Independent Abortion Providers Provide Majority of Abortion Care in U.S. As Threats to Access Loom Large

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Abortion Care Network's new report on independent providers finds the majority of people who have abortions receive care at independent clinics, which are closing at an alarming rate.

As a shifting Supreme Court poses a direct threat to legal abortion care in the United States and anti-abortion extremists continue to target providers, Abortion Care Network’s fourth annual Communities Need Clinics report — released today — finds that 3 out of 5 people (58%) who have abortions receive care at an independent clinic. The report also finds that independent providers continue to close at an alarming rate: the number of independent clinics in the U.S. has decreased by over a third since 2012, making it increasingly difficult for patients to get the care they need.

“Our analysis demonstrates just how essential independent abortion providers are to the availability of compassionate abortion care throughout pregnancy, and how critical it is that they are able to stay open,” said Nikki Madsen, executive director of Abortion Care Network. “From fighting for their patients and winning at the Supreme Court to defeating political attempts to exploit the pandemic and ban abortion, independent providers continue to show up for their communities in the face of unparalleled challenges.”

Key findings in the report include:

In some parts of the country, independent clinics are the only places people can get abortion care.

  • Independent providers operate the only clinic in three of the five states with one remaining abortion clinic—Mississippi, North Dakota, and West Virginia.
  • All of the abortion clinics in Louisiana and Wyoming are independent.

Access to abortion as pregnancy progresses heavily relies on independent clinics:

  • 62 percent of U.S. clinics that provide care after the first trimester are independent;
  • 81 percent of U.S. clinics providing care after 22 weeks are independent;
  • Independent clinics are more likely to provide both medication and in-clinic abortion – 80 percent of independent clinics offer both options, as opposed to 48 percent of Planned Parenthood clinics. Limiting abortion care to medication only means that services are only available for 10–11 weeks of pregnancy.

The total number of independent clinics in the United States has decreased by more than 34 percent since 2012.

COVID-19 Impact on Abortion Care and Independent Providers

As COVID-19 continues to ravage the health care system, economy, and communities across the country, this year’s report highlights the pandemic’s impact on independent abortion providers, from financial challenges as well as increased attempts by anti-abortion elected officials to exploit the pandemic for their own political gain.

Eleven states, including Texas, attempted to effectively ban abortion via executive order, forcing clinics to cancel or delay appointments and forcing patients to decide between risking their health and safety by traveling across state lines or forgoing care entirely. Other states placed unnecessary restrictions on medication abortion care via telehealth by requiring in-person appointments and therefore forcing patients to put themselves at increased risk of COVID infection to get care.

“Our staff battled the constant changes and updates to policies and procedures, as we took all precautions to keep everyone safe,” said Marva N. Sadler, Senior Director of Clinical Services, Whole Woman's Health, LLC, in Texas. “Through it all, what has remained true is the dedication of our clinic staff and providers to protect and provide for the women and families that need our essential services. That is the light that guides us through this unforeseen time and continues to shine bright."

"For years, unnecessary restrictions have forced the doors of many abortion clinics to close. Access to abortion services is already scarce and many patients have to travel long distances and incur increased costs,” said Dr. Yashica Robinson, Medical Director, Alabama Women's Center for Reproductive Alternatives in Huntsville, Alabama. “The current pandemic has created more job loss, travel restrictions, and increased health concerns that have made accessing abortion services even more difficult. This is abundantly true for low-income patients and patients in rural areas, and the people who have been most negatively impacted are the same people who have historically been disproportionately affected by systemic healthcare disparities: people of color."

“The pandemic has hit us hard financially. Our huge concern was risk mitigation, so we made efforts to limit the number of people in the clinic and cut our appointments so we could stagger and distance patients,” said Mercedes Sanchez, Director of Development, Communications, and Community Education and Outreach, Cedar River Clinics in Washington. “Like many clinics, the majority of our revenue comes from patient services so cutting our schedule affected our financial health greatly. It feels like we are figuring out what the future holds on a month-to-month basis, and this is going to impact us financially for a long time. Our future isn't certain."

The full report is available here.

Abortion Care Network
The Abortion Care Network (ACN) is the only national membership association dedicated to independent, community-based abortion care providers and their allies. ACN works to ensure that all people are able to experience respectful, dignified abortion care. or

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Alexa Garcia-Ditta
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