"People across the US are like, ‘How did we get here?’ and we’re like, ‘Where have you been?’”

Annie Flanagan for BuzzFeed News Clinic escorts use large umbrellas to shield patients from anti-abortion demonstrators in Montgomery, Alabama.

When she found out she was pregnant, Sam Blakely balled up her shower curtain, bit down, and screamed.

“There were so many emotions: Overwhelming devastation, anguish, terror, despair,” the 25-year-old said. “And I didn’t tell anyone about it except my rapist. I didn’t feel like I could.” A few weeks before taking her first pregnancy test, a friend whom Blakely now refers to as a coworker “because friends don’t rape you” sexually assaulted her in her own apartment. She stayed in the same clothes for three days. Raised in Eclectic, Alabama, by devout Christian parents who taught her to not look boys in the eyes a certain way or wear revealing clothing, she couldn’t tell her family. Then, she missed her period. “I googled a lot of dangerous things: tea from China that would induce labor, some sort of pills, natural remedies I looked up and considered,” she said. “There’s so many things I didn’t know as a young black woman in Alabama. We are given no information and there are so many barriers and obstacles to get an abortion, and I believe that is on purpose.” At the time, Blakely was 23, fresh out of college, saddled with student loan debt, and trying to budget for groceries. Raising a kid seemed impossible. Giving birth to the child of the man who raped her “was a death sentence.” After three frantic days, she learned there was one clinic close to her in Montgomery, but she had no idea she would have to find $600 to pay for the procedure up front, sit for hours in the crowded waiting room for her first appointment, undergo mandatory counseling, wait 48 hours, and then come back. “I had to call in sick from work, have an ultrasound, and follow all these rules,” Blakely said. “It was traumatic.”

Annie Flanagan for BuzzFeed News Sam Blakely at home in Birmingham on May 23.

In 2017, five clinics performed abortions in Alabama, down from about 20 in the 1990s. There are now three strung across the state in a wide triangle and shouldering an increasingly heavy patient load as the South continues to solidify its position as one of the largest abortion deserts in the US. Only one provider, the Women’s Center in Huntsville, performs abortions on clients who are up to 20 weeks pregnant, the state’s current legal limit. Emboldened by the appointment of Supreme Court Justice Brett Kavanaugh, conservative lawmakers across the country have been successfully purging abortion services from their states. Last week, Louisiana’s governor signed a bill banning nearly all abortions, making it illegal for doctors to provide the procedure after 6 weeks of pregnancy. Missouri is in danger of losing its last remaining clinic, while Kentucky, West Virginia, South Dakota, Mississippi, North Dakota, and West Virginia are down to one. About 90% of counties in the US do not have an abortion provider, according to a 2017 study by the Journal of Medical Internet Research, and experts and abortion rights advocates emphasize that restrictive laws disproportionately cripple lower-income communities of color. While Alabama’s recent law, which is currently being challenged in court by the American Civil Liberties Union and Planned Parenthood, may have attracted national attention, state lawmakers have been chipping away at access to reproductive care since Republicans won a legislative supermajority in 2010. “This has been a long time coming. No one is surprised. It’s about controlling women’s bodies and sexual agency,” said Kari Crowe, codirector at the group POWER (People Organizing for Women’s Empowerment & Rights) House, which works with the Montgomery Area Reproductive Coalition. “We sue the state basically every year.” The clinic performs about 50 abortions a week, treating patients from Mississippi, Louisiana, and the Florida Panhandle, but just getting them in the door is a challenge. The staff uses donations to help patients buy gas and food. Sometimes they need a ride and a place to stay, or someone to watch their kids because most can’t afford to pay for or tell people about their abortion. “We have had women who call and say they are pawning everything they can pawn to make it up here,” Crowe said while filling out new patient forms. “They borrow money. We had one young woman who was doing sex work to pay for her abortion. Women are desperate and they will do what they have to do.” And that’s what Blakely did. She called in sick from her job at a casino, scrambled together some cash for her first appointment, and, like so many others, kept her decision a secret. On March 30, 2017, she made her rapist drive her to and from the procedure — Alabama law requires that patients be accompanied by someone to the clinic — and fork over $450 to cover the remaining cost. “It was the worst day of my life,” she said. “But it was a small price to pay for my life at the end of the day.” As traumatizing as her experience was, Blakely said she knows she is one of the luckier ones. She wasn’t forced to tell a parent, get their written permission, and bring a state-certified birth certificate, like pregnant minors in the state are required to do to get the procedure.

Annie Flanagan for BuzzFeed News Left: A sign on the highway leading to Alabama from Mississippi. Right: A woman prays outside an abortion clinic in Mississippi.

“This system is designed to humiliate you,” Blakely said. “Growing up, we heard, ‘What if your mom had aborted you?’ People across the US are like, ‘How did we get here?’ and we’re like, ‘Where have you been?’” Many people in Alabama have to drive about 100 miles to get to a clinic. Often, they’re forced to go out of state, like Sarah (who asked that her last name not be used), from Mobile, who went to New Mexico; and Hevan Lunsford, who drove four hours to Georgia because she decided to get an abortion at 21 weeks after learning that her son had life-threatening heart and lung issues and would have had to fight for his life after birth. “I couldn’t let my son suffer like that,” Lunsford said. “I had no support system and couldn’t share the process, but I couldn’t imagine any other scenario where I would have carried that pregnancy to term.” Back in the Montgomery clinic, Crowe, who drives almost two hours every day to get there, stresses that one of the biggest barriers is getting information to those who need an abortion. “We have teens call and say they got abortion drugs off of Amazon,” she said. “We have doctors who fly in from all over the country because doctors here won’t—” The phone interrupts her. “Yes, abortion is still legal in Alabama,” Crowe tells the caller, before launching into a to-do list of what they need and how they should enter the clinic. “Just pull into our driveway and you will see our clinic escorts and we will help you get inside.” Crowe picks up where she left off: Few doctors in Alabama will perform abortions because of the stringent regulations, the stigma, and the increasingly hostile opposition. “One of our doctors got shot,” she said, waving a blue highlighter the same color as her hair. “I am not afraid to shoot someone if I have to. I guarantee you most Southern abortion providers are packing.”

Annie Flanagan for BuzzFeed News David McHale packs up a crib while his wife is in the Reproductive Health Services center, on May 24.

It’s barely 6 a.m. but David McHale is already sweating, his cheeks a bright pink as he juggles two baby carriers, a 4-year-old girl, and a diaper bag while watching his wife hunch behind a black umbrella as an escort leads her from their car, past a smattering of praying and shouting protesters, and into the clinic’s windowless, bunker-like entrance. Inside the POWER House’s dim, cool living room, two volunteers help McHale set up a portable crib for his 6-month-old twins and a coloring station for his older daughter, who’s talking excitedly. “She’s the best thing that’s ever happened to me,” he said, nodding toward the toddler. The 23-year-old father of three and his wife, who is 26, recently moved into a two-bedroom house in the “backwoods” of Tallassee, a small, riverfront town about 40 miles from Montgomery. He is a manager at Walmart and works long hours, sometimes until 10 p.m., while his wife stays at home and takes care of the girls. McHale had to take two days off work to be at the clinic, which will hurt financially because things are “already extremely tight,” but he isn’t really thinking about that right now. He gestures outside, toward the yelling protesters and the escorts blasting rock music to drown them out. “People don’t know how to mind their own business,” he says. “I bet you, if one of their 16-year-olds came home pregnant, they would be one of the first to say we need to do something about it.” His wife is pregnant with another set of twins. McHale says they would have had to buy a new house, get another car, and find a way for her to earn money while taking care of four kids in diapers — something that just isn’t feasible, so she decided to get an abortion. “Some people don’t understand the struggles of what is going on and the possibilities we have and making this decision is not easy, but sometimes —” he pauses, looking down into the crib. “Sometimes, it’s the most responsible thing you can do.”

Annie Flanagan for BuzzFeed News "I'm a lonely petunia in the onion patch," said Janet, 76, while holding her pro–abortion rights signs and waving to traffic passing by in front the Reproductive Health Services center in Montgomery on May 24.