Why It Might Get Even Harder to Access Abortions in NC

Black and poor women at greater risk in North Carolina if the US Supreme Court restricts reproductive rights.

Abortion is legal in North Carolina, as it is in every other state.

But that doesn’t mean there’s easy access to the medical procedure for those wanting to exercise their right to decide when, or if, they will become parents.

There are just 15 clinics in the state performing abortions right now, making just getting to a clinic difficult. Then, there are federal and state-ordered restrictions like a ban on abortion coverage with public and some private insurance, a 72-hour wait period and required ultrasound when seeking an abortion.

“People are still experiencing barriers to accessing actual abortion care,” said Maya Hart, the North Carolina coordinator of Sister Song, a reproductive justice coalition, during a recent WomenNC panel about abortion access. “We really need to push beyond choice and think more about access, who does have access and who doesn’t.”

Things could become even more difficult this year, with a much-anticipated decision from the US Supreme Court coming this summer that could curtail, or eliminate, a person’s constitutional right to an abortion. That right was outlined in the landmark Roe v. Wade case 49 years ago this month.

In North Carolina, abortion wouldn’t immediately go away if Roe v. Wade is overturned, but the Republican-led state legislature may move quickly to seek more restrictions, said Tara Romano, the executive director of Pro-Choice North Carolina.

“We anticipate that things will get harder for access here in North Carolina so we’re definitely going to be watching,” she said.

The state hasn’t seen additional restrictions placed on abortion since 2017, Romano said, largely because of the election of Gov. Roy Cooper, a Democrat with the power to veto bills and who has voiced support of reproductive rights.

“North Carolina is one election away from not being a safe state for abortion care,” she said.

Existing Barriers

Black women, who made up nearly half of the 25,000 abortions performed in North Carolina in 2020, stand to be disproportionately hurt if Roe v. Wade is overturned given existing health inequities and lower access to health care and reproductive health items such as birth control.

Those living in rural stretches of the state face even more obstacles.

Right now, the 15 clinics in North Carolina where women can get an abortion are clustered in the state’s Piedmont cities, forcing those in rural areas to travel significant distances. The western part of the state has a single clinic in Asheville, while the eastern part of the state’s only option is in Wilmington.

Women seeking abortions also have to wait three days after an initial appointment before receiving an abortion, which would require resources for staying multiple days for out-of-towners, and must listen while someone reads them a state-provided script.

Then, there’s the cost of the procedure. Public health insurance in the state, including the state health plan, won’t cover abortions, nor does federal programs like Medicaid or the military-associated Tricare, except in cases of rape, incest, or if the woman’s life is in danger.  Add in the travel, missed days of work, and/or cost of securing childcare, and it adds up to shockingly high barriers.

These restrictions are stopping people from getting the care they need now, and that needs to change, said Camille Adair of the Carolina Abortion Fund, a direct-service organization that helps people in South and North Carolina afford and access procedures. 

“My community is of folks who do not and cannot depend on the flimsy fabric that is policy and do not keep up with elections,” she said. “Because whether we like to hear it or not, they … are purposely excluded from legislation and otherwise do not have access to abortion whether or not Roe stays intact.”

The WomenNC discussion about the future of reproductive rights in NC can be viewed below.