After Roe v. Wade Struggling with Mental Health Issues – National

Danielle Maness squeezed the hands of hundreds of anxious patients who were lying on tables in the now empty treatment room. She recorded countless vital signs and brought dozens of snacks to the recovery area, which is now silent.


As the head nurse peered into every darkened room at West Virginia’s only abortion clinic, she wondered if she would ever treat abortion patients here again.

“It’s literally making me sick, and we don’t know what her future holds for her,” Maness said of the residents who rely on the West Virginia Women’s Health Center. “It’s the kind of heartbreak that’s hard to put into words. There are all these “what if” questions.”

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The waiting room should have filled with patients for two days last week when the clinic reserves all the seats for abortion appointments. But since the US Supreme Court Roe v. Wade days earlier and ruling that states can ban abortions, the clinic was forced to stay the procedures under an 18th-century state statute that banned them. The West Virginia ACLU filed a lawsuit on behalf of the clinic, demanding that the law be declared unenforceable so staff can immediately resume abortions. Other states are in various stages of legal limbo.

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Across the country, workers at clinics that have closed abortion services are feeling fear and stress as they try to pick up the pieces and find a way forward. In central West Virginia, the days following the historic court ruling brought a different kind of grief for employees as their new reality set in, one Maness said will last long after the initial trauma of the decision.

Conversations with distressed patients on that first day play out in an inevitable loop in her mind.

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

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Like many clinics that perform abortions, the facility did not offer the procedure on a daily basis. Several days of the week are dedicated to routine pelvic care — cervical exams, cancer screening — mostly for low-income patients who are on Medicaid and have nowhere else to go. The determination to continue this work has given the staff a boost.

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Immediately after the decision was published, Maness was one of the few employees tasked with calling patients to cancel abortion appointments. On the other end of the line, she had never heard anyone speak with such fear.

The entire workforce was in crisis mode for days, even though they and others across the country had been anticipating the verdict for months. “You think, you think you’re prepared for the moment, but you’re never really prepared until it becomes a reality,” said executive director Katie Quinonez.

She watched her staff collapse and sobbed. Some called patients or answered the phone. Workers who had the day off turned up, some still in their pyjamas, to relieve colleagues and offer support. Quinonez encouraged everyone to take breaks and often managed the phones himself.

She will forever remember this Friday as one of the worst days of her life. On the weekends, she turned off her phone, lay on her couch under a weighted blanket, ate junk food, and watched TV. It was the only way she could escape and deal with it.

When she and her staff returned to work, she held off to fill vacancies from canceled abortion appointments. Some patients required other services, but she wanted to let the workers catch their breath. She told them to be late if necessary. Clinic rooms remained largely empty, dark and silent.

But the phones rang anyway.

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Beth Fiddler sat at her desk behind the clinic’s glass reception window in the waiting room. She didn’t have to check patients in, scan Medicaid data into charts, hand out information packs.

Instead, she kept answering the same questions and directed callers to a hotline or website to help them find the nearest out-of-state abortion provider.

“You guys are going to close 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 contraception?” I’ll help you make an appointment.

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

Some callers denied it. Some remained stoic, others cried. Some reacted with hostility, insisting Fiddler was wrong. She tried to be polite and empathetic – but the conversations are taking their toll.

“This frustrates me,” she said. “I’m already stressed and upset. I understand that I want to find a way, but there is no way.”

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As one of the first working-class patients sees, Fiddler prides himself on making people feel welcome and safe. Having to turn them away and just direct them to a website is annoying, she said.

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

It’s also quiet outside the clinic. There’s no buzz of patients arriving at the parking lot to be escorted by volunteers in pink vests. The only cars belong to employees and a security guard. Across the street, an anti-abortion organization’s property is empty except for a large white cross.

A regular protester, a pastor with a “Jesus Loves You” sign, prayed outside a few early mornings, but the usual crowd urging patients to reconsider has disappeared. Some cars slow down as they pass. Workers recognize some as protesters’ vehicles and imagine the clinic is being monitored to make sure patients aren’t coming for abortions.

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Director Quinonez said she knew the next steps would be challenging, with a long road ahead for workers to recover from the pain.

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

Just being at work is tough, but the staff are committed to helping patients.

“We showed up on Monday and I was like, ‘Okay, what do I do now?'” said Kaylen Barker, who oversees the clinic’s public messaging. “It is grim to come back here and realize we will not be able to provide the life-saving care people need and we will have to refer them to websites. It’s the best we can do now.”

Barker came to the clinic 12 years ago as a patient during a breast cancer scare. She was cared for when she had no other options. She knew she wanted to work at this place that would help save her, so she applied until she was eventually hired. Knowing that she can help others like her keeps her going whether abortions are planned or not: “People deserve to receive health care in a welcoming environment, without prejudice or judgement.”

So Quinonez and her staff are focused on keeping the clinic open. Abortion services account for 40% of clinic revenue, leaving a gap that could mean layoffs — but Quinonez is determined to avoid it.

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

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

“Yeah, we’re tired, we’re devastated, we’re angry,” Quinonez said. “But that’s far from over. I want to reassure people that no matter how hopeless and dark it feels right now, this is not the end.”

© 2022 The Canadian Press After Roe v. Wade Struggling with Mental Health Issues – National


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