In Alabama’s Health Care Desert, This Clinic Could Be Crucial. There’s Just One Problem.

But staffers there are finding that providing comprehensive women’s health care services post-Roe is almost as difficult as providing abortion services before the state’s ban took hold.

The procedure is illegal even in cases of rape and incest in Alabama, and as the state legislature weighs charging women who end a pregnancy with homicide, the state attorney general is also threatening to prosecute anyone who “aids and abets” abortion. But patients are still terminating pregnancies by traveling to other states or ordering medication online. The clinic often sees women who are trying to figure out how far along they are in their pregnancies so they can come up with a travel plan to obtain an abortion, and women who have already had the procedure elsewhere and need additional care.

With the legality of such abortion-adjacent care still murky, the staffers are worried they could be shut down at any moment for providing it.

The clinic is struggling financially, too. Known for decades as primarily an abortion provider, the West Alabama Women’s Center has struggled to get the word out that they’re now providing other care and worked to build a new patient population from scratch, mainly through word-of-mouth.

Facing these challenges, the clinic and others like it in other red states across the country are barely holding on. If they disappear, women who already live in dangerous maternal care deserts could lose a lifeline.

“I’m afraid I’m going to have even worse health outcomes for the people I represent” if the West Alabama Women’s Center shuts down, said Terri Sewell, the Democratic congressperson for the clinic’s district since 2011. Sewell noted that many of her constituents depend on the clinic to get mammograms, contraception and STD tests, and can’t afford to travel further for care. “I mean, there’s a whole host of services that may go away because the abortion decision did away with that service, and that service had with it a whole bunch of resources that are now no longer there.”

Robin Marty, the operations director at the clinic, estimates it could have only a few months left before it has to close, even as patients continue to stream through their doors from 100, sometimes even 200 miles away.

“This is life and death to us,” she said. “I want us to be able to do abortion, obviously. But there’s so little care of any type here — trans care, HIV care, basic preventative health care — that we still need to be here. There is just as much of a lack of access for everything else as there ever was for abortion.”