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Opening an Abortion Clinic Means Jumping Through Absurd Hoops

Located on a residential street near downtown Charlotte, North Carolina, a white, two-story building appears out of place. The property sits across the street from single-family homes and is surrounded by an iron fence. It’s impossible to miss the bold blue lettering above the entrance that reads “Planned Parenthood.”

“We’re not trying to hide who we are,” said Marcie Shealy, director of philanthropy for Planned Parenthood South Atlantic (PPSAT), about the signage. “We wanted people to be able to find us.”

But the work to get this new 10,000-square-foot space was much more discreet. Although the fundraising campaign to open the facility launched in 2016, local media didn’t catch wind until this spring.

That was intentional, Shealy said. Another clinic in town, A Preferred Women’s Health Center, attracts thousands of anti-abortion protesters.

By the time the Charlotte Observer reported on PPSAT’s plans to move its current center from a rented space to a stand-alone building, the campaign had already secured $8.5 million of its $10 million goal by talking to donors one on one. For a majority of the campaign, the website and campaign materials the fundraising committee used were password-protected. The group purchased the building under a generic-sounding LLC—a common real estate practice—and, since the property previously housed doctor’s offices and was already zoned for medical use, no city council hearing was necessary. As a result, PPSAT managed to keep the project out of the news until May—a little more than a month before the ribbon-cutting took place.

And now, for the first time in decades, PPSAT will offer abortion services in Charlotte, joining three other abortion providers in the area.

Shealy said she and her colleagues knew from past experience that publicity could attract negative attention and affect progress. “When we built our Asheville health center, there were obstacles,” Shealy said of the clinic that opened in 2015. “It was very public, and the people that opposed what we were doing would picket the contractors. They would harass their families, and it slowed construction down.”

As abortion care continues to become more difficult to access—six states have only one clinic left and the fate of Missouri’s only abortion facility remains uncertain till October—it might seem intuitive to simply open more facilities, such as the one in Charlotte.

Providers, though, point out that’s much easier said than done. Aside from the difficulty in raising money to cover the costs of construction, equipment, and hiring staff—abortion care isn’t exactly viewed as a stable business, said Julie Burkhart, the founder and CEO of independent nonprofit abortion provider Trust Women—many organizations have also found their work to open new clinics stalled by various anti-abortion tactics.


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In Indiana, for example, a new Whole Woman’s Health Alliance (WWHA) clinic that offers abortion care was delayed from opening in South Bend for almost two years because of issues with licensing. WWHA first applied for a state-required license in late 2017. A few months later, the state health department denied the application, noting the nonprofit failed to meet its requirements of having “reputable and responsible character,” among other factors.

After a few exchanges with the department, WWHA finally asked a federal district court to step in in March. (WWHA also filed a civil lawsuit challenging Indiana’s abortion regulations; the case starts next year.) What is essentially paperwork had delayed the clinic’s opening by 18 months at that point.

“We have done everything possible to open this clinic, but have been met with nothing but politically motivated, medically unnecessary obstruction by state bureaucrats,” CEO and founder Amy Hagstrom Miller said in a statement at the time.

Hagstrom Miller told VICE that Whole Woman’s Health—which has clinics in Texas, Minnesota, Virginia, and Maryland—has never been denied a license before.

“These layered restrictions like licensing laws, construction requirements, mandatory delays and so many more, work to create an environment where it is nearly impossible to open a facility or even to run one sustainably,” Hagstrom Miller said. “This, of course, is by design, not by default, as a tactic of those who oppose safe and legal abortion care.”

In June, a federal judge ruled the South Bend clinic could open temporarily without a state license, pending the final ruling from WWHA’s federal lawsuit. The facility began taking patients a few weeks ago.

Burkhart, who founded Trust Women in 2009, also knows what it’s like to face hurdles in bringing abortion care to more patients. In addition to opening clinics in Oklahoma City, Oklahoma, and Seattle, Washington, Burkhart also led the 2013 reopening of the Wichita, Kansas, clinic of George Tiller, the provider who was murdered in his church in 2009 by an anti-abortion activist.

Burkhart said early on she assumed she and her team could reopen Tiller’s clinic in Kansas without attracting much attention. All they had to do, she thought, was to go about it quietly.

“I must have been living in an alternate reality because as soon as people really got wind that this was a topic of conversation, and something that was seriously being considered, the anti-choice folks started speaking out,” Burkhart said.

Protests at the clinic took off after local media reported she had purchased the building from Tiller’s widow, she said. “The anti-choice folks tried to rezone the clinic twice,” Burkhart said. “I had to go before the zoning commission of the City Council to defend the organization and why we needed that clinic. It was interesting how vociferous they were right off the bat.”

Abortion opponents interfered in the opening of the Oklahoma City clinic as well, though the action really ramped up during construction in 2016. “They were coming into the building and filming the construction workers and harassing them, both inside and outside of the building,” Burkhart explained. “They posted information on social media. They were able to find out where the construction workers went to church [and] were contacting their churches and trying to get the ministers and congregants to put pressure on them, which led to a lot of our construction workers there being quite upset.”

“In each place, we faced our own difficulties in finding certain people to work with us,” Burkhart said. “That’s part of the process because people are afraid of anti-choice folks, and fear is a big motivator.”

Intimidation of construction workers is not uncommon. The Planned Parenthood Gulf Coast New Orleans Health Center opened its doors in June 2016 after experiencing delays related to arson and death threats to contractors, The New Orleans Advocate reports. Although the center was outfitted to offer abortion care, three years later it still has not been given a permit to do so. The nonprofit has taken its case against the state health department to federal court.

In Alabama, the Associated Press reported last month that Planned Parenthood Southeast is building a new 10,000-square-foot clinic in Birmingham—despite the governor signing a law to ban all abortions except those necessary for a mother’s health. (The facility is slated to open in November, which is when the law would go into effect, though it’s likely to be blocked by legal challenges.)

Opponents of the Birmingham clinic told the AP they plan to “convince the Alabama Department of Public Health to deny a license for the facility” and try to sway construction contractors to walk off the job.

“We still stand and we will kneel in prayer that this facility will not be built,” one opponent said.

Keeping the Charlotte Planned Parenthood project under the radar helped officials open their new center with minimal interference, particularly during construction.

The new center in Charlotte, which began taking patients early this month, was never exactly a secret, Shealy said. “It was quiet. There’s a big difference. We worked with a local architect. We had to get all of the permitting. Everything was on the up and up as normal business practices go.

“It was just—we didn’t put it out into the universe.”

Inside the new health and education center, the waiting area and patient and procedure rooms all boast brightly painted walls. The equipment is state of the art: The clinicians are particularly excited about the new hands-free lighting fixtures and warming drawers for medical instruments, Shealy said. A spa-like recovery area includes tall faux plants and journals for patients to write in, while staffers in the administrative offices on the second floor walk past living plant walls.

“We tried to make [the new space] so that it’s really serene,” Shealy said. “It’s very quiet. We built a ton of soundproofing into the building…for protesters.”

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