‘We’re always prepared’: How abortion advocates and providers are preparing for the next Trump administration

Featured photo: Abortion clinic escorts in Greensboro volunteer to ensure patients can access the clinic without harassment from protesters. (courtesy photo)

The Saturday after Donald Trump won this year’s presidential election, dozens of anti-abortion protesters showed up at the only procedural abortion clinic in Greensboro.

Like they had done for years, members of Love Life, a national Christian, anti-abortion organization, gathered in the Midori Express parking lot next to A Woman’s Choice off of Randleman Road in their signature teal shirts. They lifted their hands, sang and prayed.

But something about the group’s overall tone had changed. There was a slight shift in the air, an edge.

“Usually they’re there, and they don’t impede access,” said Lauren O., a clinic escort volunteer who ensures that patients can access the clinic safely. Escorts typically do not engage with protesters or respond to them. Lauren and another escort who spoke to TCB opted to use only their last name initials for fear of harassment from anti-abortion protesters. “But that Saturday, they actually kind of trapped a person in the Midori parking lot, and we had a hard time getting them out. And then one of them just walked into me like I wasn’t there.”

Kirstin C., who has also volunteered as an escort at the Greensboro clinic for years, recalled what she saw.

“It was some of the worst behavior from Love Life,” Kirstin said. “My impression was that it was coming out of their celebration. They tend to have a vested interest in seeming nice, but that Saturday they did not care.”

This marked shift in the attitude of the anti-abortion movement is something that locals fighting to ensure reproductive healthcare are steeling themselves against after the re-election of Donald Trump. For both volunteers and healthcare providers, a second Trump term could lead to deadly consequences.

“It’s really alarming to me,” said Amber Gavin, vice president of advocacy and operations for A Woman’s Choice, which operates clinics in Florida, North Carolina and Virginia. “It should be a cause of concern for everyone.”

Since the overturning of Roe v. Wade in 2022, which allowed individual states to make laws around abortion access, NC lawmakers have rolled back access to abortion to just the first 12 weeks of a patient’s pregnancy. Prior to the Dobbs decision, the state allowed abortions up to 20 weeks. Now, with Trump returning to the Oval Office, abortion providers are concerned that he may institute a national abortion ban.

“That’s part of the anti-abortion movement,” said Jillian Riley, director of public affairs for Planned Parenthood South Atlantic. “It would be literally devastating.”

Planned Parenthood operates clinics that provide medical and procedural abortions in Winston-Salem and Greensboro.

One of the first acts that the Trump administration could take includes the banning of the use of mifepristone, a medication used to end early pregnancies and manage early miscarriages. As a progesterone blocker, mifepristone is one of two drugs that is typically used in medication abortions, which make up the majority — about 63 percent — of all abortions.

Currently, mifepristone is approved for use by the Federal Drug Administration, but if Trump were to direct the FDA to revoke access, medication abortion would only be available as a one-pill process using misoprostol. That pill causes cramping and bleeding that empties the uterus. If mifepristone is restricted, that would mean that pregnancy hormones, which are usually blocked by the drug, could cause patients to experience pregnancy symptoms like breast tenderness or vomiting. That’s why having the use of both pills is seen as a more compassionate process for medication abortions, Riley said. 

“It ends the pregnancy itself,” she said. “It ends all the symptoms of pregnancy.”

Another potential threat to abortion access is the Comstock Act, an anti-obscenity law from 1873 that could be used to restrict the mailing of medication abortion, restrict ultrasounds or restrict the mailing of the morning-after pill and other forms of contraception and birth control.

“I think that history has shown us that it’s not just about abortion,” Gavin said. “It’s about our entire reproductive health. It’s about control of our bodies and our families. It’s not stopping with abortion. It’s birth control, it’s IVF access, it’s all of it.”

To prepare for these possibilities, Gavin and Riley said that they’re doing what they’ve been doing for years: educating people and fighting to continue offering access.

“We’re always prepared to continue to care for people,” Gavin said.

Riley agreed.

“Our health centers are well equipped to provide care in hostile environments,” she said.

Riley noted how abortion providers resisted Trump’s first term. And that’s what they plan to do again.

“We’ve been through a Trump administration before,” Riley said. “We’re not going anywhere. We will continue to provide care to our patients.”

Since the overturning of Roe, both Riley and Gavin said that they’ve seen an increase in patients from across the south coming to NC, which is the last state in the region that allows for abortions after six weeks of pregnancy.

“People have always traveled for abortion care, but it’s harder than ever,” Gavin said. 

She noted the cost of travel plus time off of work and childcare issues  as barriers to accessing abortions in other states. That’s why abortion funds like the Carolina Abortion Fund, which helps patients pay for abortions but also pay for travel and childcare costs, are more vital than ever, she said.

According to Riley, more than half of Planned Parenthood’s patients are on Medicaid or another federal program. Reporting by KFF found that the median cost for abortions ranges from about $568-$775 nationwide. In NC, the cost is about $450.

“Most healthcare insurers don’t cover abortion care,” Gavin said. “A majority of patients receive assistance from one or more abortion funds.”

In addition to supporting local abortion funds, Kirstin and Lauren said that they’re working on making sure people understand the current abortion laws and any future changes to the laws that may come up.

“We need to pay attention to what’s happening,” Kirstin said.

Lauren added that in conjunction with protecting the access they have now, reproductive rights supporters are in a unique position to advocate for an expansion of protections that didn’t exist even when Roe v. Wade was still in place. She’s pushing for things like expanding who can prescribe medication abortions or repealing the Hyde Amendment, which heavily restricts the use of federal funds for abortion.

“They can’t take our ability to dream of better systems,” she said. “They cannot take that from us. They can’t stop us from sharing these ideas and reminding people that better things are possible. We won’t let them steal that from us.”