Clinic facilities

Clinic staff grapple with trauma after abortion decision

CHARLESTON, West Virginia — Danielle Maness shook hands with hundreds of anxious patients lying on tables in the now empty operating room. She recorded countless vital signs and delivered dozens of snacks to the now quiet recovery area.

Peering into every dark room at West Virginia’s only abortion clinic, the head nurse wondered if she would ever again treat patients here for abortion care.

“It literally makes me sick, and we don’t know what their future holds for them,” Maness said of the residents who rely on the West Virginia Women’s Health Center. “It’s the kind of grief that’s hard to put into words. There are all those “what ifs”.

The waiting room should have filled with patients over two days last week, when the clinic books all slots for abortion appointments. But since the U.S. Supreme Court overturned Roe v. Wade days earlier and ruled that states could ban abortion, the clinic was forced to suspend the procedures due to an 1800s state law banning them. The ACLU of West Virginia filed a lawsuit on behalf of the clinic, asking that the law be declared unenforceable so staff can immediately resume abortions. Other states are in various stages of legal limbo.

Across the country, clinic workers who have shut down abortion services are feeling fear and stress as they try to pick up the pieces and chart a path forward. At the West Virginia center, the days following the court’s landmark decision brought a different kind of heartbreak for staff as their new reality settled in, Maness said, which will linger long after the initial trauma of the decision. .

Conversations with frantic patients that first day are spinning in his head.

“I don’t think any of us can block it,” she said. “It’s constantly on our minds.”

Like many clinics that perform abortions, the facility did not offer the procedure daily. Several days of the week are devoted to routine gynecological care — cervical exams, cancer screenings — mostly for low-income patients on Medicaid who have nowhere to go. The desire to continue this work stimulated the employees.

Immediately after the decision was released, Maness was one of the few staff members responsible for calling patients to cancel abortion appointments. On the other end of the line, she had never heard people speak with such fear.

The entire staff found itself in crisis mode for days, although they and others across the country waited months for the decision. “You think you think you’re ready for the moment, but you’re never really prepared until it’s a reality,” said general manager Katie Quiñonez.

She watched her staff break down and sob. Some were calling patients or answering the phone. Workers who had the day off showed up, some still in pajamas, to relieve their colleagues and offer their support. Quiñonez encouraged everyone to take breaks, often handling the phones herself.

She will always remember that Friday as one of the worst days of her life. Over the weekend, she turned off her phone, lay under a weighted blanket on her couch, ate junk food and watched TV. It was the only way for her to escape and cope.

When she and her staff returned to work, she waited to fill vacancies from canceled abortion appointments. Some patients still needed other services, but she wanted to let the workers catch their breath. She told them to come late if necessary. The clinic rooms remained largely empty, dark and silent.

Still, the phones rang.

Beth Fiddler sat at her desk behind the clinic’s glass reception window in the waiting room. She had no patients to register, no Medicaid data to scan into charts, no information packets to hand out.

Instead, she found herself answering the same questions over and over again, referring callers to a hotline or website to help them find the nearest out-of-state abortion provider.

“You’re going to close soon, aren’t you?” No, the clinic will be open to provide other services.

“Can I have Plan B – the morning after pill?” What about an IUD or other method of contraception? “I’ll help you make an appointment.

“Are you sure I can’t make an appointment for an abortion?” Isn’t there a gap, an exception?” There are no abortion services at this clinic.

Some callers were in denial. Some remained stoic, others wept. A few responded with hostility, insisting that Fiddler was wrong. She tried to be polite, empathetic – but conversations have an impact.

“It frustrates me,” she said. “I’m already stressed and upset. I understand wanting to find a way, but there’s no way.

As one of the first workers patients see, Fiddler takes pride in making people feel welcome and safe. Having to refuse them and just send them back to a website is gutted, she said.

“As helpless as I feel about it, I can’t imagine how they must feel,” she said.

Outside the clinic, it’s quiet too. There is no buzz of patients arriving in the parking lot to be escorted by volunteers in pink vests. The only cars belong to staff members and a security guard. Across the street, land owned by an anti-abortion organization is vacant except for a large white cross.

A regular protester, a pastor with a “Jesus loves you” sign, prayed outside a few mornings, but the usual crowd pleading with patients to reconsider disappeared. Some cars slow down as they pass. Workers recognize some of them as protest vehicles and imagine the clinic is being watched – to make sure patients don’t show up for abortions.

Manager Quiñonez said she knew the next steps would be difficult, with a long way to go for workers to recover from the pain.

“Our staff need space and time to process this very traumatic loss,” she said. “And all the secondary trauma that we experience from all the patients.”

Just being at work is hard, but employees are dedicated to helping patients.

“We arrived on Monday and I was kind of like, ‘OK, what do I do now?'” said Kaylen Barker, who handles the clinic’s public messaging. “It’s bleak to come back here and realize we won’t be able to provide the life-saving care people need and we’re going to have to refer them to websites. It’s the best thing we can do right now. »

Barker came to the clinic as a patient during a breast cancer scare 12 years ago. She got treatment when she had no other options. She knew she wanted to work at this place which saved her, so she applied until she was finally hired. Knowing that she can help others like she keeps her alive, whether abortions are scheduled or not: “People deserve to receive health care in a welcoming space, without bias or judgment.”

So Quiñonez and his staff are focused on keeping the clinic open. Abortion services make up 40% of the clinic’s revenue, leaving a void that could mean layoffs — but Quiñonez is determined to avoid that.

She encourages residents to transfer their gynecological care to the clinic and plans to offer new services. The clinic recently added gender-affirming hormone therapy services, as well as HIV prevention and treatment services. She hopes other programs will follow.

And donations flow into the clinic’s abortion fund. Prior to this year, the fund balance never exceeded $50,000. In one weekend after the decision, they raised $75,000. Staff will use the money to help send people out of state for abortions.

“Yes, we are tired, we are devastated, we are angry,” Quiñonez said. “But it’s far from over. I want to reassure people that no matter how desperate and gloomy it is right now, it’s not the end.”