By Rachel Crumpler
Planned Parenthood’s Asheville clinic, the only abortion provider in western North Carolina, is temporarily closed because of damage inflicted by the remnants of Hurricane Helene — taxing an already strained environment of abortion access.
Helene, which brought historic rainfalls to western North Carolina, tore a path of destruction across the region. Buncombe, the most populous county in western North Carolina and home to the city of Asheville, was among the hardest hit. At least 72 people died.
Roads crumbled. Power lines fell. Some buildings ripped apart. Others were filled with swirling water and thick layers of mud.
Planned Parenthood South Atlantic President and CEO Jenny Black told NC Health News the Asheville clinic was not severely damaged. The building is intact and has already had its power restored. Additionally, she said, all staff are safe and accounted for.
But there’s no running water at the clinic — an essential element of operating a health care center. That’s because Asheville’s public water system sustained “catastrophic damage” from the unprecedented flooding. Helene washed away about 25 feet of earth, exposing and breaking essential pipes that were once buried deep.
City and contract workers are making steady progress each day to repair breaks in the municipal system’s more than 1,800 miles of water pipeline, but the timeline for water restoration remains uncertain. Some major steps need to be completed before many taps in Asheville will be flowing again.
“Our restoration for water is still measured in weeks, not days,” Ben Woody, Asheville assistant city manager, said during an Oct. 7 media briefing.
Black said the abortion clinic can’t operate without running water, so that will be a key factor in when the clinic can reopen. She added there are other considerations.
“It’s more than just power and the running water,” she said. “We have to make sure that we’re adequately staffed, and that therefore means those staff have homes to go back to and that the roadways are passable enough for people to get to us.
“We just really don’t know right now what the closure timeline looks like, but we’re obviously committed to our presence in western North Carolina and are really looking forward to being able to be back open as soon as it is logistically possible and from a public health standpoint.”
Strain to the system
One fewer clinic operating in the state — even if for a short time — has ramifications on abortion access, said Calla Hales, executive director at A Preferred Women’s Health Center, which operates two abortion clinics in North Carolina.
“Anytime a clinic has to close — whether it’s temporarily or permanently — it absolutely has an impact on access because there are so few of us,” she said. “It’s very difficult when anyone has to reduce capacity because no one else can really take on any additional burden.”
Before Helene, the state’s 14 abortion clinics spread across 12 counties reported they were already stretched to meet the demand of North Carolinians seeking abortion care and the many more coming from out of state.
In particular, people from Georgia, South Carolina and Tennessee have frequently traveled to North Carolina, where abortion is legal through 12 weeks of pregnancy. That’s more weeks of access than in their home states — according to data from Guttmacher Institute, a reproductive health organization that tracks abortion nationwide.
In June, there were an estimated 3,660 clinician-provided abortions in North Carolina, according to the most recent data from the Guttmacher Institute’s Monthly Abortion Provision Study. A couple hundred of those abortions were at Planned Parenthood’s Asheville clinic.
- Planned Parenthood’s Asheville health center is continuing to offer telehealth services for birth control, gender-affirming care, HIV services and more.
- Patients can schedule an appointment at another location online or call 1-800-230-PLAN.
Making adjustments
The Asheville health center’s closure since Friday, Sept. 27, has led to disruptions.
Planned Parenthood staff worked quickly to reschedule dozens of appointments, as abortion seekers needed to obtain care within specific gestational time limits permitted by state law. Black said most patients were rescheduled to receive care at Planned Parenthood’s Charlotte or Winston-Salem clinics, but they also sent some people out of state, such as to Virginia where there are fewer gestational restrictions on abortion.
In response to the closure, Black said Planned Parenthood is adding capacity at its other North Carolina clinics to minimize the disruption to care as much as possible.
“We’re working really quickly to kind of increase our availability of appointments in other centers, which is logistically a little bit complicated, but not impossible,” Black said. “We are moving resources around to try and make sure that everybody who wants care and can get to it — that is an important if — are able to get that care.”
Some Planned Parenthood staff who temporarily evacuated from Asheville have relocated to hotels and Airbnbs near other clinic sites where they will work, enabling additional appointments to be offered.
Due to these adjustments, Black said she’s less concerned about clinic capacity limiting access to abortion care. Rather, she said, access will hinge on whether patients can navigate the increased challenges of getting to a clinic farther away while the region’s only abortion clinic is temporarily closed.
“I’m really thinking a lot about the people who really want and need and deserve abortion care and how those barriers have just become too high,” Black said.
Compounded challenges
Ash Williams, an abortion doula, knows how logistically fraught abortion access can be under normal circumstances for people in western North Carolina — let alone amid a natural disaster. As a member of the Mountain Area Abortion Doula Collective, a group of volunteers who support people in western North Carolina seeking abortion care, he’s worked with dozens of folks to navigate barriers to care.
“Sometimes it’s people who can’t get a ride,” Williams said. “Sometimes it’s people who can’t get no money. Sometimes it’s people who don’t have anyone to watch their other children. Sometimes it’s because they were afraid and they couldn’t get access to the information.”
The damage and conditions caused by Helene add an additional layer of complexity, Williams said, which he worries will put abortion access even further out of reach.
Maren Hurley, an abortion doula and co-founder of the Mountain Area Abortion Doula Collective, shares that concern.
Hurley has talked to clients over the past week who have reached out in the wake of Helene. She said people’s cars and homes have washed away. Many are out of work and seeking necessities like drinkable water and food from county distribution sites.
“A lot of folks that I have worked with as an abortion doula express that they are afraid of not being able to meet their needs or a child’s needs if they have to carry to term, but that fear is so much more amplified now,” Hurley said. “People have so much less emotional bandwidth.”
Hurley said people from western North Carolina seeking abortions will need even more financial and logistical support to make it to clinics farther away. North Carolina law requires people receive in-person counseling at least 72 hours before their abortion, necessitating at least two visits to a clinic.
“For people who are closer to Asheville, it feels like a very different mental and emotional lift to drive a few hours to Asheville and then be able to return home, versus ‘Now I have to drive to a place that I’m unfamiliar with, and I don’t have the ability to come back quickly and need to take more time off work,’” Hurley explained.
Need for more assistance
Hurley said damage from Helene has also created a new group of need: People who could previously afford the costs of abortion or could crowdsource the funding from family or friends may no longer have those resources.
Hurley said Mountain Area Abortion Doula Collective offers financial support to people in western North Carolina seeking abortions. Carolina Abortion Fund, a nonprofit that distributes money to help people cover the costs of an abortion, is also prioritizing allocating funds to western North Carolinians this month.
Typically, Carolina Abortion Fund allocates about $275 or $300 per caller, which partially covers a procedure. But Carolina Abortion Fund’s goal is to fully fund western North Carolina women most affected by Helene, said Hannah, operations manager at Carolina Abortion Fund who requested that NC Health News use only her first name for security reasons.
The organization is working to secure a $15,000 grant to specifically help this group, she said. That amount would likely fully fund the costs of an abortion procedure and travel for 15 to 25 people.
“It’s been … making sure these people are covered more than what we’re usually able to do,” Hannah said.
Even with support, Williams said getting to a clinic farther away may not be feasible for some people. That’s why Williams said he is also sharing with people information on self-managed abortions, which is when people take abortion pills to end a pregnancy at home. Research shows this method is safe and effective and has become more common post-Dobbs as access to clinic-based abortions have diminished due to state laws banning abortion.
Difficulties accessing health care
Black, who has led Planned Parenthood South Atlantic for nearly 10 years, said she’s always playing “whack-a-mole” keeping the 14 clinics spread across North Carolina, South Carolina, Virginia and West Virginia operating. She’s dealt with other hurricanes but said until Helene none had resulted in closure as extended as this is expected to be.
“When you operate a big network of health centers, it’s always something,” Black said. “We’re not unaccustomed to dealing with these types of things, but this is a very different set of circumstances that I think is a historic set of circumstances that are really creating very, very difficult conditions for people to live in, much less access health care.”
In addition to the impact of the temporary closure of Asheville’s abortion clinic, Hales is thinking about other potential consequences from Helene, such as the loss of resources and medications.
“Natural disasters also mean you’re losing access to things like birth control, condoms, emergency contraception — any of those things,” Hales said. “So it amplifies the possibility for future abortions, as well, that could further tax the system.”
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