ATLANTA — Georgia's abortion clinics remain open and their phones are ringing off the hook.
But a bit more than a month after the state's strict new abortion law went into effect, the clinics are turning more patients away.
And with abortions banned or severely restricted in many nearby states, women seeking the procedure are traveling ever-longer distances as they also try to avoid long wait times.
"The whole South right now is difficult," said Melissa Grant, chief operating officer of Carafem, which operates an abortion clinic in Buckhead. "All of the states are trying to get appointments at the same few places."
Georgia is on the edge of a Southern swath of states, including Alabama and Mississippi, that have introduced even-stricter abortion bans this summer. That has sent many women to North Carolina and Florida, two neighboring states with more lenient laws that are struggling to handle the influx.
"Our North Carolina facilities are swamped," said Calla Hales, executive director of A Preferred Women's Health Center, which has clinics in Charlotte and Raleigh, as well as Forest Park and Augusta in Georgia. "There are tons of patients that we're not able to see."
Callers to North Florida Women's Services in Tallahassee, a short drive from Georgia's southern border, are being asked to be patient.
"We are now servicing the entire Southeast of the country and the hold time may be prolonged," said an automated phone greeting.
Adding to the confusion, state laws are still in flux. On Thursday, a near-total abortion ban took effect in Tennessee, which previously allowed the procedure in the first six weeks of pregnancy. The week before, South Carolina's highest court temporarily blocked its state's law banning abortions once fetal cardiac activity is detected. The same day, North Carolina tightened its laws.
Scrambled plans and growing wait times can push women who would have been administered abortion pills in the first 11 weeks of pregnancy into surgical abortions — or past the point of qualifying for an abortion at all.
Georgia's new abortion law went into effect July 20, a little less than a month after the U.S. Supreme Court overturned Roe v. Wade, the landmark 1973 decision that had constitutionally protected abortion.
The new state law prohibits most abortions after fetal cardiac activity is detected, usually about six weeks into a pregnancy. The previous law allowed abortions up until 22 weeks. The new law allows for later abortions in cases of rape, incest, if the life of the pregnant person is in danger or if the fetus would not survive.
Several nearby states have recently banned abortions beginning at conception. Florida and North Carolina's abortion bans kick in later, at 15 weeks and 20 weeks, respectively.
In metro Atlanta on Tuesday, cars started to pull into Feminist Women's Health Center by 6 a.m.
Security officers had set up earlier to guide those seeking abortions away from two regular protesters with loudspeakers at the Brookhaven clinic.
"You're sacrificing a baby on the altar of convenience," said Jason Cantrell, a Kathleen resident who travels to the clinic three times a week to discourage women from getting abortions. "Please have mercy on that baby."
Several people waiting in their cars while friends or family were inside the clinic exchanged heated words with the protesters. "You're going to burn in hell," one driver yelled at Cantrell as she sped out of the parking lot.
About a dozen patients filtered through the abortion clinic on Tuesday. A handful were turned away because their pregnancies were too far along to comply with Georgia's new law.
"Our phone educators are trying to explain to people over the phone before they come so that they can use their judgment because we don't want them to have to make multiple trips to multiple clinics if they don't have to," said Kwajelyn Jackson, the clinic's executive director.
Jackson said the clinic saw more than 230 patients in the first month after Georgia's abortion law went into effect. Of those, slightly more than 50 were turned away after an ultrasound detected fetal cardiac activity. The clinic performs abortions four days a week.
The number of abortions at Feminist Women's Health Center has yo-yoed throughout the spring and summer. Before the U.S. Supreme Court decision in June, the clinic performed about 60 abortions each week. That number jumped to about 150 a week in the 26 days between the repeal of Roe v. Wade and a federal appeals court allowing Georgia's law to take effect. Now it performs about 40 abortions a week, including for some women traveling from Alabama and Tennessee.
A Preferred Women's Health Center in Forest Park performed 20 to 30 abortions a day, six days a week, before Georgia's law took effect, according to Hales. Now, the clinic sees 15 to 20 patients on a busy day, and of those, five or six still legally qualify for abortions. Most of the rest are referred to the network's North Carolina clinics.
At Planned Parenthood's clinic in Asheville, North Carolina, less than two hours from the Georgia and Tennessee borders, about one-third of patients are coming from out of state, said Jillian Riley, a public affairs director for Planned Parenthood South Atlantic.
North Carolina clinics have reported extending their hours. Planned Parenthood is hiring more nurses and administrative staff there.
"Right now, we're able to meet all our patients' needs, but that could change depending on other state laws and also what happens in the North Carolina elections," said Riley, referring to efforts in that state to restrict abortions further.
Planned Parenthood's health centers in northern, southern and eastern Florida saw a 40% increase in patients seeking abortions after the Georgia restrictions took effect last month, spokeswoman Christina Noce said. Volume increased by 27% in Tallahassee and 40% in Jacksonville, the two clinics closest to Georgia. The majority of out-of-state patients come from Georgia, an average of 60 to 70 a week.
"People will drive through the night," said Laura Goodhue, executive director of the Florida Alliance of Planned Parenthood Affiliates. "We also see people in Miami, if they can get a plane."
Planned Parenthood is in the process of hiring nine new doctors in Florida, Goodhue said.
Some Southern patients are traveling as far as Illinois and Kansas for abortions, especially if they have family or friends there to stay with, according to various clinic officials.
Clinics are giving varying amounts of help to those they turn away.
Planned Parenthood Southeast, which has three clinics in metro Atlanta and one in Savannah, initially planned to provide money for patients who needed to travel out of state for abortions. It is instead directing them to abortionfinder.org, spokeswoman Lauren Frazier said.
Anti-abortion lawmakers across the country have said they plan to target people or organizations who pay to transport abortion patients from states where it is illegal. The National Right to Life Committee in June proposed that states charge those who help abortion patients with felony conspiracy or "aiding and abetting."
Planned Parenthood Southeast is working with lawyers to determine whether Georgia's law allows the organization to provide travel resources for patients who would not qualify for abortions in the state, Frazier said. The Planned Parenthood affiliate also operates in Alabama and Mississippi and has those states' laws to consider as well, she said.
"We just aren't sure of what we can and can't do legally," Frazier said. "As an organization, we have to decide how much risk we're willing to take."
But neighboring Planned Parenthood affiliates are running their own systems that help patients traveling into Florida and the Carolinas.
A spokeswoman for Georgia Attorney General Chris Carr did not respond to questions about whether Georgia's law criminalizes helping patients leave the state for abortions.
Some clinics aren't shying away.
When the Jackson Women's Health Organization, the Mississippi clinic at the center of the case that overturned Roe v. Wade, closed July 6, its patients were referred to the sister Columbus Women's Health Organization in Georgia, said Diane Derzis, owner of both clinics. After Georgia's law took effect, the Columbus clinic, while still open, largely became a referral center.
"Women finding out they're pregnant that early in the pregnancy is not the norm," she said. "Many people calling are in a place where they know they're not able to be seen."
The clinic is sending some patients to a new facility in Bristol, Virginia, on the Tennessee line. The Pink House Fund, an affiliated nonprofit, pays some expenses and connects patients with additional funding.
Access Reproductive Care-Southeast, which provides financial aid to abortion patients from six Southern states including Georgia, last month received $300,000 from the city of Atlanta and has received hundreds of thousands more in individual donations since a draft of the U.S. Supreme Court ruling overturning Roe v. Wade leaked in May, said Jalessah Jackson, interim executive director.
The donations are paying for the increased number of patients and the costs of traveling longer distances. The nonprofit hit a monthly record of 800 callers after the Supreme Court ruling, according to Jackson. Since Georgia's "heartbeat law" took effect, the organization has provided financial assistance to 52 patients, including 25 from Georgia. ARC-Southeast established a relationship with a clinic in Virginia after noticing many headed there.
In Brookhaven, Feminist Women's Health Center has no plans to close down. The clinic, which opened in 1976, also offers gynecological services, prescribes birth control, tests for diseases spread through sex and assists with gender transition.
"I can't predict the future. But I can say I feel like we're in a position to be able to survive this moment and come out the other side," said Kwajelyn Jackson, the director.
