Dozens of independently owned abortion clinics were forced to shut their doors after the U.S. Supreme Court reversed Roe v. Wade in 2022, according to a new report released by the Abortion Care Network.
Twenty-three independently owned clinics closed in 2023 and 42 closed in 2022, leaving patients without comprehensive reproductive health care.
Lizbeth Rodriguez is the community engagement coordinator for the Philadelphia Women’s Center and the Delaware County Women’s Center in Pennsylvania. She told the American Independent that many independent clinics have closed in large part due to what are called targeted regulation of abortion providers laws.
TRAP laws are often promoted by anti-abortion groups under the guise of improving patient safety, but in reality, they force clinics to meet costly and medically unnecessary building requirements for ambulatory surgical centers, standards that include required corridor widths, and patient room sizes. According to the Guttmacher Institute, Michigan and Pennsylvania are among the states with laws that impose the strictest standards.
“In Pennsylvania, it is mandatory that a doctor provides the abortions when a clinician is very much capable of providing either a procedural abortion or providing the abortion by pill,” Rodriguez said. “We already are experiencing an OB-GYN shortage. And so when we have these types of restrictions on providers, there really isn’t any other choice but to close. Everybody, especially in health care, has experienced staff shortages,” she added.
Brick-and-mortar independent clinics, those not associated with a larger network such as Planned Parenthood, account for 24% of all facilities where abortion is available, and they provide 55% of all abortion procedures, according to the report. Additionally, 60% of all independent clinics operate in states with severe restrictions or bans on abortion.
“In order to meet the needs of communities, there have to be many different providers, not just Planned Parenthood, not just independents,” Dr. Sarah Wallett, chief medical operating officer for Planned Parenthood of Michigan, told the American Independent.
Although the number of clinics in Michigan has been relatively stable, Wallett said, the recent closing of an independent clinic in Grand Rapids, the second-largest metropolitan area in the state, left the area without a facility available to provide procedural abortion care.
“So what we saw from that is, across West Michigan and in some of our other health centers, an increase in demand, which means people are waiting longer to get an appointment. … They’re having to drive a longer distance. We saw how the loss of one provider, one clinic, really made a difference in Michigan for ability to access for patients. Imagine that hundreds and hundreds of times in different states across different communities. It’s a domino effect,” Wallett said.
A dozen states have just one independent clinic — Nevada, Wyoming, Wisconsin, and Mississippi, to name a few — and 14 states have no independent clinics that provide abortions at all.
Dr. Sheila Ramgopal is the chief executive officer at Allegheny Reproductive Health Center in Pittsburgh, Pennsylvania.
Ramgopal explained to the American Independent that unlike clinics run by Planned Parenthood, independent clinics have the freedom to adapt and make changes to provide better care.
“I’m a board-certified OB-GYN and I’ve practiced in independent clinics as well as Planned Parenthood, and there’s definitely a big difference in the way that these facilities are run,” Ramgopal said. “The majority of the independent clinics do focus on abortion, whereas Planned Parenthood’s are much more full-spectrum in terms of reproductive health care,” Ramgopal added.
Independent clinics are vital in helping to lighten the load of providers offering health care to patients traveling out of states with bans and restrictions and into safe-haven states such as Michigan.
“We have seen abortions increase in Michigan across the board. Planned Parenthood of Michigan has seen our out-of-state patients triple since Dobbs, and that has been pretty steady,” Wallett said. “It is patients getting on a plane or driving hundreds of miles and coming to us from Texas and Georgia, and Louisiana, and places that we never saw patients from before in Michigan.”
Although the cost of living has increased significantly since the 1970s, Ramgopal said it’s important to remember the cost of abortion care has largely remained the same.
“An abortion in that first trimester should be around $2,000 to $2,500 if you actually look at how everything else has gone up in cost, whereas abortion facilities have made it as accessible as possible. We’ve tried to keep that cost pretty low,” Ramgopal said.
Abortion care today costs on average between $500 to $600, according to Ramgopal: “I think that historically, the anti-abortion movement has really tried to say that abortion facilities are just here to make money and all of that stuff. We actually operate in a very — we have very limited room for error. The margin is very low, since overhead costs are rising, but we’ve not increased the costs of an abortion.”
Rodriguez said that the patients most impacted by the closures of independent clinics are low-income folks, those in the immigrant community, and patients with disabilities.
“It really is the most vulnerable communities who are being affected by these restrictions. And it is literally the people we put into office who are doing this to us. But one thing we’ve learned within the past election cycle is abortion wins on the ballot, and Pennsylvania has truly shown that,” Rodriguez said.