesota. Although the physical distance between North Dakota and Minnesota is not too far for anyone to walk, it is still quite significant in terms of political impacts from another state that does not have a provider. Reproductive Health Services of Montgomery was the oldest-standing provider of abortion in Alabama. It had been there for 43 years, but it finally closed its doors.
Tina Collins gave ella to Tina Collins on July 22.
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Leah Torres, Dr. meets with the patient who received an IUD July 21.
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Medical assistant Jessica McKinstry ties balloons outside the clinic for the emergency-contraception fair on July 22.
Lucy Garrett for TIME
Five days after the decision, West Alabama Women’s Center, too, stopped seeing patients, but only temporarily and with no intention of leaving. We opened as a new entity on July 11th, just 12 days after we had received our last patient referral. West Alabama Women’s Center—the for-profit abortion provider established in 1993—was gone. But what came back was West Alabama Women’s Center, a new full-spectrum reproductive-health center dedicated to meeting the needs of the uninsured, underinsured, and Medicaid patients neglected in our region. We are also now a nonprofit, a move that had been in the works for months, because we believe no one should ever be making money off someone else’s health needs.
Alabama already faces a crisis in health care. It has the highest maternal and infant mortality rates, as well as the lowest life expectancy. The ban on abortion won’t improve any one of these figures and in fact will make things worse. But we can, and that’s why we are still here.
Jessica McKinstry is a medical assistant
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Alesia Horton is the clinic director
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Because the truth is, we can’t go away. Although we are unable to provide elective abortions we still need to help the new mom to be who brought her for prenatal care. Her Medicaid approval meant that no doctor would accept her as a patient until she was approved by Medicaid. We need to be here for the terrified woman in her 50s who showed up for an IUD, even though she was near menopause, because she knew a pregnancy at her age would potentially kill her and we have no clear rules on how “in danger” someone’s life has to be before an abortion is legally allowed. We need to be here for the patient with the ectopic pregnancy who went to the local hospital only to find out they didn’t have methotrexate in stock to terminate that unviable pregnancy. We need to be here for every patient we have seen miscarrying who was turned away by their hospitals even before abortion was illegal here, even before an accusation of “illegal abortion” meant the end of a medical professional’s career at best or a life in prison at worst.
Our doors will remain open.We will remain open as long as it is financially possible. Our biggest job now is to make sure that our community knows we are here—that we can be a resource for them to turn to when they don’t have a private doctor, when they don’t want to go to a hospital, and that we can offer them the preventative services that will save them from so many long-term health issues down the road. We’ve made brochures; reached out to all of our local media—we’ve even hosted a pay-what-you-can emergency-contraception fair—all hoping to get to the people who will need us the most.
It is clear that it will take us three more months before we can be sustainable. We also know that we had seven patients total in our first week—all of whom received health care for whatever they could pay out of pocket. We have little chance of survival.
Left to right: Alesia Hutton, Francia Webb and Gail Latham, as well as administrative assistant Kyandria Benjamin on July 21.
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Clinic visit by Buttons
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Robin Marty looks out the window to see if their promotion of the emergency-contraception fair brought out any protesters on July 22.
Lucy Garrett for TIME
Even if we have to close the doors once again, it will be knowing that we gave as much as possible for as many people for as long time as was practical, and we are proud of this. It is a decision we make knowing that those doors won’t be open again, regardless of the ongoing need within the community.
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