Probal Rashid/NurPhoto via AP
Abortion rights activists gather in front of the Heritage Foundation building during the Women’s March in Washington, November 9, 2024.
After Southern states began implementing abortion bans in the wake of the Dobbs decision, Washington, D.C., became a hub for abortion care. The city has five abortion providers, but more significantly, the nation’s capital is home to one of the only five remaining abortion clinics that offer care in the later stages of pregnancy.
“It is why we are where we are right now with the extreme restrictions and bans that exist across this country, and why I’m having to see patients traveling from as far as Texas and Oklahoma and Florida and Tennessee,” says Dr. Serina Floyd, the chief medical officer at Planned Parenthood of Metropolitan Washington, D.C. “To say that I have concerns is an understatement.”
But the future is murky: Under the 1973 District of Columbia Home Rule Act, the mayor and city councilmembers act independently of Congress to pass laws and manage the annual budget. However, Congress retains the power to review and block legislation. Come January, abortion providers fear that a Republican Congress will move to further restrict abortion access in the District. In Washington, abortion is legal at any stage of pregnancy. But under the federal Hyde Amendment restrictions that the city is subject to, local tax dollars cannot be used to pay for abortions for Medicaid recipients, except in cases of rape, incest, or a medical emergency endangering the life of the mother.
Anti-abortion advocates could threaten both home rule generally and the city’s status as a safe haven specifically. In July, Sen. Mike Lee (R-UT) sponsored a bill that would repeal the D.C. Home Rule Act. In 2023, Rep. Andy Ogles (R-TN) had also proposed repealing home rule. While Rep. Andy Harris (R-MD), an anti-abortion advocate, claims he does not enjoy interfering with home rule, he believes Congress can step in as the “ultimate authority” if needed.
Harris, the co-chair of the Pro-Life Caucus, is a frequent critic of the District’s policies. He once tried to block the city law that legalized marijuana, arguing that local leaders “made a bad decision.” Harris has a clear stance on abortion. In 2022, he said he would support a national “heartbeat” ban. In 2023, he co-authored a statement with other pro-life members of Congress criticizing the American College of Obstetricians and Gynecologists’ choice to exclude pro-life doctors from presenting at their annual medical conference.
The day after the election, there was a “dramatic increase” in patients seeking long-acting reversible contraceptive (LARC) methods like IUDs and contraceptive implants and injections, Dr. Floyd says. Traffic to the plannedparenthood.org pages on vasectomies and how to get an abortion also skyrocketed, according to Danika Severino Wynn, the vice president of care and access for Planned Parenthood Federation of America. And scheduled appointments at Planned Parenthood centers across the country spiked dramatically as well: Vasectomy appointments increased by 1,200 percent, IUD appointments increased by over 760 percent, and birth control implant appointments increased by 350 percent.
Since the election, Floyd has also had more patients request LARC devices when they undergo abortion procedures than she has seen in previous years. “They’re realizing that, while I’m getting this abortion here, in this place where I have the access, let me go ahead and get my contraceptive needs taken care of at the same time before I have to travel back to a place where I don’t know what that access is going to look like,” Floyd explains. The Washington clinic also provides gender-affirming and hormone therapy care, which further contributes to the tension among reproductive health care providers under a Trump presidency.
New restrictions “would definitely be really catastrophic [for] abortion access across the whole country because we are really kind of a sanctuary city right now for folks accessing care,” says Stephanie Spector, the co-president of the student-led George Washington University Reproductive Autonomy and Gender Equity (RAGE) group and an executive board member of Foggy Bottom Plan B, an organization that provides emergency contraception.
These reproductive health care justice organizations, which focus primarily on relaying information to local students and residents about their services, have decided not to urge people to stock up on contraceptive care before Donald Trump takes office on January 20. “We have been trying not to fearmonger too much,” says Spector, “so we have been cautious of putting a lot of things out that have warned folks or told folks that they need to be accessing care now.”
Right now, Dr. Floyd and other abortion providers want to ensure that Washington clinics do not become overwhelmed with patients seeking reproductive health care in the coming weeks. “There’s so many devastating impacts that were felt from the first term that we’re still recovering from,” Floyd says.
