Charlotte has been the focal point of a national debate over abortion rights for years. The city is now becoming a sanctuary for those seeking abortion care in the South.

What’s happening: The Supreme Court overturned Roe v. Wade last month, and in some nearby states, facilities that provide abortions have already been forced to shutter or stop providing many services.

Driving the news: North Carolina, where abortion remains legal up until fetal viability (between 24 to 28 weeks typically), remains an island in a sea of Southern states banning or limiting abortion. As a result, clinics are ramping up staffing and expanding hours to keep up with an influx of out-of-state patients.

• Since the Supreme Court ruling, A Preferred Women’s Health Center, which has a clinic in east Charlotte, has seen a 50% spike in calls, says executive director Calla Hales.
• Last week, Planned Parenthood’s facilities in the state saw nearly 200 patients from out-of-state for abortion services.
• Around 1/3 of the patients in Planned Parenthood’s North Carolina clinics, including its Charlotte health center in Cherry, are from other states, says Jillian Riley, Planned Parenthood’s North Carolina director of public affairs.

Yes, but: The future of abortion care in North Carolina likely hinges on the outcome of the November election. Republicans are eyeing tighter restrictions, which they may push if they win a supermajority in the General Assembly.

Why it matters: Charlotte, a blue city in a purple state, has been a refuge for those seeking abortion care for years. It is home to four of the state’s 15 abortion clinics, all of which are located in urban areas.

• Those same providers are already or will soon be the closest for some patients in Tennessee, South Carolina and potentially a large swath of the South, depending on the outcome of legal challenges to pending restrictions in states like Georgia.

State of play: The patchwork of state laws has left people seeking care confused and anxious.

Less than a half-hour south of Uptown, for instance, South Carolina now has a so-called “fetal heartbeat” law in effect, banning abortion after about six weeks.

• “As states across the U.S. continue to pass their own type of abortion law … that just means that people in those states are confused about their own laws. Because we see different states get highlighted on a national news, it doesn’t always make it clear what their state’s laws are around abortion,” Riley says.
• Callers to A Preferred Women’s Health Center have asked whether or not abortion is still legal, for example, or whether they can order abortion pills preemptively (which clinics cannot do).

Of note: A health clinic providing abortions is not the same as a crisis pregnancy center — and that’s another common misconception Hales says the clinic has to clear up. Crisis pregnancy centers, usually religiously affiliated, do not provide abortions, but often try to dissuade people from receiving abortion care through counseling.

The impacts: It’s taking longer for some patients to receive abortion care in North Carolina.

• Before the ruling, Hales says the clinic could typically schedule patients for a procedure within a week (even with the mandatory 72-hour counseling period), but now it’s more like two or three weeks.
• Planned Parenthood works to see patients within a week, Riley says, but that’s becoming difficult to maintain because many patients are dealing with logistical challenges of traveling to receive care. The organization is working to assist patients with the costs of childcare, lodging and other expenses associated with the travel.

Meanwhile, an executive order signed by Gov. Roy Cooper protects out-of-state patients seeking abortion care in North Carolina from extradition and bars agencies under his authority from cooperating with other states to prosecute people receiving or providing legal reproductive health care in North Carolina.

Between the lines: The same clinics that are hubs for abortion care in the South are also the epicenter of the fight over abortion rights. A Preferred Women’s Health Center on Latrobe Drive has seen some of the most frequent and largest protests nationwide, chief program officer Melissa Fowler of the National Abortion Federation told me recently.

• Anti-abortion advocates stand outside of the clinic daily: sometimes dozens, and on Saturdays, sometimes thousands. Many are with Love Life, a group that started in Charlotte and now works nationally to mobilize the Christian church to bring an end to abortion and the “orphan crisis,” per its website. 
• The group did not respond to a request for comment sent through Facebook. But on its Facebook page, it celebrated the Supreme Court’s ruling and said there is “much more work to be done to provide equal justice for all human beings.”

Hales is cautiously optimistic that this time, attention won’t fade on what’s been playing out at the clinic for years.

• “People still don’t know about it, and it’s because of the willingness to put their head in the sand,” she says. “I’m hopeful that the media, and just news in general, can continue to keep this a pertinent topic, because we really don’t have the ability to not care anymore.”