What It’s Like To Open An Abortion Clinic Right Now

This is the first entry in a series tracking what it’s like to open an all-trimester abortion clinic in the U.S. as abortion rights are being curtailed. It’s an unsettling time to be an abortion provider in America. Late last year, Dr. Diane Horvath and Morgan Nuzzo decided they wanted to take the plunge and start their own business. To achieve this, 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.

Legal Uncertainty and Regional Impact

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 Financial Reality of Clinic Operations

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 that said they were committed to helping expand abortion access. 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.

Specifically, regarding their 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. Despite these unconventional methods, both Horvath and Nuzzo are curiously upbeat. “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.

Barriers and Market Statistics

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. 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.

In terms of the broader market landscape, the following data highlights the challenges for independent providers:

• Total providers opened or reopened (Jan 2013 – June 2022): 356
• Total clinics closed, reclosed or stopped providing abortions: 405
• Planned Parenthood affiliation: About 58 percent of the newly opened or reopened clinics are connected to Planned Parenthood.

Because of these challenges, it’s relatively rare for a new provider not affiliated with Planned Parenthood or another existing clinic to find its footing. “We all want to burn shit down and light it on fire but we’re going to build something instead,” Horvath noted, emphasizing their commitment to the project.