Crowd gathers to hear speakers at Oct. 3 Reproductive Justice Rally in Asheville // Watchdog photo by Starr Sariego

More than half of the patients seeking abortion care at Asheville’s Planned Parenthood clinic are now coming from out of state, as nearby states move to ban or restrict the procedure in the aftermath of the Supreme Court’s Dobbs decision that struck down the constitutional right to abortion, according to Planned Parenthood officials.

Molly Rivera, communications director for Planned Parenthood South Atlantic, which runs all of North Carolina’s Planned Parenthood clinics, warned that the Asheville clinic may yet be further inundated. “As more states move to ban abortion, including South Carolina, we expect the demand to continue to increase in North Carolina, particularly in Asheville,” she told Asheville Watchdog.

The Asheville clinic is the sole provider of abortion services in Western North Carolina.

Rivera said that in North Carolina, the number of out-of-state patients accessing abortion care at Planned Parenthood’s six health centers has more than tripled since June 24, when the Supreme Court’s conservative majority overturned Roe v. Wade.  

To accommodate the increase in out-of-state patients, the McDowell Avenue Planned Parenthood health center has had to hire more staff and increase the number of appointments available for patients, Rivera said. She did not immediately respond to a question from Asheville Watchdog about the actual number of abortions being performed at the Asheville clinic.

Planned Parenthood health clinic on McDowell Avenue in Asheville // Watchdog photo by Starr Sariego

The clinic provides both surgical abortions and medication abortions, using a combination of mifepristone and misoprostol. In North Carolina, only a licensed medical doctor may perform an abortion in a hospital or clinic that has a license to perform abortions.

While abortion remains legal in North Carolina, the laws are relatively restrictive, requiring the written consent of parents or guardians, a 72-hour waiting period, banning abortion after 20 weeks (except to save the life or health of the mother), and the requirement that abortion providers be licensed medical doctors.

Bans Pending in Neighbor States

Currently, more than a third of patients seeking abortion care at North Carolina’s Planned Parenthood health centers are from out of state, Rivera said. This is a substantial increase, she noted, from last year when just 14 percent of patients were from out of state. 

The South Carolina Supreme Court temporarily blocked a ban on abortion after six weeks of pregnancy. Lawmakers there are working on a bill that would ban or further restrict abortion. In Georgia, abortion is banned after six weeks of pregnancy, before many women know they are pregnant. Abortion rights groups have sued to block the ban.

Tennessee, Kentucky, West Virginia, and Alabama have banned all abortions since Dobbs. Abortion is legal in Virginia up to viability (the ability of a fetus to survive outside the uterus, generally about 24 to 26 weeks), but the right to abortion is not protected by state law. 

Jacquelyn Hallum of Asheville speaks at Reproductive Justice Rally // Watchdog photo by Starr Sariego

According to Dr. Rathika Nimalendran, a family health physician in Chapel Hill, N.C.,  many North Carolinians also must travel for abortion care because, she told WNUC, “91 out of 100 counties have no abortion provider.”

Top Republican leaders in North Carolina are vowing to ban or further curb the right to abortion.

Their first victory came in August. After the Dobbs decision, Senate leader Phil Berger (R-Eden) and House Speaker Tim Moore (R-Kings Mountain) urged U.S. District Court Judge William Osteen Jr. to lift an injunction that he had imposed in 2019 on an abortion ban after 20 weeks. That ban was enacted in North Carolina in 1973, the year of Roe v. Wade.

On August 17, Judge Osteen lifted the ban, reducing abortion access in the state from fetal viability — usually between 24 to 26 weeks — to 20 weeks with few exceptions. According to the North Carolina Department of Health and Human Services, only 30 abortions were performed after 21 weeks, or 0.1 percent of the total of 24,694 in state procedures in 2020.

GOP Lawmakers Promise Ban

Anti-abortion Republican state lawmakers have promised to introduce an abortion ban next year if they can gain a supermajority in the North Carolina legislature. While Republicans currently control both houses, a supermajority would allow them to override a veto by Democratic Gov. Roy Cooper, an abortion rights supporter.

Republicans will need to gain two Senate seats and three House seats, and hold all of their current seats. “If they secure enough votes to override Governor Cooper’s veto, then Virginia would be the next closest state with legal abortion,” Rivera said.

Asheville Mayor Esther Manheimer speaks to crowd at a Reproductive Justice Rally in Asheville. Dr. Rathika Nimalendran, Congressional candidate Jasmine Beach-Ferrara, and Lindsey Prather, a candidate for NC House dist. 115, are in background. // Watchdog photo by Starr Sariego

Buncombe County Democrats are working to mobilize voters. “We are one bad election away from losing abortion rights,” state Rep. Caleb Rudow (District 114) said at an abortion rights rally at the Orange Peel in Asheville on Oct. 3.

Other Democratic elected officials, including Buncombe County Commissioner Al Whitesides and state Sen. Julie Mayfield attended, and speakers included Asheville Mayor Esther Manheimer and Buncombe County Commissioner Jasmine Beach-Ferrara, who is also the party’s candidate for the District 11 U.S. House seat.

Manheimer told the rally that the Dobbs decision and the threat of losing abortion rights in North Carolina “makes me want to scream. Please scream your vote.”

Beach-Ferrara called western North Carolina “a place of great political consequences,” and pledged to “fight for our fundamental freedoms.”

Nimalendran, the Chapel Hill physician, also spoke at the rally and said the right to abortion care “should not be an elephant in the room between me and my patient.”

A majority of North Carolina voters support abortion rights

A post-Dobbs poll of North Carolina voters found that a majority opposes further restrictions on abortion. Among all groups of voters, only Republicans favored banning or making abortions more difficult to obtain. 

After Ohio’s new abortion restrictions forced a 10-year-old girl to travel to Indiana to get a legal abortion after being raped, western North Carolina Congressman Rep. Madison Cawthorn (R-Hendersonville) introduced a bill in Congress to limit travel across state lines for abortions.

Given public sentiment, some Republicans appear to have recently softened their public stances on abortion bans, though Gov. Cooper warned that they should not be believed.  

“Don’t be fooled by what they say now before an election,” Cooper wrote on Twitter. “Republican supermajority would override my veto and pass an extreme abortion ban with no exceptions.”

Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Barbara Durr is a former correspondent for The Financial Times of London. Contact her at