Report finds independent abortion clinics face more threats, decline post-Dobbs

In May 2023, a man drove a car through a future reproductive health clinic in Danville, Illinois. He arrived with bottles of gasoline, a hatchet, road flares, and matches with plans to set it on fire, authorities reported.

While no one was harmed, the clinic, Affirmative Care Solutions, hasn’t been able to open.

Affirmative Care Solutions Director LaDonna Prince said this is just one example of growing hostility toward her shrinking profession.

“It was more than just destroying a building. It took a piece of me away and a piece of the security that I’ve had,” Prince said during a December 3 forum held by Abortion Care Network (ACN), a national membership and advocacy organization for independent clinics not affiliated with a larger company like Planned Parenthood.

ACN’s annual Communities Needs Clinics report, released on Tuesday, details the harassment, increased administrative burdens, and closures that clinics like Prince’s have faced since the US Supreme Court overturned constitutional abortion protections in Dobbs v. Jackson Women’s Health Organization in June 2022.

Decline in clinics

The ACN’s report found that independent abortion providers are an endangered species.

In total, there are 363 brick-and-mortar independent abortion clinics plus 223 online-only clinics across all 50 states, Puerto Rico, and Washington, DC—compared to 510 when the ACN started tracking clinic closures in 2012.

Since 2022, at least 76 independent clinics have stopped offering abortions or closed altogether, including at least 23 in 2023 and 11 in 2024, as of November, according to the report.

Harassment increasing

Clinics that are still open are struggling to keep the lights on while also maintaining staff amid the job’s difficult work environment, providers said during the forum.

“Most doctors are not willing to do this work due to threats and harassment and intimidations,” Ona Marshall, co-owner of EMW Women’s Surgical Center in Kentucky—which made abortion illegal in 2022—explained.

There are also administrative and legal barriers that make it difficult financially and logistically to stay afloat, she added.

In 2023, nonprofit the Guttmacher Institute reported on state regulations for abortion providers that went “beyond what is necessary to ensure patient safety in the event of an emergency.”

Nine states, for instance, require procedure rooms to be a specific size, and eight states require corridors to be a specific width. Several have “onerous” licensing standards for abortion clinics that are “comparable or equivalent” to those of ambulatory surgical centers, according to Guttmacher’s report.

EMW had a Lexington location that closed in 2017 after a months-long legal battle with then-Governor Matt Bevin’s administration over licensing requirements. (Abortions were legal in Kentucky at that time, with restrictions.)

“There are cycles of winning and losing in these legal challenges, and clinics can be forced to close for a period of time. And for many clinics, when they close, there’s no income,” Marshall said.

Ripple effects

The ACN’s report confirmed that while at least 32 new clinics opened between 2022 and November 2024, it wasn’t enough to offset the closures.

This decline is partly a response to state laws following the Dobbs ruling. As of December 3, the New York Times abortion ban tracker shows 13 states currently ban the procedure with few or no exceptions and seven restrict it to 18 weeks of gestation or earlier.

But eight of the 11 clinics that axed abortion services in 2024 were in states where the procedure was protected, the report found. That means even clinics in states where abortion is legal face resistance, Prince said during the forum.

“It doesn’t matter if you go into a state where abortion is still legal and welcomed—it just depends on what’s going on in that community. It’s not necessarily just a statewide welcome mat,” she said.