They also keep gas cards on hand, since transportation issues often mean patients miss appointments, and help find emergency housing for those in need. A makeshift food pantry started in January is filled with boxes of macaroni and cheese, canned goods and baby food.
by Savonne N. Torain, Heartbeat International Headquarters
TUSCALOOSA, Ala. — Once, it was the sole abortion clinic in this half of the state. Then Roe v. Wade fell, the legislature’s near-total ban on the procedure took effect, and the protesters who would mass in the parking lot vanished. Nowadays, the crowd that gathers when word goes out follows the handwritten signs for “FREE STUFF.”
In the post-Roe world, the clinic has become an unlikely safety-net provider in one of the reddest states — which has some of the country’s lowest rankings for maternal and infant health. With billions of federal dollars for Medicaid and related programs threatened in Washington, staff are bracing for a cascade of cuts that would make their work even more challenging.
When the U.S. Supreme Court ended a constitutional right to abortion in 2022, the several hundred patients whom the clinic scheduled monthly evaporated overnight and staffing was cut to just a few positions. Other abortion clinics went further. Reproductive Health Services of Montgomery, the longest-standing abortion facility in Alabama, shut its doors. Whole Woman’s Health closed all of its Texas locations. A clinic in Jackson, Mississippi, was sold, while a few elsewhere relocated to blue states such as Illinois and New Mexico.
In Tuscaloosa, Marty committed to remaining open and serving the most vulnerable female patients, slowly rehiring and expanding services to meet their needs. The clinic employs eight people, including a community outreach coordinator, a mental health counselor, doulas and midwives — who later this year will be able to deliver babies in a birthing center converted from what was once an abortion recovery room. Many of the 150 patients seen monthly have multiple needs, and the staff test for HIV and other sexually transmitted diseases, counsel on substance abuse and even fund care for dental needs, a leading cause of miscarriages.
Robin Marty, director of the West Alabama Women's Center
“We get a lot of unhoused population who come through here. How are you going to raise a child if you don’t have stable housing?” Marty said. “You can’t take a baby home from a hospital if you don’t have a car seat. What are you going to do? That’s one of the reasons we make sure everybody has car seats.”
Outside Alabama’s major cities, low-income women have relatively few options. Local health departments often have small staffs, and the wait for basic care can last months. Tuscaloosa is home to a federally qualified health center, with satellite locations serving parts of western Alabama. Another FQHC serves central Alabama. The state’s only Planned Parenthood clinic is nearly an hour away in Birmingham.
Midwife Nancy Megginson began working here last fall after seeking permission from the elders of her evangelical church.
Midwife Nancy Megginson began working here last fall after seeking permission from the elders of her evangelical church.
“Is it in line with our values?” they asked.
Yes, she told them.
“Would you be providing any abortions?”
No, she assured them.
Megginson, who had just had her fourth child, ended maternity leave a month early to join the clinic and at first brought her infant son with her. She relishes “being able to problem-solve and address people being underserved.” A quarter of pregnant women in Alabama receive no prenatal care. As a former labor and delivery nurse, Megginson is well aware of the complications that can result.
“This job meant so much, to meet a greater need,” she said.
One patient that day had come two hours from her home in rural Thomasville.
“There’s nowhere else for me to go,” said Tawney Thurston, 28, and three months pregnant, as she sat in an exam room after getting an ultrasound. “If this place wasn’t open, I probably wouldn’t have had an appointment.”
