Looking around each darkened room in West Virginia’s only abortion clinic, the head nurse wondered if she would ever treat patients here for abortion care again.
“It literally makes me sick, and we don’t know what the future holds for them,” Maness said of the residents who rely on the West Virginia Women’s Health Center. “It’s the kind of raya that’s hard to put into words. There are all these what-ifs.
The waiting room should have been packed with patients on the two days last week when the clinic booked all slots for abortion appointments. But because the U.S. Supreme Court overturned Roe v. Wade days earlier and ruled that states can ban abortions, the clinic was forced to suspend the procedures because of an 1800 state law that banned them. The ACLU of West Virginia filed a lawsuit on behalf of the clinic, asking that the law be declared unenforceable so that staff can resume abortions immediately. Other states are in various stages of legal limbo.
Across the country, workers at clinics that have closed abortion services are feeling fear and anxiety as they try to pick up the pieces and chart a path forward. In central West Virginia, the days following the historic court ruling brought a different kind of grief for staff as their new reality set in, one Maness said will linger long after the initial trauma of the decision.
The conversations with the frantic patients that first day play on an inescapable loop in her head.
“I don’t think any of us can stop it,” he said. “It’s constantly on our minds.”
Like many abortion clinics, the facility did not offer the procedure daily. Several days of the week are devoted to routine gynecological care — cervical exams, cancer screenings — mostly for low-income Medicaid patients who have nowhere else to go. The determination to continue this work encouraged the workers.
Immediately after the ruling was released, Maness was one of the few staff members tasked with calling patients to cancel abortion appointments. On the other end of the line, he had never heard people speak with such fear.
All staff were in crisis mode for days, though they and others across the country had been waiting for the decision for months. “You think you think you’re prepared for the moment, but you’re never really prepared until it happens,” executive director Katie Quinonez said.
She saw her staff break down and cry. Some called in patients or answered the phones. Workers who had the day off showed up, some still in their pyjamas, to relieve colleagues and offer support. Quinonez encouraged everyone to take breaks, often handling the phones herself.
She will forever remember that Friday as one of the worst days of her life. On the weekend, she turned off her phone, lay under a heavy blanket on her sofa, ate junk food and watched TV. It was the only way he could escape and make ends meet.
When she and her staff returned to work, she was left to fill the vacancies from canceled abortion appointments. Some patients still needed other services, but he wanted to let the workers catch their breath. He told them to come late if necessary. The clinic rooms remained largely empty, dark and quiet.
However, the phones rang.
Beth Fiddler sat at her desk behind the glass window of the clinic’s reception desk in the waiting room. He had no patients to check in, no Medicaid data to scan into charts, no information packets to hand out.
Instead, she found herself answering the same questions over and over again, referring callers to a hotline or website to help them find the nearest out-of-state abortion provider.
“You’re closing soon, right?” No, the clinic will be open to provide other services.
“Can I take Plan B – the morning-after pill? What about an IUD or other birth control?’ I will help you make an appointment.
“Are you sure I can’t make an appointment for an abortion? Is there no gap, exception?’ There are no abortion services at this clinic.
Some callers declined. Some remained stoic, others cried. Some responded with hostility, insisting that Fiddler was wrong. She tried to be kind, empathetic – but the conversations got heavy.
“It frustrates me,” he said. “I’m already stressed and upset. I understand that I want to find a way, but there is no way.”
As one of the first patient workers sees, Fiddler prides himself on making people feel welcome and safe. To have to turn them down and just refer them to a website is outrageous, he said.
“As helpless as I feel about it, I can’t imagine how they must feel,” he said.
There is silence outside the clinic. There is no noise of patients arriving in the parking lot to be escorted by volunteers in pink vests. The only cars belong to employees and a security guard. Across the street, a lot owned by an anti-abortion organization is empty except for a large white cross.
A regular protester, a pastor with a “Jesus Loves You” sign, prayed outside a few early in the morning, but the usual crowd begging patients to reconsider is gone. Some cars slow down as they pass. Workers recognize some as protesters’ vehicles and imagine the clinic is being watched – to make sure patients don’t arrive for abortions.
Principal Quinonez said she knows the next steps will be challenging, with a long road for workers to recover from the pain.
“Our staff needs space and time to process this very traumatic loss,” he said. “And all the secondary trauma we experience from all the patients.”
Just being at work is hard, but the employees are dedicated to helping patients.
“We came in on Monday and I was like, ‘OK, what do I do now?’ said Kaylen Barker, who manages the clinic’s public messages. “It’s sad to come back here and realize we’re not going to be able to do the life-saving care people need and we’re going to have to refer them to sites. This is the best thing we can do right now.”
Barker came to the clinic as a patient during a breast cancer scare 12 years ago. She got care when she had no other options. She knew she wanted to work at the place that helped save her, so she applied until she was finally hired. Knowing she can help others like her, she continues, whether abortions are planned or not: “People deserve to receive health care in a welcoming space, without prejudice or judgment.”
So Quinonez and her staff are focused on keeping the clinic open. Abortion services account for 40% of the clinic’s revenue, leaving a gap that could mean layoffs — but one Quinonez is determined to avoid.
It encourages residents to bring their gynecological care to the clinic and plans to offer new services. The clinic recently added sex-affirming hormone therapy services, along with HIV prevention and treatment. He hopes more programs will follow.
And donations are pouring into the clinic’s abortion fund. Before this year, the fund balance never exceeded $50,000. In one weekend after the ruling, they raised $75,000. Staff will use the money to send people out of state for abortions.
“Yes, we’re tired, we’re devastated, we’re angry,” Quinonez said. “But this is far from over. I want to reassure people that no matter how hopeless and dark it feels right now, this is not the end.”
