A Florida abortion clinic braces for a Southern surge

This is the second installment in an occasional series on abortion.

Read the companion story and the first part of the series.

The debate splashes across front pages as the pope compares abortion to hiring a hitman and Missouri’s last clinic fights to stay open. Activists file lawsuits while the South embraces bans once seen as too radical to pass.

Often, the arguments are abstract.

But an hour south of the Georgia border, at two buildings a few exits apart off Interstate 95, the swirling conflict arrives in real time, as women swing open the doors.

JACKSONVILLE — Across from a Popeyes on the crowded, flat University Boulevard, a half-dozen protesters in suspenders and straw hats cluster by a bus stop.

They clutch rosaries and tilt posters toward drivers headed for the powder blue building with tinted windows.

We are praying for you.

Pregnant? Let us help you.

The parking lot at A Woman’s Choice of Jacksonville is private, set back, removed from the whoosh of passing cars and the evangelism of strangers.

Still, sometimes women walk up the steps crying about the pictures of fetuses.

Six days a week, they enter the quiet cool of the one-story clinic and stoically fill out forms, if they haven’t already, noting birthdates and last periods. They sink into homey couches in the waiting room, next to boyfriends and aunts and best friends, here from one-night motels or just down the road. A tropical Glade plug-in makes the pale pink room smell like Hawaiian Punch. A TV plays Family Feud, or maybe The Fresh Prince of Bel-Air. Coffee is free. Abortion is a choice, explained by videos on an iPad.

A framed motto hangs by the door. “At this clinic we do sacred work that honors women and the circle of life and death.”

As patients walk beyond the front desk, a banner reassures: Good women have abortions.

• • •

ABOUT THE REPORTING: Two facilities allowed Tampa Bay Times reporters inside, absent clients, to see places often glimpsed only from the outside. Read about an anti-abortion pregnancy center in Jacksonville.

It’s late one June morning, before the doctor arrives and patients with 12:30 p.m. appointments start filling the lot. A staffer sets out menstrual pads in the Maya Angelou operating room, then wheels a cart of sterilized speculums down the hallway, toward the room named for Wonder Woman.

Manila patient files fill a side room. Security cameras roll. And outside strolls an off-duty sheriff’s deputy. He comes at a cost, yet he and another officer are here more often these days.

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So, too, are women from Georgia. Already, they’re arriving in greater numbers, taking sick days from work and scrambling for babysitters while lawyers at home battle over an impending ban on most abortions after six weeks. Some show up unsure whether abortion is still legal.

Clinic owner Kelly Flynn hopes she has the capacity to handle the surge.

With gritted teeth, she’s followed the bans catching fire across the South that outlaw abortion before many women know they’re pregnant. She’s watched independent clinics like hers forced to shutter. A Woman’s Choice offers abortions into the second trimester, as late as 20 weeks — assuming women can scrape together the money and the time to get there.

The clinic has never closed, even for a day and even as Flynn works, battleworn, under Tallahassee’s thumb. State lawmakers once made abortion seekers wait 24 hours, sending clinic staffers scrambling to secure hotel rooms, until the law got blocked in court. Florida law now requires the clinic to secure expensive malpractice insurance and a hospital transfer agreement. Other legislation tried to mirror laws that curtailed abortions in other states, like the medically unnecessary mandate to outfit clinics as ambulatory surgical centers.

Flynn can hardly think about what’s on the horizon -- the intensifying push to stop abortions in Florida after six weeks.

And don’t get her started on the crisis pregnancy centers around the state, the ones she says peddle pseudoscience designed to manipulate women out of a valid, legal choice. She hears patients talk about getting drawn inside and shamed, and the complaints are echoed by medical ethicists.

“A woman just does not wake up and say, ‘It’s a pretty day, I think I’m going to get an abortion,’ ” Flynn says.

In this city of nearly 900,000, Flynn’s abortion clinic is one of four, all within a few miles. It’s been hers since she was 25, in 2002. Before that, she’d worked at an independent North Carolina clinic, ever since she and her boyfriend decided they weren’t ready to be parents and she’d gotten an abortion there at age 19. An employee had spotted her comforting a fellow patient and asked, “Can you work Saturdays?”

After that, there was no other life.

She went on to run six clinics, then stepped into ownership, starting here. She has kept A Woman’s Choice independent, surviving on the limited dollars of patients and word-of-mouth. They’re seeing more patients lately, doing 40-plus abortions a week.

In the runup to the 2016 election, as Donald Trump promised to appoint pro-life justices to the Supreme Court, Flynn was busy expanding in North Carolina. “You can get out if Trump is elected,” a landlord in Charlotte had told her. When he won, she wept. And then she got angry.

She remembered an 11-year-old who’d come in pregnant and clueless, and asked herself, “What happens to those people?”

Any clinic of hers, she’d vowed from the start, would not be gray, and her new clinics wouldn’t, either. Her patients would feel like they were in a spa, robed in compassion.

They’d walk out, she hoped, feeling free.

• • •

READ MORE IN THIS SERIES: Those on Florida’s front lines in the abortion battle know change is coming

In an administrative building across the parking lot — bought so “the antis” wouldn’t move in next door — Paola Davidovich flips through her trusty binder’s plastic-sleeved pages and waits.

“Thank you for calling A Woman’s Choice, this is Polly speaking, how can I help you today?”

“I think I’m here, but I can’t find the building,” a woman says in a voice pinched with stress.

“Down the road from Memorial Hospital,” Davidovich explains.

From her small desk, with bursting pen cups and taped-up price lists and a fluffy heart pillow on her lap, Davidovich often feels like she’s the command center, the callers her soldiers. Some days the calls come back to back to back.

Pro-life women who say, “I never thought I’d do this.”

Women for whom abortion brings no sadness, just a reset.

Women who speak in Spanish of husbands deported and nobody to drive them home.

One woman told her about getting assaulted on her commute. Davidovich tried to console her and mustered a discount.

From down the hall, snippets drift from other staffers: “That’s to numb your cervix.” “Any other questions or concerns?”

Along these hallways, away from patients’ eyes, the walls take on a defiant tone. The Lady Parts Justice League painted a mural of a uterus, “Property of NO ONE!!” There’s also a quote from comedian Sarah Silverman: “Abortion kills... YOUR WHOLE DAY.”

The phone strobes red with a new caller, a 23-year-old from Jacksonville, who wants to know if this place does abortions.

Davidovich walks her through the options. The pill, actually a series of pills, starts at $595. That includes an ultrasound, blood work, a birth control consultation and a follow-up.

Anyone further than 10 weeks along would need a surgical abortion, which runs from $595 to $2,100, largely depending on timing. That includes anesthesia.

“Would you like to move forward and secure an appointment by any chance?” Davidovich asks, and when the woman says yes, they calculate how far along she is. Early enough for the pill.

But the woman says, “I only make $10 an hour.”

Salary after taxes?

“About $13,000.”

Whew, Davidovich mouths, and says, “All right, and it says here that you’re eligible.”

The new copay is $450, Davidovich says, thanks to money from advocacy groups and the clinic’s own flexibility. For more help, she gives another number to call. She says, “Plan to be here two to four hours.”

Davidovich lets her dark hair down, then rubber bands it back up into loose Princess Leia buns. There’s so much to walk these women through, and a year into her job, Davidovich has the pricing and protocols down. She asks about past pregnancies. She reminds them to bring maxi pads and not to eat anything too greasy or heavy. She asks: “Is this a safe number to leave a message at?”

Calls come, too, from Flynn’s clinics in North Carolina, and Davidovich informs those women that they’ll have to wait 72 hours after counseling to get an abortion.

“I do apologize in advance, but we have to abide by it,” Davidovich tells a weary caller from Greensboro.

Before Davidovich hangs up, she likes to add: “Thank you for calling A Woman’s Choice, where we honor your hopes and dreams.”

• • •

Vahstie Balan first walked through the clinic doors a year ago.

It had been a tumultuous week, with a check-up that ended in, “Congratulations, you’re nine weeks pregnant,” and a workday that ended in a group layoff and $100 severance.

“Vahstie, what are you going to do?” a colleague had asked.

How long would it take Balan to find a good job as a single mom with a son in elementary school and the specter of a new baby?

She called A Woman’s Choice. First appointment, she’d be there.

She felt welcome at the clinic, even as she pushed down her underwear for an ultrasound and staff gave her the state-mandated option to view it.

“So what brings you here?” the clinic vice president asked, pricking Balan’s finger to examine proteins in the blood.

“I can’t afford this,” Balan said and explained how she’d lost her job at a chiropractor’s office.

“You have a medical background?” the staffer said. “We’re looking for somebody.”

“Stop playing,” Balan said.

She sat in a counseling room, where staffers explained the options, including adoption that would let her stay in touch with the family. Balan remembers they wanted to be sure this was the right decision for her.

This is where one of the medical assistants likes to tell patients that women take on too much, drowning in other people’s worries, and if ending a pregnancy is one thing they need to do for themselves, then they should. That their bodies are their own.

Balan had read online about what to expect — a pill at the clinic to stop the fetus’s growth, then four other pills at home to expel everything, like in a miscarriage. Cramps, blood clots, maxi pads.

If she’d gone for a surgery, she’d have heard about how nothing would be cut open, how a doctor would dilate her cervix and gently suction the tissue from her uterus. It would take about 10 minutes. She could choose sedation and expect recovery to take a few days, with some cramping and bleeding.

Paper hearts covered the walls with words from women who’d sat there before. A 20-year-old who took the pill at eight weeks wrote: “We’re currently unable to provide for another life while trying to pave a path to a better lifestyle.” Another said: “God still loves you, I promise you that.”

After the doctor administered her pills, Balan filled out an application. Even before her follow-up appointment, she was hired as a medical assistant.

Quickly she learned about life as an abortion worker, how some protesters memorize staffers’ cars, or how one co-worker got disturbing mail in a slow imitation of Hangman, each day a new letter. Or how one day, to offset the chants of protesters, staff and patients parked in a ring around the clinic and let their car alarms blare.

In a short time, Balan became clinic manager. She stays up late, fielding emails about how to get patients more help and posting ZipRecruiter ads to deal with the growing demand. She prefers, however, to leave her office and chat up patients, asking, “What are you guys doing next week?” making them laugh, giving them peace of mind. She’s grateful for the privilege of their stories, though she knows the burden of taking the heaviest ones home.

Patients like to know that even the woman in charge has been through it. So she tells them: “I understand. It’s not so bad.”

• • •

The whiteboard with a smiley face says Nurse: Michelle. In the recovery room, Michelle Mejia helps sedated women sink into pink recliners, draping over them a blanket printed with a lion’s face.

She takes their vitals, waits five minutes for the light sedation to wear off.

“Am I done?” women ask, groggy.

There’s a plastic cup of peppermints, cheery curtains, a boombox loaded with a Bruno Mars and Lady Gaga mixtape one of the doctors made. Other days, it’s oldies, The Temptations.

“Are you hungry? Thirsty?” Mejia asks them, and hands out lemonade and ginger ale, animal crackers and pretzels. Heating pads soothe their cramps.

Some women announce, “That was the best decision I ever made.” Others, still dazed, get angry. Some start crying, flooded with hormones, a soup of relief and hunger and low blood pressure, and sometimes, grief. Mejia hugs them if they let her, and she lets them talk. She tells them she remembers the big clinic she went to in Miami, and that she has forgiven herself.

“It’s OK,” she says, “what you’re feeling right now.”

When patients come back a few weeks later, for follow-up appointments, they often can’t remember if they cried, or why.