Tag: Whole Woman’s Health

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Abortion access in Virginia two years post-Dobbs

Whole Woman’s Health President and CEO Amy Hagstrom Miller says the number of Florida-based patients seen at the Alexandria WWH clinic has increased by 600 percent since the Supreme Court decision that overturned Roe v. Wade. Photo by Amy and Jackson Smith.

Two years after the Dobbs decision that overturned Roe v. Wade, abortion in Virginia remains protected up to 26 weeks and six days into pregnancy (with some exceptions for maternal health). In Charlottesville, organizations are working to uphold and expand existing protections around reproductive healthcare in the commonwealth and across the country.

Despite stringent restrictions in bordering states—including near-total abortion bans in Kentucky, Tennessee, and West Virginia—patients in Charlottesville can obtain an abortion through clinics like Whole Woman’s Health and Planned Parenthood. 

For the last two years, Whole Woman’s Health Alliance, the nonprofit arm of WWH, has been working to protect abortion access post-Dobbs both in the states it directly operates in and nationwide. The organization introduced litigation in Charlottesville last year to protect access to mifepristone, a drug commonly used for medication abortion in the United States since 2000.

The WWHA suit against the FDA is ongoing, but the Supreme Court affirmed on June 13 that access to mifepristone would remain unchanged. Recent rulings, including the mifepristone case and the June 27 SCOTUS decision to reinstate a lower court ruling allowing doctors to provide emergency abortion care, are good signs for the pro-choice movement, but they don’t protect against future efforts to restrict abortion access.

“We were encouraged by the Supreme Court’s two rulings in this session, although I think they had the opportunity to rule even stronger than they did,” says Amy Hagstrom Miller, President and CEO of WWH and WWHA. “I think we’re going to see more restrictions to come.”

Post-Dobbs, WWH has seen a surge in the number of out-of-state patients at Virginia clinics, a trend which has only accelerated in the last year. Virginia is the last remaining state in the South to not pass heavily restrictive abortion laws, making it a key sanctuary for people in neighboring states.

As of May 2024, about 30 percent of patients seen at WWH clinics in Virginia are from outside the commonwealth.

Since a six-week abortion ban went into effect in Florida on May 1, Hagstrom Miller says the number of patients seen from the Sunshine State at the Alexandria clinic has increased by 600 percent. While the total number of actual patients is relatively small, approximately 60, the dramatic trend demonstrates the cascading effects abortion bans in other states have on local reproductive care.

“Florida was serving as a destination for people from Alabama, Louisiana, Mississippi, Texas, [and] other places that had banned abortion,” says Hagstrom Miller. “It’s a pretty deep challenge for the care infrastructure to lose a place like Florida.”

To support the growing number of out-of-state patients traveling to Virginia for abortion care, WWH is opening a new clinic in Petersburg this July. With the opening of the new clinic—chosen for its convenient location along I-95—WWH will operate three clinics in Virginia.

Beyond brick and mortar clinics, WWH is also providing abortion care in the commonwealth through telemedicine and the mail.

“We are very committed to never having longer than a week wait for an appointment, and we’ve been able to uphold that even as people are traveling in from other places,” says Hagstrom Miller. “Abortion is completely accessible, and people can still get access to the medication abortion that they choose in Virginia and and in all the states where abortion is still protected.”

“You can get a safe abortion legally in Virginia, no matter if you’re from Virginia or you’re from another state that has banned abortion,” she says. “You can travel for abortion and it’s well within your rights to get a safe and legal abortion with us in Virginia.”

With Democrats holding control of the state legislature, Virginia is unlikely to pass any abortion restrictions in the near future. Still, conservative, pro-life Republicans remain active in Virginia, including Charlottesville-area Rep. Bob Good.

Immediately following the SCOTUS decision affirming access to emergency abortion care on June 27, Good introduced legislation that would make it “a federal crime for a licensed medical professional who accepts federal funds to perform or prescribe an abortion at any point after fertilization.”

“Thankfully, the Dobbs decision did overturn Roe, finding there is not a Constitutional right to abortion, and returning the regulation of abortion to the people’s representatives,” said Good in a press release. “In a post-Roe America, Congress must legislate to protect life. It is our duty to follow the science that life begins at conception and end abortion so that every American has the chance to live.”

With the exception of Good, Charlottesville-area legislators broadly support abortion access.

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Staying vigilant

Amy Hagstrom Miller says the future of reproductive rights in Virginia remains uncertain. Photo: Amy Smith

“Right now, Virginia is seen as a haven state,” says national abortion rights advocate Amy Hagstrom Miller. But all that could change with one Supreme Court decision, as Hagstrom Miller knows all too well: She’s lead plaintiff in the challenge to Texas’ Senate Bill 8, which is aimed at undermining the right to choose established in Roe v. Wade.

Hagstrom Miller is founder, president, and CEO of Whole Woman’s Health, the operator of nine clinics offering gynecological services and abortions in five states, including Virginia-—Charlottesville became its corporate headquarters when her family moved here in 2016. She has been a leader in efforts around the country to fight outdated and restrictive abortion laws and regulations. In Virginia, her advocacy group, Whole Woman’s Health Alliance, worked with many other reproductive rights supporters to pass last year’s Reproductive Health Protection Act. The Virginia legislation repealed requirements for 24-hour waiting periods, medically unnecessary ultrasounds, biased counseling, and other restrictive provisions.

In other states, however, the anti-abortion lobby has been successful in passing burdensome and unnecessary requirements, so-called TRAP laws (Targeted Restrictions on Abortion Providers), and trigger laws designed to reinstate abortion bans in the event that Roe is struck down. 

“It’s important to connect Virginia to the rest of the country,” Hagstrom Miller says. “Virginia will not be fine if Roe falls.”

Women’s health and reproductive rights have been Hagstrom Miller’s mission for almost 30 years. “[Whole Woman’s Health’s] main lane is providing the best possible reproductive health services,” she says, based on viewing abortion as just one part of the health care support system needed to enable women (and their partners) to make their own reproductive decisions. 

“Almost 70 percent of our clients are parents already,” she notes. “Most of them [make the decision to] have an abortion because they can’t afford another child.” The real issue, in her view, is the need to make sex education, family planning, and reproductive health care available and affordable to all people. But apparently, that’s something that has to be fought for.

In 2013, Hagstrom Miller agreed to serve as lead plaintiff in Whole Woman’s Health v. Hellerstedt, challenging a Texas law requiring abortion providers to obtain local hospital admitting privileges, even though the great majority of abortions are not surgical procedures. By 2016, when the U.S. Supreme Court finally struck down the law as imposing an undue burden and therefore unconstitutional, almost half of Texas’ abortion clinics had already been forced to close.

Texas’ latest anti-abortion effort, SB 8, prohibits abortion after six weeks (before most women even know they are pregnant) and allows citizens to bring “bounty hunter” lawsuits against anyone “aiding and abetting” an abortion. The Supreme Court’s refusal to issue an injunction while legal challenges to the law are under way was “shocking,” Hagstrom Miller says. “I was surprised that the Supreme Court issued this statement in a shadow docket, without a trial hearing.” The Supreme Court has agreed to review a Mississippi law banning abortions after 15 weeks. That legislation, in fact, was specifically designed to draw legal challenges and thus create an opportunity for the newly conservative court to overturn Roe.

With this heightened focus on anti-abortion efforts, Hagstrom Miller says Virginians can’t afford to be complacent about access to choice. The Reproductive Health Protection Act only passed when Lieutenant Governor Justin Fairfax cast his tie-breaking vote in the state Senate; restrictions on funding abortions for public employees or those on Medicaid are still in place.

With anti-abortion challenges likely next year, voting in November’s off-year elections (when voter turnout is historically much lower) is “critical,” says Hagstrom Miller. Democratic candidate Terry McAuliffe promises to try to enshrine abortion protections in the Virginia Constitution, a process that requires a citizen referendum. Republican candidate Glenn Youngkin, meanwhile, has said he’ll “go on offense” against abortion rights. 

Charlottesville and Albemarle County’s four delegates are likely to vote along party lines on abortion rights. Statewide, the critical factor will be which party ends up in the majority. Democrats currently hold a 55-45 advantage in the House of Delegates, and a slim 21-19 edge in the state Senate. With one Democrat likely to vote with the GOP on abortion issues, whoever is in the lieutenant governor’s seat could be casting a tie-breaking vote. 

“Abortion access has always been used as a political football,” says Hagstrom Miller. “It’s critical that we maintain these freedoms,” especially with the potential for Roe to be overturned or substantially eroded.

“I have a map hanging in my office that I’m looking at 24/7,” she says. The map shows abortion laws in each state. Only a few have codified the right to reproductive choice in their constitutions or through legislation. But 50 years ago, before Roe, abortion was illegal in 30 states and only allowed under certain conditions in the other 20—not a place Hagstrom Miller wants to go back to.

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‘You are not alone in this:’ Inside a local abortion clinic

Sean Mehl, the clinic director at Whole Woman’s Health in Charlottesville, has worked with Hagstrom Miller for years. Photo: Amy Jackson Smith

By Sydney Halleman

The waiting room of Whole Woman’s Health mimics that of a spa foyer. A selection of organic herbal teas lies on a back table, amid an array of fitness and mindfulness magazines. On the wall is a quote from Georgia O’Keeffe, in pale purple: “I’ve been absolutely terrified every moment of my life—and I’ve never let it keep me from doing a single thing I wanted to do.”

It’s not what you might imagine an abortion clinic would look like. But the positive, relaxing atmosphere is part of the larger organization’s mission—to end the stigma around terminating a pregnancy.

Today, the nonprofit has taken its pledge one step further. As a growing number of states attempts to outlaw abortion, the Charlottesville clinic has opened its doors to the community, inviting the public to take a walk-through of the facility.

Besides the staff, I’m the only one here.

“Our goal is for you to see what it’s like to be a patient here,” says Sean Mehl, the clinic director. Though I’m only here for a tour, I’m a bit nervous.

If you’ve heard of Whole Woman’s Health before, it’s likely because they were the plaintiffs in a landmark U.S. Supreme Court decision challenging abortion restrictions in Texas. In Whole Woman’s Health v. Hellerstedt, in 2016, the court found that a Texas law that required abortion clinics to meet the same regulatory standards as ambulatory surgical centers, causing clinics throughout the state to close, created an undue burden on those seeking abortions.

CEO Amy Hagstrom Miller now lives in Charlottesville (C-VILLE ran a profile of her last fall), and Whole Woman’s Health has filed litigation against abortion restrictions in Virginia and Illinois.

The proactive fight for abortion rights seems far away from the waiting room, where I’m suddenly feeling much more relaxed—maybe from the light instrumental music that has started to play in the background.

“Women are walking in expecting to be judged,” Mehl says, leading me down a hallway. “A patient should expect a much higher level of care.”

Mehl and Jessica Shein, another staff member, show me to the sonogram room, which looks more like a doctor’s office. Virginia law requires an ultrasound before an abortion, something Mehl says is “definitely not necessary in most cases,” and could potentially make the patient uncomfortable. Yet the serene atmosphere of the waiting room has clearly been designed to carry through to this room, which has its own inspirational quote (Tracee Ellis Ross: “I am learning every day to allow the space between where I am and where I want to be to inspire me and not terrify me”).

Next door are two small counseling rooms. The staff hopes to make the state-mandated counseling sessions soothing to the patient. “We want to reinforce that what they’re feeling is normal,” Mehl says. But they’re required to repeat the potential risks of abortion complications (though the complication rate is less than 1 percent), as well as give patients information about abortion alternatives. “It’s another way to throw that information at them in hopes that they’ll change their mind,” Mehl says.

Patients are required to wait 24 hours between the counseling session and their procedure, as long as the patient lives within 100 miles of the provider. That means a woman who lives, say, an hour and a half away from the nearest clinic must either go back home between visits or stay overnight near her clinic. These are the restrictions Whole Woman’s Health is fighting in Virginia, in the class action lawsuit Falls Church Healthcare Center et al v. Norman Oliver.

Mehl and Shein then take me to the procedure room. I’m not quite sure what to expect. I know almost nothing about the medical side of abortions. The room is, well, normal. It’s the same size as the sonogram room, with the same shade of purple on the walls. I notice some medical equipment and Mehl unwraps blue paper, showing me metal tube-like rods on the inside. I learn that this equipment is used to dilate the cervix.

“There’s no incision in the procedure,” Mehl says as he re-wraps the equipment. “That’s a common misconception.”

Finally, Mehl and Shein show me the aspirator, which removes the pregnancy. It’s small and flimsy looking. Surprisingly not intimidating, it’s not even as big as my forearm. There’s a lever. It’s made of plastic.

“A woman came up here on a tour once,” Shein tells me later. “And once she saw the simplicity inside the procedure room, she said, ‘Is this what everyone is fighting over?’”

The last stop on the tour is the recovery room. There are huge leather recliners, a giant picture of Audrey Hepburn, and a Frida Kahlo quote on the wall. More tea sits on a coffee table, blended and mixed by the CEO herself.

“The blend is supposed to help with uterine contractions,” Shein tells me. Blankets lie on each chair.

As I sit in the recliner, imagining the women who sit in this room after a procedure, Shein hands me a small notebook. Inside are pages upon pages of notes written by patients who have recovered in this room. The words are meant to encourage those women who come after them.

“You made the right choice for you,” one page reads. “You are not alone in this.”