Heavy rains from Hurricane Helene caused record flooding and damage on Sept. 28 in Asheville, North Carolina. The city is home to the only abortion clinic and high-risk obstetrics center in the western part of the state. (Melissa Sue Gerrits/Getty Images)
Since Hurricane Helene struck North Carolina in late September, the full spectrum of reproductive health care in the region has been in precarity, from treatment for high-risk pregnancies to abortions.
Western North Carolina’s only abortion clinic is still closed, and third-trimester, high-risk pregnant patients have been transferred out to hospitals across the state, health care workers told States Newsroom.
Dr. Bhaskari Burra is an Asheville-based OB-GYN who works at the only high-risk obstetrics center in western North Carolina. She’s also a fellow with Physicians for Reproductive Health.
The clinic had to close after the storm and wasn’t able to fully open back up until the middle of October, Burra said: “We’re already in a maternity care desert in this area and that sort of further ostracized people from accessing care on the outpatient side.”
Asheville is the seat of Buncombe County. But six nearby counties — Alleghany, Clay, Graham, Madison, Mitchell and Swain — have no hospitals or birth centers that offer obstetric care, according to the March of Dimes.
“On the inpatient side, folks who are high risk and already hospitalized prior to the storm were transferred to other facilities” in the east, including hospitals in Chapel Hill, Charlotte and Greenville, North Carolina.
Some patients were transferred to Greenville, South Carolina.
Mission Hospital in Asheville had no running water for four days, according to AVL Watchdog. Burra said the labor and delivery unit was open for emergencies and people who could not evacuate.
“Imagine if you’re postpartum, if you’ve had a C-section and you also have an abdominal incision to care for — and obviously a baby to care for. That is impossible to do without access to clean water,” Burra said, adding that they encouraged new mothers who could to evacuate.
Even though Burra’s clinic is fully operating now, they’re still dealing with the effect of the storm, more than a month after landfall.
“I think we’ll be seeing the ramifications of this from a patient standpoint for a long time,” she said.
Ash Williams, a member of Mountain Area Abortion Doula Collective, echoed that sentiment.
“People were really talking about the impact of the storm two weeks ago, and now some of that support and attention is dwindling, but there are still people that are really impacted and needing support,” he said.
It’s unclear when Planned Parenthood’s Asheville Health Center will reopen, but staff hopes to resume abortion services soon, said Molly Rivera, the organization’s regional spokesperson.
The clinic has been closed since the storm landed in Asheville on Friday, Sept. 27, she said.
Patients were rescheduled to affiliate clinics in Charlotte and Winston-Salem. Telehealth appointments for birth control and gender-affirming care were not interrupted by the hurricane, Rivera said.
But telehealth appointments for medication abortion are not available. Even though a federal judge struck down several restrictions on medication abortion in June, North Carolina law still requires patients to fill out informed consent paperwork in-person.
North Carolina has been under a 12-week abortion ban since July 2023, but the state is still considered an access point in the Southeast, where most abortions are illegal. South Carolina law bans abortions past six weeks, with limited exceptions.
With the Asheville clinic’s closure, Tennessee patients were especially affected, Rivera said. Major parts of Interstate 40 between Tennessee and North Carolina were damaged by the storm.
Patients from out of state seeking abortion can turn to abortion funds. But since the U.S. Supreme Court overturned Roe v. Wade more than two years ago, fund operators say donations have dwindled.
In July, the National Network of Abortion Funds — Carolina Abortion Fund is a member — announced it would cover 30% of abortion costs, down from covering half of the costs, States Newsroom reported.
Williams said his group helps fill in the gaps in abortion access in the western part of the state, and for people in Georgia, South Carolina and Tennessee who need abortions. But after the storm, the collective decided to focus on people who needed abortions in their region, he said.
A national organization called Elevated Access that flies people across the country to get abortions recently sent a plane full of supplies — emergency contraception, period products, pregnancy tests and gender-affirming care products — to Asheville to help with relief efforts, according to Williams and Mike Bonanza, the group’s executive director.
“The storm made people outside of the affected area want to support abortion access with funding. We were able to raise money to support the people that were needing care, and we did see a little bit of an influx of funding during the storm,” Williams said. “But similar to how it goes after a ban and a restriction, people will sometimes donate a lot of money to abortion funds. And then weeks later, we’re seeing those things dwindle and die down. That is kind of what we’re noticing now.”