The team at Alabama Women’s Center in Huntsville was only an hour into a morning full of appointments when Dr. Sanithia Williams got the phone call: The Dobbs v. Jackson Women’s Health Organization Supreme Court decision had come down. As expected, it was bad; the waiting room was full of patients scheduled for abortion care, but they were to cease services immediately. “It was as if someone had sucked all the air out of the room,” Williams recalls on the phone when we talk a few days afterward.
She, like many others, thought they had a bit more time; she had expected the Court to wait until its final session of the summer, when abortion rulings have traditionally been issued. The clinic team took a minute to digest the news, and Williams excused herself to her office, where she cried. The moment had a physical impact, and the decision would have left her breathless even if it had come the following week. To lose the ability to legally provide the medical care she knew her patients needed was to lose part of the reason why Williams decided to practice medicine in the first place.
Some of the patients in the waiting area were there for an initial appointment, to meet Alabama’s pre-Dobbs requirements that included an ultrasound and state-issued counseling. Others had already completed their first appointment and the mandatory 48-hour waiting period. After the ruling came down, a few people left the waiting room on their own. A staff member at the clinic told the remaining patients that they were trying to get clarity on what it all meant in practice for them.
Within mere hours, what it meant came through with harsh clarity. Almost immediately after the Supreme Court overturned 50 years of precedent, the state of Alabama had filed an emergency motion to reinstate the 2019 Human Life Protection Act, which had been deemed unconstitutional three years ago.
The law makes abortion illegal in the state and makes providing that care a felony. Before Judge Myron Thompson even responded to the state’s motion, the writing was on the wall; patients were called one by one to the back of the clinic to be given the news that no abortions could be provided. Williams and her team did their best to provide resources to patients who still wanted to pursue abortion care elsewhere, but many of them were still struggling to wrap their heads around the news. Patients wept, many of them tried desperately to bargain: Isn’t there anything you can do? Can I come back next week? Can I give you extra money? I need this.
“All of those conversations are really, really difficult as an abortion provider, because I feel like [offering abortion care] is morally the right thing to do,” Williams tells me, her voice soft and carefully steadied. “It’s really hard to be in front of a patient who’s telling you, ‘This is something that I really need and really want,’ and not be able to offer a procedure that I know is safe, and that I know that I can safely provide.”
By late afternoon, Judge Thompson lifted the injunction and abortion officially became illegal—making Alabama one of the first states to ban abortion in the immediate aftermath of Roe’s demise.
One hundred and fifty miles southwest of Huntsville, in Tuscaloosa, the day was equally agonizing for Robin Marty, who had been putting out fires all week. When I meet her a few days later at her home, she laughs a lot, as usual, but there’s an edge in her laughter that I’ve never heard in our many previous conversations. She’s distracted and tense, leaning forward in her computer chair every so often to check her texts and her email while we catch up.
Just a few days before Dobbs came down, the medical director and main abortion provider at the West Alabama Women’s Center had suffered a death in the family, and Marty, as operations director of the clinic, had been scrambling to find a doctor who could fill in in those last precious few days before she knew care would be cut off. They were only able to get a doctor for one day that week; he came in from Georgia. To accommodate as many people as possible, the staff at the clinic asked patients who were eligible if they would be willing to get medication abortions instead of surgical abortions. The doctor came that Thursday, and clinic staff started working at 6:30 a.m. to get through 75 patients.
The next day, Friday, WAWC ran on a skeleton staff, as everyone was exhausted from the marathon of the day before. Like Williams, Marty’s team had hoped the decision would come down the following week, so that Friday would be dedicated to getting patients through their first appointment and all the steps the state requires of clinics before patients can enter their waiting period. The weekend would serve as the waiting period, and most of the group scheduled would return as early as Monday to get their abortions.
So that morning, as Roe fell, Marty was doing a live TV interview. She had asked someone to keep an eye on the Supreme Court rulings so she could focus on the conversation at hand and not have one eye on the news feeds. Ten minutes in, her phone buzzed with a text from that person. “FUCK.” Then: “STOP.” As in, stop services. Marty explained what was happening to the anchor and ended the interview, picking up her phone to call the staff at WAWC and tell them they had to cease work immediately.
To the southeast, in the state’s capital of Montgomery, that Friday morning Mia Raven was at her other job. Thirty minutes into her shift at the local LGBTQ advocacy center, the Dobbs news broke, and she knew where she needed to be.
She drove straight to POWER House.
POWER House is a historic gray Craftsman next door to Montgomery’s abortion clinic, Reproductive Health Services, which functions as a place for patients to rest—overnight, if necessary—between their appointments, and also as a social justice organizing hub. As the threat of the Dobbs ruling loomed, the house was often filled. But that Friday, it seemed cavernous without any inhabitants. As founder and director of POWER House, it’s something of a second home to Raven—there’s even a tiny bedroom behind her office, where she has traditionally slept on nights before she had to be at the clinic in the wee hours of the morning.
For the past several years, she’s stood outside for hours in nearly every climate imaginable and put on a mask to safely escort abortion patients into Reproductive Health Services, shielding them from the frenetic shouts of anti-abortion protesters trying to divert patients to a truck parked across the street. Run by a group called “Life on Wheels,” the truck has an ultrasound machine, and its volunteers refer patients to local crisis pregnancy centers, where abortion is not an option.
While Reproductive Health Services is typically closed on Fridays, on this Friday, Raven saw some seven cars drive up after she arrived. They were former patients who wanted to know what they could do to help; the only place they could think to go was the place that had once helped them. “That kind of broke me,” she says. Later, as I reported in late June, she sat on the pink-tinged concrete porch of POWER House, her usual place of rest between escorting patients hundreds of times before, and wept.
The anti-abortion group across the street rejoiced. The protesters and the clinic escorts have long been at odds for obvious reasons, just as it is at other clinics across the country. The porch of POWER House is somewhat hidden from the view of the “antis,” as abortion-rights folks call them; though light leaks through holes in the camouflage curtain covering the porch, it’s still enough to obscure the identity of anyone who decides to settle there to get some air or have a smoke break. The protesters, for their part, are very much exposed, pacing along the sidewalk and around the lot where their ultrasound truck is parked. Sometimes, Raven says, they have gotten bold. On the porch behind her, blue tarp still covers a giant tear in the wall of the house that abuts the clinic parking lot—lingering damage from the time a patient accidentally drove into it. She had the windows down and two kids in the backseat, and an anti-abortion protester yelled that if she was going to have an abortion, she might as well kill those two kids while she was at it. The children were old enough to understand what the protester said, and in her distress, she put the car in drive instead of reverse, and hit the gas.
Around 5 p.m., Raven left the POWER House to head downtown and join a protest at the statehouse. Being in a crowd, having a place for her rage and grief, helped. But when Raven wasn’t protesting that weekend, she was meeting with lawyers who were advising her and the clinic on how they could safely move through this new post-Roe Alabama. “I have criminal attorneys,” she says. “I’ve never had criminal attorneys in my life.”
These attorneys advised staffers to be cautious—no naming specific clinics in other states for patients who are seeking abortion care, lest the state try to bring conspiracy charges against them. Lawyers for the clinics in Tuscaloosa and Huntsville have given similar advice.
The providers and care workers I speak with all mention how the days since the Supreme Court ruled in Dobbs have held a mild unease—the world feels somewhat normal, and it takes a moment for the grief to reveal itself in the mornings, to remember that all is not well. After all this time of talking about and planning for a post-Roe America, it’s uncanny to be living it. Suddenly, it’s real instead of speculative.
Predicting the eventual twists and turns of the law in this new world has been tricky. Ever since the ruling came down, the law has been fluid, and has held a potential for very real danger, but no one seems sure precisely what is legal now or what could become illegal very soon. “It’s both frustrating and terrifying to know that we’re in a completely new world,” Marty tells me. “We don’t have a history of how this works.”
To be sure, Alabama has been in its own kind of post-Roe world for decades now. The state legislature is ardently anti-abortion, as is Alabama Gov. Kay Ivey. Alabama, along with neighboring Georgia, led a string of states that tried to ban abortion in 2019. Alabama’s legislative effort was the Human Life Protection Act, which of course, is now the law of the land. In the days before the Dobbs decision, the Alabama legislature boasted a patchwork of regulations intended to restrict access to abortion care—state-directed counseling, a 48-hour waiting period, an ultrasound requirement, a ban on the use of telemedicine to administer medication abortion, which meant that Alabamians who wanted an abortion had to travel to one of three cities in the state that had a clinic in order to get care. It can be a dangerous place to be a pregnant person—Alabama has the third-highest rate of maternal mortality in the United States, and twice the national average. Black women are more likely to die from pregnancy and childbirth-related causes than any other racial group.
So, too, does the American criminal justice system disproportionately target Black people for all manner of infractions. This history, stretching well into the present, weighs heavily on the minds of the team in Huntsville. The clinic there is owned by a Black man, Dalton Johnson, and its two abortion providers are Black women, Williams and Dr. Yashica Robinson. Robinson gave a searing testimony in support of abortion rights before the US House Judiciary Committee in May, winning widespread praise for keeping her cool in the face of blatant disrespect from white male representatives. They are examining the risks of this uncertain landscape, trying to assess a threat that has not fully taken shape. As Williams told NPR in early July, she and her colleagues are “well aware that the state knows exactly who [they] are,” as people of color who have provided abortion care, and they feel even more pressure as a result. “As a Black woman, I’m really familiar with the idea of what happens to Black folks when they interact with the criminal justice system,” she said.
The Tuscaloosa clinic—which is run primarily by white women, though their staff is comprised mostly of people of color—did ultimately decide to give patients information regarding where the closest clinic was that could legally perform their abortion. They did not pass along any information that was not already public. Marty, who is white, says that the staff felt a moral obligation to continue care in whatever legal way that they were able.
“We did not encourage them to continue with their abortion, we did not discourage them and tell them that they shouldn’t, we simply listened to them,” Marty says. “We told them that this was an option that if they wish to continue their abortion, they could still do that, and then we made sure that they understood that they could not get an abortion here with us.” To protect the staff from any legal retribution, Marty told them all that if they didn’t comply, she would fire them—not to make them do anything they didn’t want to, but rather to keep the responsibility on her shoulders.
The future of these clinics, especially given the ever-changing legal landscape, is uncertain. But they are already having conversations about how they can stay open and provide other forms of reproductive and gender-affirming care. The Huntsville clinic has been open for two decades; Williams calls it a “staple of the community,” and she speaks passionately of how it’s been a resource for many Alabamians to get safe, nonjudgmental health care. The West Alabama Women’s Center, meanwhile, plans to provide reproductive health services, including contraception, HIV treatment, prenatal care, and gender-affirming care as long as they are financially able.
POWER House, for its part, has decided to start a “Pro Choice Assistance Program,” wherein people can come by the house for free safer sex supplies, including pregnancy tests, ovulation test strips, emergency contraception, condoms, lube, and more. And one of these days, Raven says she wants to get an ultrasound machine, so she, too, can provide free ultrasounds—just like “Life on Wheels” across the street—but by offering support in a vastly different framework, one focused on reproductive justice.