CHARLESTON, West Virginia –
Danielle Maness has shaken the hands of hundreds of anxious patients lying on tables in the now-empty procedure room. She has recorded countless vital signs and delivered dozens of snacks to the now silent recovery area.
Peering into each dark room at West Virginia’s only abortion clinic, the head nurse wondered if she would ever treat patients here for abortion care again.
“It literally makes me sick, and we don’t know what the future holds for them,” Maness said of residents who rely on the West Virginia Women’s Health Center. “It’s the kind of angst that’s hard to put into words. There’s all these ‘what ifs’.”
The waiting room should have been filling up with patients for two days last week, when the clinic reserves all spaces for abortion appointments. But since the US Supreme Court overturned Roe v. Wade days earlier and ruled that states can ban abortions, the clinic was forced to suspend the procedures due to a 19th-century state law that prohibited them. The ACLU of West Virginia sued on behalf of the clinic, asking that the law be declared unenforceable so staff can resume abortions immediately. Other states are in various stages of legal limbo.
Across the country, workers at clinics that have shut down abortion services are feeling fear and stress as they try to pick up the pieces and chart a way forward. In central West Virginia, the days following the landmark court ruling brought a different kind of pain for staff as their new reality settled in, one that Maness said will linger long after the initial trauma of the decision.
Conversations with frantic patients that first day play on an inescapable loop in his head.
“I don’t think any of us can block it,” he said. “He is constantly on our minds.”
Like many clinics that perform abortions, the center did not offer the procedure every day. Several days of the week are dedicated to routine gynecological care (cervical exams, cancer screenings), primarily for low-income Medicaid patients with nowhere else to go. The determination to continue that work has encouraged employees.
Immediately after the decision was published, Maness was one of the few staff members tasked with calling patients to cancel abortion appointments. On the other end of the line, he had never heard people speak so fearfully before.
All staff found themselves in crisis mode for days, though they and others across the country waited months for the ruling. “You think you’re ready for the moment, but you’re never really ready until it’s a reality,” said Executive Director Katie Quinonez.
He watched his staff break down and sob. Some called patients or answered phones. Workers who had the day off showed up, some still in pajamas, to relieve colleagues and offer support. Quiñonez encouraged everyone to take breaks, often handling the phones herself.
You will always remember that Friday as one of the worst days of your life. Over the weekend, she turned off her phone, lay under a heavy blanket on her couch, ate junk food, and watched TV. It was the only way she could escape and cope.
When she and her staff returned to work, she refrained from filling vacant slots from canceled abortion appointments. Some patients still needed other services, but she wanted the workers to catch their breath. She told them to be late if necessary. The clinic rooms remained largely empty, dark and silent.
But 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 guys are closing soon, right?” No, the clinic will be open for other services.
“Can I get Plan B, the morning after pill? What about an IUD or other birth control?” I’ll help you make an appointment.
“Are you sure I can’t make an abortion appointment? Isn’t there a loophole, an exception?” There are no abortion services at this clinic.
Some callers denied it. Some remained stoic, others wept. Some responded with hostility, insisting that the Fiddler was wrong. She tried to be courteous, empathetic, but conversations take their toll.
“It frustrates me,” he said. “I’m already stressed and upset. I understand that you want to find a way, but there is no way.”
As one of the first hard-working patients sees, Fiddler prides himself on making people feel welcome and safe. Having to turn them down and simply refer them to a website is devastating, he said.
“As helpless as I feel about it, I can’t imagine how they must feel,” he said.
Outside the clinic there is also silence. There are no rumors of patients arriving in the parking lot to be escorted by volunteers in pink vests. The only cars belong to the employees and a security guard. Across the street, a piece of land owned by an anti-abortion organization is empty except for a large white cross.
A regular protester, a pastor with a “Jesus loves you” sign, prayed outside early on some mornings, but the usual crowd pleading with patients to reconsider was gone. Some cars slow down as they pass. The workers recognize some as vehicles of the protesters and imagine that the clinic is being watched, to make sure that no abortion patients arrive.
Director Quiñonez said she knows the next steps will be challenging, with a long way for workers to recover from the pain.
“Our staff needs space and time to process this very traumatic loss,” he said. “And all the secondary trauma that we’re experiencing from all the patients.”
Just being at work is hard, but the employees are dedicated to helping patients.
“We came in on Monday and I was like, ‘Okay, what do I do now?'” said Kaylen Barker, who handles public messaging for the clinic. “It’s bleak to come back here and realize that we won’t be able to provide the lifesaving care people need and we’ll have to refer them to websites. That’s the best we can do right now.”
Barker came to the clinic as a patient during a breast cancer scare 12 years ago. She received care when he had no other options. She knew she wanted to work at this place that she helped save her from it, so she applied until she finally got hired. Knowing that she can help others like her keeps her going, whether abortions are scheduled or not: “People deserve to receive health care in a welcoming space, free of bias and judgment.”
So Quiñonez and her staff focus on keeping the clinic open. Abortion services make up 40 percent of the clinic’s revenue, leaving a gap that could mean layoffs, but Quiñonez is determined to avoid that.
She is encouraging residents to transfer their gynecological care to the clinic and plans to offer new services. The clinic recently added gender-affirming hormone therapy services, along with HIV prevention and treatment. She hopes more shows will follow.
And donations are flooding the clinic’s abortion fund. Before this year, the fund balance never exceeded $50,000. In one weekend after the ruling, 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,” Quiñónez said. “But this is far from over. I want to assure people that regardless of how desperate and dark you feel right now, this is not the end.”