By Rachel Crumpler
North Carolina now has one fewer abortion clinic, shrinking access to the procedure in a state where nearly 48,000 abortions were provided in 2025.
Last week, A Woman’s Choice closed its clinic in Greensboro, North Carolina’s third-largest city. The closure leaves 17 abortion clinics in North Carolina, scattered over nine counties across the state, that provide in-person abortion care to thousands of patients — including people traveling from more restrictive states across the Southeast.
Amber Gavin, vice president of advocacy and operations at A Woman’s Choice, said the decision to close one of their three North Carolina clinics stemmed from a “hostile political environment” and financial strain.
The decision wasn’t made lightly, she said.
“It’s really hard to know that we have to close our doors when we know that we have been a crucial access point, especially in Greensboro, for people for over a decade,” Gavin said. “It directly impacts our patients. It means longer travel times, more time off of work. There’s additional costs, and we also know that these folks are already our most vulnerable.”
Nationally, the number of brick-and-mortar abortion clinics shrank by 2 percent — to 753 clinics — between March 2024 and the end of 2025, according to the Guttmacher Institute, a national organization that tracks trends in reproductive health. This marks the first abortion clinic closure in North Carolina since the Supreme Court’s 2022 Dobbs decision, which overturned Roe v. Wade, the 1973 Supreme Court decision that had established the right to an abortion.
Operating an abortion clinic has long been a precarious business undertaking. Providers have to navigate changes in laws, the politicization of providing abortion care and tight financial margins, as many insurance plans do not cover abortion and patients often struggle to pay.
Gavin said sustaining operations got much tougher after North Carolina’s increased abortion restrictions took effect July 1, 2023, shortening the window for most abortions from 20 to 12 weeks. The change reduced the number of patients that clinics could serve.
The law also mandated that patients receive in-person counseling 72 hours before a procedure, creating more logistical hurdles for patients and providers.
“It’s double the amount of appointments for the same amount of money that we were bringing in for care — double the staffing days, double the resources,” Gavin said.
That added strain on clinic operations.
Patient volume further declined in 2024 when Planned Parenthood began dispensing abortion pills at its Greensboro location, Gavin said.
“It all compounds,” she said.
While the number of abortions had been steadily declining at the Greensboro clinic, Gavin said more and more patients from North Carolina started skipping Greensboro altogether, instead traveling to A Woman’s Choice’s abortion clinic in Virginia, where abortion access is less restricted.
The Danville clinic, which opened in February 2024, is 47 miles from where the Greensboro clinic was located — roughly a 50-minute drive. At the Virginia clinic, patients can get an abortion in a single visit at up to 20 weeks gestation.
A Woman’s Choice still has clinics in Raleigh and Charlotte, as well as in Jacksonville, Florida.
“We’re taking all of our resources from inside the Greensboro clinic and reallocating and putting them into other clinics to amplify them and make sure we’re continuing to provide really great patient care,” Gavin said.
She said the remaining clinics are in a “good place” and will be strengthened by the added resources, which will allow them to expand capacity.
“When a clinic closes, abortions don’t stop,” Gavin said. “It just means that the where and how shifts, and it just makes it harder for patients, and sometimes harder for providers as well.”
Feeling the strain
A Woman’s Choice isn’t alone in facing financial and operational strain. Other North Carolina abortion providers say they are feeling similar pressure.
Since 2016, Calla Hales has been executive director at A Preferred Women’s Health Center, which operates two abortion clinics in North Carolina and two in Georgia.
She said the challenges of operating have intensified in recent years, culminating in the toughest climate she’s faced.
“It’s definitely much more precarious than it was,” Hales said. “I’m not naive enough to think that this wasn’t the intended outcome of a law like Senate Bill 20,” the 2023 law that imposed new restrictions on access to abortion services.
“The struggle is by design,” she said.
“Nothing feels stable, nothing feels certain,” Hales said about the clinics she operates. “I don’t feel secure. I mean, hell, this past week alone, we’ve had laws change within 24 hours,” referring to opposing rulings handed down by federal courts on dispensing mifepristone, one of two medications used to provide medication abortions. One ruling limited telehealth and mail access to mifepristone, and a second one stayed that ruling.
Abortion providers across the state scrambled to adjust workflows and expand capacity after North Carolina’s increased abortion restrictions took effect. The providers’ efforts have allowed the state to increase abortion volumes by about 3 percent last year over 2023 despite the tighter limits, accommodating floods of patients from other states that have tightened restrictions in the wake of the Dobbs decision.
Still, providing care now requires more time, staffing and coordination.
“It was a massive project to be able to accommodate all of those in-person consents,” Katherine Farris, Planned Parenthood South Atlantic’s chief medical officer said, noting that the patient consent process could previously be done over the phone.
Farris said Planned Parenthood South Atlantic hired more staff to manage the increased appointments and established a patient navigation program to help patients manage the logistics of care. Since April 2025, patient navigators have helped about 3,700 patients access abortion care, according to Planned Parenthood data provided to NC Health News.
“Everything is harder with the law,” Farris said. “We have excellent support from donors and supporters that allow us to be perhaps more agile than some other clinics, and give us a little bit of more flexibility.
“It is incredibly difficult to provide this care right now — and it is also our mission to do so. If somebody puts up a barrier, we’re going to help our patients jump over it.”
Sustaining that level of care over time takes a toll, fueling burnout among staff, Hales said.
Broader economic pressures — including rising inflation and gas prices from the Iran war — are adding to the strain.
“This moment would have felt tough regardless, without the economic piece to it,” Hales said.
Rising costs — particularly for travel — are making it harder for some patients to reach clinics, Hales said. Abortion seekers traveling many miles for care are feeling the pinch at the gas pump; the current average price of a gallon of regular gas is $4.22 in North Carolina — up from $2.86 a year ago, according to AAA.
Hales said there’s been a noticeable decrease in patients in the past few months. She said they’re still calling for appointments but increasingly aren’t making it to the clinic.
“When we call patients back and ask them if they want to reschedule, it’s really always the same: ‘I can’t afford to make it there right now, or I can’t get child care. I can’t make it work.’
“They’ll try to reschedule, and they’ll try to find funds — but it is just so hard.”
To cope with financial pressure, some businesses have passed on increased prices to consumers. Hales said that’s not a viable option for abortion providers, given how many patients already struggle to pay and need to turn to strapped state abortion funds to help afford the procedure.
That leaves clinics working on increasingly tight margins, as her own supply and operational costs rise.
“In a lot of places, a lot of good providers are struggling just to really make it work, to get by — between their own finances and patients being able to make the travel to get there,” Hales said.
Farris said Planned Parenthood closely monitors demand at its eight clinics that offer abortion care in North Carolina and adjusts operations as needed — including for any additional need that may arise from the Greensboro clinic closure. The average wait time now for an abortion at a Planned Parenthood clinic in North Carolina is about seven days, a Planned Parenthood spokesperson told NC Health News.
“We will increase the number of clinics we’re offering, or add more visit slots, or add more consent visits if we see that there’s an increased demand, because we find that demand does fluctuate over time, and we try to be very aware of that,” Farris said.
Mifepristone access
While brick-and-mortar clinics still provide the majority of abortions, an increasing number of people are obtaining care through telehealth, with providers from states with shield laws in place sending abortion pills by mail.
In the first six months of 2025, 27 percent of the 591,770 abortions obtained in the U.S. health care system were provided through telehealth, according to the latest #WeCount report, an abortion data collection effort led by the Society of Family Planning. By June 2025, nearly 15,000 abortions were provided under shield laws, accounting for more than half of total telehealth abortions.
North Carolinians are also taking advantage of this means of access. In the first six months of 2025, about 18 percent of total abortions in North Carolina were obtained by telehealth through out-of-state shield law providers, according to #WeCount data.
This access became possible when the U.S. Food and Drug Administration eased restrictions on the abortion medication mifepristone by eliminating the in-person dispensing requirement — a rule change made permanent in January 2023. That change expanded access, including by allowing the drug to be mailed. Studies show that abortion provided through telehealth is as safe as in-person care.
However, this provision of medication abortion has become the subject of multiple lawsuits as anti-abortion advocates have worked to curtail access to mifepristone in the years since the 2022 Dobbs decision. On May 1, a federal appeals court in Louisiana ruled to reinstate an in-person dispensing requirement on mifepristone nationwide — a major upheaval to abortion access. The Supreme Court stepped in on May 4 to issue a one-week administrative stay preventing that ruling from going into effect until at least May 11, giving all nine justices time to consider whether the in-person dispensing requirement can be reimposed while the case proceeds.
Abortion providers in North Carolina are closely watching the case and preparing for possible changes. Because North Carolina’s law already adds restrictions beyond the FDA’s rules — requiring all medication abortion pills to be dispensed in person by a physician after a 72-hour waiting period and state-mandated counseling — the impact of any rollback in access could be less pronounced in the state than elsewhere.
Still, any reduction in access to mifepristone would put new pressure on the state’s abortion clinics to absorb patients — in state and across the Southeast — who would otherwise seek care remotely.
“A lot of online things have opened, and I think if something’s really going to make a huge impact on the [abortion] landscape, it’s going to be the decision [on what happens to mifepristone],” Hales said.
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