Photo by Jenny Warburg

This story originally published online at N.C. Policy Watch. 

North Carolina is one of the states that might see an increased demand for abortion services if the U.S. Supreme Court weakens or overturns the landmark 1973 decision that established the constitutional right to abortion.   

Conservatives hold a majority on the U.S. Supreme Court, which heard arguments this month over a Mississippi law that would make most abortions illegal after 15 weeks of pregnancy.  

The court could decide to limit its ruling to upholding the Mississippi law, or it could overturn Roe vs. Wade and leave decisions about abortion up to the states. 

Planned Parenthood in North Carolina is anticipating that such a major change will compel people in neighboring states to seek abortions here.   

Twelve states, including Tennessee, have so-called “trigger laws” laws banning abortion in the first two trimesters that could go into effect if Roe vs. Wade is overturned. South Carolina passed a law this year that prohibits abortion in most cases if a “fetal heartbeat” is detected, or at about six weeks, according to the Associated Press. That law is being challenged in court and is on hold until the U.S. Supreme Court decides the Mississippi case, according to the AP.  

People already cross state lines seeking abortions. The practice is expected to accelerate if states can outlaw abortion or impose more severe restrictions.   

“We are already working to increase our capacity in North Carolina in order to accommodate any potential surge in patients and serve our North Carolina community,” said Molly Rivera, spokeswoman for Planned Parenthood South Atlantic. “We’re working hard to prepare for the future and help patients navigate what new reality may come.”  

In May, Texas passed a law that bans abortions at six weeks. The Supreme Court allowed the state to enforce the law, but in a ruling Friday allowed a lawsuit challenging it to continue, according to the Texas Tribune.   

In response, some Texans are seeking abortions in other states, and a few have reached North Carolina. Rivera said those Texans who have come to North Carolina have friends or family here.   

Underfunded nonprofits struggle to meet the demand

Nonprofits around the country, including the Carolina Abortion Fund, help people pay for abortions and for associated costs, such as travel and lodging. North Carolina clinics are clustered in metro areas.   

The Carolina Abortion Fund, which covers both North Carolina and South Carolina, already receives about 100 calls a week for help and can’t fund them all, said Justine Orlovsky-Schnitzler, the organization’s director of engagement.  

“If we could triple our budget, we wouldn’t be able to fund every caller,” she said. 

North Carolina has been identified by some analysts as a “haven state” for abortion if Roe is overturned. “That’s looking at the best of a bad lot,” said Orlovsky-Schnitzler. 

Federal money cannot be used to pay for abortions, so Medicaid does not cover them. State employee health insurance and health insurance plans offered through the Affordable Care Act marketplace in North Carolina are also prohibited from covering most abortions.   

“I think you are seeing abortion funds and other activities think about how to beef up,” said Tara Romano, executive director of Pro-Choice North Carolina.  

Medication abortions

Not all people need to go to clinics. Early pregnancies can be ended with medications, and this year the FDA allowed patients to get prescriptions for the pills via telemedicine visits and receive the medications by mail.   

North Carolina, however, is one of 19 states requiring people to take the pills in the physical presence of the person who prescribes them, according to the Guttmacher Institute.   

Still, the percentage of people seeking medication abortions in North Carolina has increased dramatically, from 19 percent of abortions in 2010 to nearly 46 percent in 2019, according to state data.   

A new Texas law prohibits providing abortion pills after seven weeks of pregnancy and prohibits sending them through the mail, the Texas Tribune reported.   

More states are expected to add restrictions on abortion pills, Rivera of Planned Parenthood said. “It’s really concerning for many reasons,” she said.   

Abortion rights in NC remain fragile

North Carolina does not have a trigger law, but could be poised to pass more restrictions on abortion. Republicans make up a majority in the state legislature and are the majority supporting abortion restrictions. 

After Republicans won majorities in the state House and Senate in 2010, they passed the “Women’s Right to Know Act” over Democratic Gov. Bev Perdue’s veto. The act requires people seeking an abortion to undergo an ultrasound and a 24-hour waiting period.   

In 2015, Republican Gov. Pat McCrory signed a law extending the waiting period to 72 hours.  

Gov. Roy Cooper, a Democrat, has vetoed bills that would further restrict abortions, including legislation introduced this year and during last session.   

Republicans in the legislature do not have enough votes on their own to override Cooper vetoes.   

That could change with the 2022 elections. Republicans drew new boundaries for legislative districts that, according to independent evaluations, favor their party and give the GOP a good chance of winning supermajorities in the state House and Senate. Lawsuits challenging the plans as extreme gerrymanders are pending in state court.   

“Many folks are viewing North Carolina as a state that won’t ban abortion outright,” Rivera said. “The thing is, that’s just not true. A lot of people have become accustomed to having Roy Cooper veto every anti-abortion bill that comes across his desk. The only reason it’s upheld is the current makeup of the General Assembly. Those numbers are already so close. The Democrats in the General Assembly are able to uphold a veto by a very slim margin. It will only take a couple of seats for this to turn.”  

The impact of abortion restrictions falls disproportionately on people experiencing financial hardship, she said. They are less likely to have the money to travel or pay for lodging in states where abortions are available. 

“Wealthy folks, especially wealthy white folks will be able to get one,” Rivera said.   

And the patchwork of state restrictions might get only more complicated.   

“There’s going to be a great need for patient education and awareness that these barriers are in place,” Rivera said. “People don’t know about these things until they face them.”

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