When Tara Romano heard that the Supreme Court had upheld the Texas law that bans abortions after just six weeks, she said it felt like a punch to the gut.

“It felt really heavy,” she said. “Abortions have pretty much been banned in Texas.”

Romano, who works as the executive director for NARAL Pro-Choice North Carolina, a nonprofit that advocates for abortion access, said that she and her colleagues had been watching the Texas bill — known as SB8 — since it was passed back in May. When the law finally went into effect on Sept. 1, and then was subsequently upheld by the majority-conservative United States Supreme Court, Romano couldn’t help but wonder if a similar thing could happen in North Carolina.

“It feels like we’re approaching a time when we could be beyond Roe,” Romano said. “As in, a post-Roe world where people won’t have the protection that came from the Roe v. Wade precedent and anti-abortion legislation in states will have more free will and it will be harder to stop them.”

Despite the stunning passage of SB8, other abortion bills moving through state legislatures aren’t nearly as broad in scope. For example, one of the key parts of the Texas law is that private citizens, not the government, are tasked with enforcing the law through civil lawsuits. It works a bit like a bounty system. Ordinary people can bring lawsuits against abortion providers and anyone who aids someone in the act of getting an abortion which includes things like giving patients a ride to the clinic. The law does not target the people seeking abortions. If the plaintiffs are successful in their cases, the law allows them to collect cash judgements of $10,000 plus their legal fees from those they sue. If they lose, they don’t have to pay the defendants’ legal costs. Since the law went into effect, the roughly 24 abortion clinics across Texas have stopped offering virtually all abortions or have closed altogether, according to CNN.

On Sept. 9, a little over a week after the Supreme Court refused to block the law, the US Justice Department, led by Attorney General Merrick Garland, sued the state of Texas over the ban, noting that it was “unconstitutional.” On Sept. 13, a Texas state judge issued an injunction on the anti-abortion group Texas Right to Life, blocking it from trying to enforce the new law against the Planned Parenthood in Texas. And as the rest of the country watches the fight over abortion access unfold in Texas, abortion providers in other states like North Carolina, wonder if they’re next.

What does anti-abortion legislation look like in NC?

Currently, there are four anti-abortion bills that have been introduced this session in North Carolina. At least one made it to Gov. Roy Cooper’s desk where it was vetoed. The other three remain stuck in committees.

The one bill that gained the most traction is HB453, otherwise known as the “Human Life Nondiscrimination Act/No Eugenics.” Primary sponsors of the bill include Rep. Pat McElraft, Rep. John R. Bradford, Rep. Kristin Baker and Rep. Dean Arp. Local representatives John Faircloth of Guilford County and Lee Zachary of Forsyth and Yadkin County were among those who sponsored the bill. Unlike the Texas law, HB453 targeted patients directly by preventing them from getting abortions based on their supposed reasons for doing so. The bill would prevent abortions based on presumed race or a fetal diagnosis of Down syndrome.

The bill was vetoed by Gov. Cooper in June and would require a 3/5 majority vote to override Cooper’s veto. The bill has been stalled in committee since July 19.

Bans such as this one, aiming to limit abortions based on the patients’ reasoning, have been introduced across the country and “set a dangerous precedent of politicians defining ‘good’ and ‘bad’ reasons to obtain an abortion,” according to Planned Parenthood.

“People access abortion care for all different reasons,” Romano said. “They’re shaming patients for the decision that they are making.”

Nearly one in four women will have an abortion in their lifetime. That’s according to data analyzed by the Guttmacher Institute from 2014. And while abortion rates have been declining in the last couple of years due to an overall decrease in births and pregnancies, Amber Gavin of A Woman’s Choice wants people to know that abortions are a common experience.

“It’s incredibly common,” she said. “You probably know someone who has had an abortion,” she said.

Currently Gavin works as the vice president of advocacy and operations for A Woman’s Choice, a network of abortion clinics with locations in Greensboro, Charlotte, Raleigh and Jacksonville, Fla.

Gavin said that even though an anti-abortion bill hasn’t been signed into law in several years in our state, the bills add stigma to what should be a private, individual-oriented health procedure.

“These bills are medically unnecessary and they aren’t about healthcare,” she said. “They’re created to add barriers and to shame people.”

The other bills that have been introduced this session but have since stalled in committees include SB405 or HB510, otherwise known as the “Born-Alive Abortion Survivors Protection Act;” SB404 or the “Second Change for LIFE;” and HB31, or the “Detected Heartbeat/Prohibit Abortion” bill. Rep. Joyce Krawiec of Forsyth County and Rep. Amy Galey of Alamance and Guilford Counties, both Republicans, are listed as primary sponsors for SB404 and SB405. The latter has been pushed for by Republican legislators since 2019, when it was first introduced. Similar bills with the same name have also been circulating across the nation for the last 20 years. SB405 targets doctors and providers with the threat of criminal penalty and requires healthcare providers present at the time a child is born alive following an abortion to exercise the same degree of professional care and skill to preserve the child’s life.

Gov. Cooper vetoed the bill in 2019 and this year’s version has been stalled in committee since mid May.

The goal with many of these bills, according to Romano, is the decrease communication between the patients and their providers and to shame patients.

“What these bills have in common is they are really trying to keep people from having honest conversations about the care that they need,” she said. “It’s a way of trying to isolate people who are seeking abortion care.”

What she wants to reiterate, is that abortion care is just another form of healthcare.

“Abortion is a common experience for a lot of people in this country, and it has been since people have been getting pregnant,” Romano said.

What does the Texas ban mean for states like North Carolina?

While none of the anti-abortion bills in NC have been signed into law, advocates like Romano and Gavin say that when a state passes such a restrictive law as in Texas, other state legislators often follow suit.

For example, in June, Mississippi Attorney General Lynn Fitch told the Supreme Court that Roe v. Wade was “egregiously wrong” and that it should be overturned. Fitch and state lawmakers advocated for the justices to allow HB1510 from 2018, otherwise known as the “Gestational Age Act” to go into effect. The law, which would bar most abortions after 15 weeks, was struck down by a federal district judge whose ruling was then affirmed by the 5^th US Circuit Court of Appeals. Now, the state is appealing the lower courts’ decisions to the Supreme Court, which has stated that it will hear arguments for the case in its upcoming term, which begins in October, according to CBS News.

Laws like the ones in Texas and Mississippi are worrying for Gavin, who says that lawmakers are increasingly trying to erase the precedent set by Roe v. Wade.

“They’re hoping to test Roe at the Supreme Court,” she said. “And with the new justices, they’re hoping to overturn 50 years of precedent.”

When bills and laws like these make national news, Gavin said that it can embolden protesters who have been showing up outside of abortion clinics and harassing patients for years. Even during the height of the pandemic, when there were mask mandates and stay-at-home orders, Gavin said that staff at the abortion clinics across the state saw a steady number of anti-abortion protesters. Romano, who also monitors protester activity across the state, said that at a Charlotte clinic recently, approximately 400 anti-abortion protesters showed up to a clinic.

“There’s this idea of emboldening private citizens to punish people who are trying to access abortion,” Romano said.

In 2019, Triad City Beat released an exhaustive look at abortion access in the Triad. At the time, close to a hundred protesters would congregate outside of the clinic in Greensboro every Saturday. Since then, not much has changed in terms of anti-abortion activity, Gavin said. There has been, however, an increase in the number of clinic escorts, or volunteers, whose sole responsibility is to shield patients from protester activity and walk them from the parking lot to the clinic. And that’s important, Gavin said, because the number of people seeking abortions locally hasn’t changed.

“We haven’t seen a decrease in folks accessing abortion care,” she said. “That’s the problem with these near total bans. Folks always need access to abortion care…. Just because bans exist, doesn’t mean that the need for abortions disappears.”

This is evidenced by the ban in Texas. Because clinics have all but stopped providing abortions in the state, according to multiple news outlets, patients are crossing state lines to access abortions. According to an AP report, one clinic in Oklahoma received more than double its typical number of inquiries, with two-thirds of them from Texas. That’s why, Romano says, it’s important to advocate for abortion access at the state level so that no matter what happens at the federal level, no matter what happens to Roe, patients can access the care they need. States such as California, New York and Maine have all passed laws that would protect abortion rights even if Roe v. Wade were overturned.

“This shows that we’ve got to have that focus,” Romano said. “It’s important what’s happening at the state level. We’ve been lucky that we’ve had Gov. Cooper to veto some of these anti-abortion bills and there haven’t been any passed since 2015. It feels like we’re holding the line, and that’s not ideal but it’s incredibly helpful for people who are seeking abortion access.”

According to NARAL NC’s numbers, there are currently 15 standalone clinics in the state that provide some form of abortion care. In the Triad, there is A Woman’s Choice in Greensboro and Hallmark Women’s Clinic and Planned Parenthood in Winston-Salem. Hallmark only offers medication abortion. And even though 15 clinics is considered to be a lot compared to neighboring states like South Carolina, which only has four clinics, and Tennessee which has seven, there are many more facilities known as crisis pregnancy centers that often masquerade as abortion providers with the goal of dissuading patients from seeking abortions.

As of 2019, there were 115 crisis pregnancy centers in North Carolina, five of them in the Triad.

“They’re part of that overall campaign of trying to shame people for accessing the care that they need,” Romano said.

In addition to the abortion clinics themselves, other organizations connect patients with clinics and also help pay for their procedures, such as the Carolina Abortion Fund. These kinds of grassroots movements are what will be key in the coming months and years for protecting abortion access in North Carolina, Gavin said.

“Right now, abortion is legal in all 50 states,” Gavin said. “I want to encourage folks to stay active and stay aware and to connect with local organizations on the ground.”

This way, as providers, Gavin said they can focus on just doing their jobs.

“Abortion providers are resilient,” she said. “You see attacks like this over and over again and we’re determined to do what it takes so people can access the abortion care that they need.”

Anti-abortion bills introduced in the NC 2021-2022 session so far:

HB 453: “Human Life Nondiscrimination Act/No Eugenics”

• What: Prevents patients from getting abortions based on their supposed reasons for doing so
• Local primary sponsors: None
• Status: Voted by Gov. Cooper on June 25. Referred to committee on July 19

HB 510/SB 405: “Born-Alive Abortion Survivors Protect Act”

• What: Penalizes abortion providers if they don’t care for a child who is “born alive” after an abortion.
• Local primary sponsors: Rep. Joyce Krawiec (R-Forsyth), Rep. Amy Galey (R-Guilford)
• Status: Referred to committees in April and May

SB 404: “A Second Chance for LIFE”

• What: Would require doctors to tell their patients that abortions can be “reversed” if they don’t take misoprosol, the pill that would complete the abortion. It would also fine providers that violate the law
• Local primary sponsors: Rep. Joyce Krawiec (R-Forsyth), Rep. Amy Galey (R-Guilford)
• Status: Referred to committee in March

HB 31: “Detected Heartbeat/Prohibit Abortion”

• What: This bill is the most similar to the Texas law as it would ban abortion when a fetal heartbeat can be detected, which is as early as six weeks.
• Local primary sponsors: None
• Status: Referred to committee in February

SB 105: “2021 Appropriations Act”

• What: While this bill is not a stand-alone anti-abortion bill, it does contain funding for anti-abortion causes. In Section 9G.6.(a), the bill states that a total of $6.4 million would be allocated to the Human Coalition. The purpose of the funding would be to increase the organization’s operation of the Human Coalition Pregnancy Support Program which aims to provide support for women experiencing under-support pregnancies. However, one of the main aspects of the program is to “support childbirth as an alternative to abortion.”
• Local primary sponsors: None
• Status: The bill passed its third reading on Aug. 12