After leaving a so-called 'abortion desert,' this doctor worries about what's next

When the Supreme Court overturned Roe v. Wade in 2022, states scrambled to enact their own legal policies to regulate abortion, and a patchwork pattern emerged across the country. While some states protected and even expanded abortion rights and access, others severely curtailed it — like West Virginia.

“West Virginia has always had areas that have been deserts in other forms of health care,” says Dr. Anne Banfield, an OB-GYN who provides abortion services and left the state in early 2022. “And so those women really, in that state, or anyone who needs full-service reproductive care, often have to travel vast distances, creating these deserts, as we call them, where services just aren't available.”

Now, Banfield is concerned about what the 2024 election could bring, and what new changes or restrictions could come.

“I was, I guess, very naive,” Banfield told NPR about her mindset for years before leaving West Virginia. “It never crossed my mind then that I would ever live in a post-Roe world.”

Next-door states with vastly different policies

When the Dobbs decision prevailed, West Virginia’s state legislature acted quickly to make abortion illegal with very few exceptions. The story in neighboring Maryland was different. Sensing that Roe was in danger, Maryland state legislators introduced a number of bills in early 2022 to protect abortion rights. One bill that passed will be up for a referendum vote this fall, and Maryland voters will decide whether or not to enshrine abortion rights in an amendment to their state constitution.

Banfield now practices in a rural area of southern Maryland, and said she doesn’t have the same concerns about being an abortion provider as she had in West Virginia, nor does she feel the same kind of pressure she previously felt to engage in political activism around the issue.

“In Maryland, yes, there are still things, of course, that as an OB-GYN are not things I would support that are introduced into the legislature,” she said. But she added that those issues “are much more few and far between” compared to West Virginia.

Still, Banfield said she had at least come to value her relationship with the community in Elkins, Wv. while she was there. She said she never received any kind of abuse or threats that some providers face, and credits that, in part, to the fact that her former clinic only offered medically-necessary abortions, and not so-called elective procedures.

“If you hear a story in the community because you know somebody's cousin or sister, they're going to tell you the part about, ‘Oh, it was horrible, the baby had no brain,’ or… ‘her water had broken and she got sick,’” Banfield said of the reactions she would hear. But in a state where a majority of residents in years past have said abortions should be illegal in almost all cases, Banfield said there was a limit to some of her neighbors’ understanding.

“You don't necessarily hear other stories … like, ‘The patient had four other children. She was on two forms of birth control and got pregnant and knew she couldn't afford to have another baby,’” Banfield said. “Well, maybe you don't consider that a good reason for an abortion, but it sure as hell is for somebody else.”

Thinking about what 2024 and beyond may bring

Banfield says she still has many friends in Elkins, and recently attended graduation for her god-daughter there. She is not sure she would have left the state based on the Dobbs decision alone, but that practicing in Maryland means she and her patients have more resources and options to make the best decision for their health. And while she is fairly confident in the state of abortion rights in Maryland, she is concerned about what could happen at the federal level.

“My bigger concern for Maryland would be if there would be a federal [anti-abortion] bill passed. And then obviously we're all stuck in the same boat,” she said.

As Banfield looks ahead to November, she is discouraged by another Biden-Trump rematch. And despite President Joe Biden’s promise to protect abortion access, and former President Donald Trump’s pledge to leave the issue up to individual states, Banfield says there are other unknowns that worry her.

“One of the things that Maryland had done was to put in place a shield law to try to protect providers here in Maryland from the consequences of laws in states that have restrictions,” she explained. “But we don't know that when one of us flies into the state of Texas, could your name be on a list? We don't know that those restrictive states aren't going to try to do more things to prevent patients from traveling to reach care.”

Still, Banfield urges voters to pay attention to their local and state candidates as much as the presidential election. The House and the Senate, she said, are the ones who would either send a federal abortion bill to the president’s desk, or kill it before it even got there.

“Please go out and vote for your local elected officials and for your senators and for your legislators,” she said. “Because they make such a difference in what happens and what actually goes to the president's desk.”