BRISTOL, Tenn. and BRISTOL, Va. — The community of Bristol is proud to straddle the border between the two kingdoms
The Tennessee flag flies on the south side of State Street, the Virginia flag on the north. A plaque in the middle of the main downtown street marks the division of the twin cities. A large sign at the end of town reminds everyone that they are right on the state line.
After the decision of the US Supreme Court in June Dobbs v. Jackson Women’s Health Organization, which returned abortion control to the states, such boundaries make all the difference in what care is available In Tennessee, most abortions will soon be illegal. In Virginia, they won’t be.
For staff members at Bristol Regional Women’s Center, an OB-GYN practice that offers abortions in Bristol, Tennessee, Virginia’s proximity creates an opportunity. They could secure access by helping open a clinic across the state line in Bristol, Virginia.
“Why did we choose Virginia?” asked Diane Darzis, who owns the clinic, which opened in July about a mile across town. “It just made sense.”
Clinics across the country are still adjusting to the new legal landscape being created Dobbs. Some have stopped altogether. Others have scaled back the services they offer. Still others migrated hundreds of miles away.
A federal appeals court has allowed Tennessee’s six-week abortion ban to go into effect, and the nearly complete ban is set to begin in late August. Meanwhile, Virginia still allows most abortions through the second trimester.
Bristol, Virginia Mayor Anthony Farnum said neighboring cities are governed independently and subject to different state laws. He said the Covid-19 pandemic has given a good example. “It was interesting,” Farnum said, sitting outside the burger bar, a diner a stone’s throw from the state line. “The bars on the Virginia side closed at 10pm and masks were required. Bars were open until 2 a.m. on the Tennessee side, no masks required.”
Also, each state handles sales and income taxes differently, Farnum said. And his town is home to Virginia’s first casino, something not found in Tennessee. What is happening with abortion is the latest example.
Darzis said a doctor at the Bristol Regional Women’s Center approached her about the Virginia clinic idea. Jackson Women’s Health, owned by Darzis, is a clinic located in central Mississippi Dobbs Lawsuit, she said, is working to offer abortions to people across the Southeast who have lost access because states have restricted the procedure. She opened Las Cruces Women’s Health in southern New Mexico in late July after closing her clinic more than 1,000 miles away in Jackson, Mississippi.
“It’s like a game of dominoes. It’s just a huge chunk of states that are no longer offering the service,” Darzis said. “So those women have to go north or west.”
Darzis opened the clinic in Bristol, Virginia — registered with the state as Bristol Women’s Health — in late July and said she already has some patients. Darzis said the Tennessee and Virginia clinics are separate, independent operations.
Relocating a medical practice across state lines presents several costly logistical challenges.
Deborah Jo Adams, who works at the Bristol Regional Women’s Center, raised more than $100,000 for the new clinic through an online fundraiser. The money will help raise “additional legal fees for practicing in Virginia, new certifications, licenses and regulations, price increases for certain medical equipment and unexpected building repairs,” he wrote on the fundraising page.
In the past, an OB-GYN in Greenville, Tennessee, Dr. Howard Harrell referred women to clinics in Bristol and Knoxville, Tennessee, and Asheville, North Carolina — about the same distance from his practice.
But even those clinics — at least an hour away by car — aren’t guaranteed to be there forever, he said. In recent months, both Knoxville clinics that offered abortion services closed after a fire, and the future of clinics in nearby states is uncertain.
“It all depends on what happens with the legislation over time in Georgia, North Carolina and Virginia,” said Harrell, incoming chair of the Tennessee chapter of the American College of Obstetricians and Gynecologists.
Bristol Regional Women’s Center, Tennessee Clinic, sits next to a busy, four-lane highway that roars with heavy truck traffic. But that doesn’t stop protesters from gathering outside the clinic that provides abortions a few days a week.
On a recent weekday morning, a handful stood on the sidewalks surrounding the clinic holding anti-abortion signs. On the clinic’s property, a group of volunteers who identified themselves as the Pink Keepers held up pro-abortion rights signs and hung large sheets in various shades of pink and purple around the clinic’s parking lot. They stay here regularly in an effort to prevent patients from being harassed by anti-abortion protesters.
“Horn twice for choice,” read a sign, which faced oncoming traffic. Pink defenders cheer when drivers oblige.
Erica Schanzenbach, who opposes abortion and has long been the subject of civil lawsuits because of protests outside the Tennessee clinic, said she heard about the Virginia clinic from an online fundraiser. This summer, he distributed fliers in neighborhoods around the new clinic encouraging locals to call city officials and the property owner to complain.
“When we were telling people about this clinic coming to their neighborhood, there were quite a few people who didn’t know,” Schanzenbach said. “A lot of people don’t want that around them.” He said he plans to protest there as well.
Farnum, the Virginia mayor, said he had received dozens of calls and emails from residents concerned about the clinic — “a lot for a town this size.” But he told them there wasn’t much he could do to stop it. “It’s really more of a state decision. And currently, at this point, the state law is that it’s legal to operate in that state,” Farnum said. “Our hands are kind of tied. We don’t really have anything to vote for.”
For now, there isn’t much activity at the Virginia clinic. The low brick building sits at the end of a residential street. On a recent weekday morning, a small pile of empty boxes, previously full of new office supplies, sat outside. While Pink Defenders and protesters gathered at the Tennessee Clinic about a mile away, Virginia sat a quiet, empty.
To Max Carwill, it symbolizes resilience. She is the program director of the Abortion Access Front, a national abortion rights group, and a co-founder of the Mountain Access Brigade, an abortion fund that works in East Tennessee.
He grew up in the area, which he calls a “healthcare access desert,” and said opening the clinic in Bristol, Virginia, would mean “a world of difference to patients” — even if people can’t make it, the door is forever open.
“It’s amazing for people who have access to short distances,” said Lori Williams, chairman of the National Abortion Federation’s board of directors. “For those who are able to move great distances, it’s also amazing. But there are many of us who will never be able to make that move.”
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