Opening an All-Trimester Abortion Clinic in Maryland

Late last year, Dr. Diane Horvath and Morgan Nuzzo decided they wanted to take the plunge and start their own business. It’s a journey familiar to entrepreneurs all over the country — but unlike Horvath and Nuzzo, those entrepreneurs aren’t opening an all-trimester abortion clinic. In a country where abortion providers are increasingly on the defensive, both Horvath and Nuzzo are curiously upbeat.

Operational Hurdles and Funding Challenges

Opening a small business is never easy, but getting an abortion clinic off the ground comes with a special set of hurdles — particularly a clinic that offers abortions later in pregnancy. They looked for funding from traditional and not-so-traditional sources, figured out creative ways to cut costs and hired lawyers to help them navigate the world of business leases, bank loans and incorporation documents. By the time I met Horvath and Nuzzo, in April, they had been trying to get their clinic off the ground for five months.

They had qualified for a business loan that they estimated would cover about a fifth of their costs, but they were still waiting to hear back from foundations. In desperation, they set up a GoFundMe page, which ended up being a major source of funding: In just over two months, they raised more than $260,000. “I never thought I’d have to crowdfund an abortion clinic,” Horvath said.

Regarding equipment, Nuzzo told me she had a lead on a procedure chair she had found on Facebook Marketplace. “I’ll put it in our storage facility next to the ultrasound machine we bought on Craigslist,” she said. This sounds a little weird, but she said the equipment worked fine and they needed to make progress.

The Legal Climate and Location Difficulties

Even when timing and funding aren’t an issue, something as simple as finding a location can be incredibly difficult. Many landlords don’t want to rent to abortion providers, and local zoning laws sometimes restrict where abortion clinics can operate. Other businesses might also object to being located in the same shopping plaza as a facility that’s a magnet for protesters.

It’s an unsettling time to be an abortion provider in America. At some point in the next few weeks, the Supreme Court could overturn Roe v. Wade, the 1973 opinion that established a constitutional right to abortion, sending the issue back to the states. Thirteen states would promptly ban the procedure, and another dozen could heavily restrict it. If that happens, abortion providers in the states where abortion remains legal would suddenly face a surge of out-of-state patients.

One state that’s likely to see an influx is Maryland, which is where Horvath and Nuzzo are opening their clinic, Partners in Abortion Care. “The one thing that’s moving us along and making it so we’re not despairing is that we’re working toward getting this clinic open,” Horvath said.

Clinic Access Statistics (2013-2022)

According to Caitlin Myers, an economist at Middlebury College who maintains a database of abortion providers who publicly advertise their services, the provider landscape from January 1, 2013, to June 1, 2022, is summarized below:

• Providers opened or reopened: 356
• Clinics closed, reclosed or stopped: 405
• Planned Parenthood affiliation: About 58 percent of the newly opened or reopened clinics.