With her blond hair pulled into a braided ponytail, a small gold cross slung around her neck and decked out in teal scrubs covered in cartoon frogs, Brenda Morgan was polite but firm as she doled out instructions to her clinic employees.

People rarely pick up their phone if they don’t recognize the number, so you’ll probably have to leave a voicemail, Morgan advised a trio of staffers. When you leave that voicemail, she continued, never say you’re calling from Whole Woman’s Health. Instead, Morgan suggested they say something vague, like: “This is Brenda from your doctor’s office. Please give me a call back.”

The last thing they want is for the wrong person to hear the voicemail and realize an abortion clinic is calling.

The staffers eyed the phones on the desk. Protecting a patient’s privacy was paramount, but they had little time to perfect their voicemail technique. Less than 24 hours later, that clinic, the latest addition to the Whole Woman Health’s network of abortion clinics, would welcome its first patient.

In the two years since the US supreme court overturned Roe v Wade and allowed more than a dozen states to ban almost all abortions, more than 100 facilities have stopped providing abortions. New clinics have sprung up in states that still allow the procedure, but there are nowhere near enough to make up for those that shuttered. Many of those clinics are also in solidly liberal, northern states.

By contrast, Whole Woman’s Health newest clinic – which quietly opened last week – is located in Petersburg, Virginia, within a purplish state that rebuked a GOP campaign to ban abortion past 15 weeks in the 2023 elections but remains ruled by a Republican governor. In opening in Petersburg, a small city perhaps best known for being home to some of the American civil war’s final battles, Whole Woman’s Health is declaring a new front in a war that has again divided the US north from south: the fight over abortion.

The new Whole Woman’s Health abortion clinic in Petersburg, Virginia, opened on 22 August 2024. Photograph: Hadley Chittum/The Guardian

Virginia is likely the last southern state where abortion providers can hope to open new clinics – and the need for southern, or southern-adjacent, abortion clinics has recently metastasized. On 1 May, Florida banned abortion after six weeks of pregnancy, decimating the last southern stronghold of abortion access. Women from Florida and its neighboring states must now travel hundreds of miles for abortions.

“We didn’t open this only because of Florida,” said Amy Hagstrom Miller, founder of Whole Woman’s Health. “We opened this clinic because we know how many people are traveling from the region.”

‘Probably should have given up earlier’

For years, Whole Woman’s Health was the face of abortion in Texas, where it ran a handful of clinics. In 2016, the organization won a US supreme court case that toppled several Texas abortion restrictions; at the time, the decision seemed to be a sign that the war over abortion rights was turning in their favor.

Eight years later, Roe is gone and Texas has banned almost all abortions. Whole Woman’s Health has closed its Texas clinics, as well as another clinic in Indiana, which has also outlawed the procedure.

Whole Woman’s Health president and CEO, Amy Hagstrom Miller, at the organization’s new abortion clinic on 21 August. Photograph: Hadley Chittum/The Guardian

It was devastating – emotionally and financially. It took more than a year for Hagstrom Miller to sell buildings where her clinics had operated. (An anti-abortion group later bought one of the buildings.) Getting out of one lease, she said, cost tens of thousands of dollars.

“Those operational things are real. They can take down – I mean, they almost did take down – one of the most stable, independent providers in the country,” said Hagstrom Miller, who likes to dress as loud as her politics. The day before the Petersburg clinic opened, she wore a chartreuse suit and a necklace that read “ABORTION”. The underside of her silvery hair was dyed a searing purple – a signature shade of Whole Woman’s Health, whose walls are usually painted in mauve hues.

Hagstrom Miller continued: “I had to spend our organization’s reserves to do all that stuff, which kept me from being able to open something in Kansas or figure out how to help people in southern Illinois.”

Over the last several months, Whole Woman’s Health has tried to start multiple abortion clinics. One, in New Mexico, successfully opened. But Hagstrom Miller purchased a building in Oklahoma – right before the state banned the procedure. “I still have that building,” Hagstrom Miller said. “I’ve been playing a mortgage on that building for – I couldn’t even tell you how long it’s been.”

She also bought a practice from a North Carolina abortion provider but spent a year battling state regulations before having to concede that the clinic would never open.

“Probably should have given up earlier,” she said. “Not so good at that.”

A few weeks later, North Carolina banned abortion past 12 weeks of pregnancy.

Morgan was part of these efforts. For the last two years, she has hopscotched across the country, closing and setting up clinics as the director of growth and acquisitions for Whole Woman’s Health. During a tour of the clinic, Morgan pointed out pieces of equipment that had been repurposed from former Whole Woman’s Health locations: black chairs in the waiting room, blush-colored surgical trays, a chair where patients get their blood drawn.

Brenda Morgan, director of growth and acquisitions for Whole Woman’s Health, poses for a portrait outside the new clinic in Virginia, on 21 August. Photograph: Hadley Chittum/The Guardian

“If it could talk, it would tell you many, many stories,” Morgan said of an exam bed from San Antonio, Texas.

Hanging in the waiting room, greeting patients as they walk in the door, is a royal purple sign bearing the “MISSION STATEMENT” of Whole Woman’s Health, which reads, in part: “We honor women’s hopes, dreams and intentions in all of the care that we provide.” Morgan stroked a finger down the sign, noting where the purple paint had faded away to reveal white underneath. The sign originally hung in a Texas clinic.

“I love the fact that it has some dings in it, because it’s just like us,” Morgan said. “It’s stood the duration of time, but it also has taken its little nicks and bruises, as we have.”

‘I have to plan’

On the clinic’s first day of operation, one woman flew in from Florida.

Whole Woman’s Health staff pass papers around during training day before the opening of the abortion clinic on 21 August. Photograph: Hadley Chittum/The Guardian

“She was so sweet and so grateful,” said Dr Meera Shah, the clinic’s medical director. “It made me angry that she had to even do that, that she had to leave Florida.”

In her other job, as the chief medical officer of a Planned Parenthood affiliate in New York state, Shah said she has treated numerous patients fleeing southern abortion laws – including one Florida woman who had an ectopic pregnancy, a nonviable pregnancy where the embryo implants outside of the uterus. If left untreated, ectopic pregnancies can rupture women’s fallopian tubes, leading them to hemorrhage and even die.

Theoretically, abortion bans should not apply to ectopic pregnancies. But the woman had been turned away from a Florida emergency room because, Shah said, a doctor found the state’s abortion laws “confusing”.

“You know, she could have ruptured,” Shah said. “The zip code in which you live really determines the type of healthcare that you’ll receive. And it shouldn’t be that way.”

Dr Meera Shaw, medical director of the new clinic, 21 August. Photograph: Hadley Chittum/The Guardian

By the weekend, the Petersburg clinic had helped another another three people – from Florida, Georgia and Alabama – get abortions. Eventually, Morgan expects the clinic to serve about 30 to 50 patients a week.

The upcoming 2024 elections, however, may scramble these plans, especially as southern abortion laws are still in flux. Floridians will vote on a ballot measure that could restore abortion access, but it needs 60% of the vote to pass. In North Carolina, a Republican who has called abortion “genocide” and “murder” is now running for governor. He has tried to soften his position on abortion recently but if he wins, North Carolina’s state government could ban abortion entirely.

The same week the Petersburg clinic opened, Donald Trump pledged not to use a 19th-century anti-vice law to outlaw abortion nationwide, while his running mate JD Vance said Trump would not sign a national abortion ban. But Project 2025, an influential blueprint for a conservative presidential administration, has a long list of anti-abortion proposals. Trump could also renege on his promise.

“I’m feeling much more engaged and hopeful than I have felt in a long time,” Hagstrom Miller said. “I also am absolutely terrified for Trump to get re-elected and I have to plan for that contingency. I have to plan for a national abortion ban.”



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