As abortion access divides US, one small town is caught in the middle

BRISTOL, Tenn.-Va. – A sign overlooking the downtown traffic on State Street marks where Virginia meets Tennessee.

Lauded as the birthplace of country music and home to NASCAR’s Bristol Motor Speedway, the two states in this Appalachian community share a library, chamber of commerce and post office.

But the fall of Roe v. Wade in 2022 tore Bristol in two.

Virginia allows the procedure. Tennessee prohibits it.

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In the nearly two years since, this border town has found itself on the front line of the nation’s highly charged abortion debate as powerful influencers from both sides moved in, fueling fierce zoning fights, legal battles and fiery protests.

“We are in a unique situation where we are right up against two very different sets of policies,” said Jon Luttrell, an official for Bristol, Tennessee’s City Council.

At the crux of the divide is Bristol Women’s Health, a clinic that opened on the Virginia side weeks before the Tennessee ban prompted a provider there to stop offering abortions.

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Its opening means people seeking an abortion don’t have to drive 150 miles to Roanoke, Virginia.

Bristol Women’s Health sees up to 150 patients a month, 90% of whom travel from states where abortion is severely restricted or banned, including Tennessee, West Virginia, North and South Carolina, Kentucky, Alabama, Georgia and Mississippi.

“It really put this clinic at the forefront,” said Neal Osborne, a Bristol native and councilman who watched the events unfold from the Virginia side.

Politicians and advocates have polarized takes on abortion. But while Bristol’s abortion laws are cleanly divided by State Street, its residents tell a more nuanced story.

Terrie Driver, who works the front desk at Bristol Women’s Health, said abortion is a “personal choice, not a political one.”

“Nobody wants to come and have an abortion. It’s a need-based situation,” she said. “This is not something people do for fun.”

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A judicial decision made hundreds of miles away in Washington, D.C., has created tension and is drawing a national spotlight on this small community straddling two states.

“Tennessee’s over there going: ‘We won. We won. We got our way.’ And Virginia’s like, ‘No, you didn’t,'” Driver said. “So there’s a lot of upheaval now.”

‘Best-kept secret’ no longer

On Oct. 25, 2022, a crowd of more than 200 gathered in the parking lot outside the Bristol, Virginia City Council building. It was the first of several attempts to shut down the clinic, then just about 4 months old.

Protesters sang, chanted and bowed their heads in prayer, clutching yellow and white signs that read “Safe Zone for Life.” They were awaiting a vote on a hotly contested zoning ordinance that sought to restrict abortion on the side of town where it was legal, preventing the new Virginia clinic from expanding and prohibiting other clinics from coming to town.

Some of the two dozen speakers at the typically sleepy council meeting said they opposed the restrictions. But the majority in this largely Southern Baptist community backed the measure.

A soft-spoken Bristol resident named Terri Brewer said she supported the anti-abortion zoning restriction. She told the council members she didn’t want others to experience heartache like she endured as a pregnant teen.

In retrospect, she felt her child was killed and should have had a chance to live, Brewer later told USA TODAY. Abortion is often pushed as the only alternative for pregnant people who don’t want to raise a child, she said in an interview in January, and other options like adoption aren’t discussed enough.

“I’ve been through the abortion process and I’ve been changed forever,” she said. “When you walk out the door and that child’s life has ended, you can’t just go on with your life like normal. … You will always carry something of that event in your heart for the rest of your life.”

At the 2022 council meeting, the Rev. Chris Hess, a Catholic pastor, told members the clinic was already attracting national media and extremists from both sides.

“Our city is becoming famous for all the wrong reasons,” he said. “We’ve gone from being the best-kept secret in Virginia to being talked about in over half a dozen states.”

The City Council passed the zoning measure, but it has been stuck in legal and procedural limbo ever since.

Since the 2022 meeting, towns around the U.S. have tackled similar local ordinances seeking to tighten the rules in states where abortion is legal.

Anti-abortion activists gave it another shot in August 2023, when Councilman Michael Pollard proposed another zoning ordinance be added to the council agenda.

The new measure would have allowed abortion facilities to operate in Bristol but only in certain parts of the town. But in this instance, council members declined to hear the proposal, which frustrated supporters.

“By being silent you have spoken,” resident Angie Bush told the council. “I just want to call you out at this moment. … We want you to take this issue on.”

Advocates tried other means to force the clinic out.

About six months into the clinic’s lease in December 2022, Bristol Women’s Health was sued by its landlord, who said the clinic owners never told him they’d be providing abortions, according to court documents.

Bristol Women’s Health said the lease was valid and asked for a dismissal. The lawsuit is pending.

In the meantime, the clinic sees a steady beat of patients at an unmarked single-story building, which shares an intersection with the sole marijuana dispensary and the forthcoming Hard Rock Hotel & Casino.

Since 2020, Virginia has seen a 76% increase in abortions, according to the Guttmacher Institute, a research and policy organization that supports abortion rights.

The clinic administrator, Karolina Ogorek, said the clinic’s patient volume rivals that of one she used to run in Knoxville, Tennessee, which provided abortions for about 35 years.

Years of experience in abortion care have taught her to expect pushback.

“People that were opposing reproductive rights and freedom to choose were not happy about us coming here,” she said. “Nevertheless, it is a legal service … and a necessary one.”

Neighbors take sides, battles ‘amp up’

In January 2023, Barbara Schwartz stood frozen in the clinic parking lot as a grey pickup gained speed, heading toward her. He’s bluffing, she thought.

She and a fellow escort had arrived at the clinic before the first patients, at about 8 a.m., when the man started yelling at them from his idling pickup.

As the truck neared the volunteers, her friend jumped out of the way, but Schwartz couldn’t move. At the last second, the man screeched to a halt, peeled out of the parking lot and drove away.

Schwartz grabbed her phone, took a photo of his license plate and called Bristol police. It’s one of the 58 times officers received a call from that location since July 2022, according to records. Most of those calls came from clinic supporters or opponents citing a conflict, police said.

Authorities arrested the pickup driver, and he was ultimately sentenced to a year’s probation for assault and battery.

The man in the truck wasn’t one of the protesters who routinely stand outside the clinic, Schwartz said. She has been in this field for years, but she believes what happened reflects this era of history. There’s more hostility since the Dobbs decision, in her view.

“I feel the diminishing of any civility whatsoever,” she said. “I see a total amp-up in the rhetoric and the threats.”

Schwartz and other volunteer escorts banded together about a year ago to create the nonprofit State Line Abortion Access Partners, or SLAAP.

Volunteers take turns working shifts at the clinic. Schwartz approaches patients on foot as they turn into the parking lot.

She sometimes carries a black and yellow striped umbrella to create a visual barrier between protesters and patients as she walks them to the clinic doors.

During a patient visit in January, Schwartz handed relatives of a young woman a SLAAP aftercare bag filled with items she might need after the procedure – menstrual pads, ibuprofen, disposable heating pads, herbal tea, fuzzy socks and a handwritten note from a SLAAP member.

Donations to the organization’s “Last Mile Fund” have helped cover patients’ transportation to and from the Tri-Cities Airport just over the Tennessee border, and their gas, food and lodging. The SLAAP members also fill the seats at council meetings where they counter the voices of their conservative neighbors.

Erika Schanzenbach, who has lived in Bristol for about 20 years, is among the rotating contingent of clinic protesters who plead with drivers and sometimes chant through a bullhorn, encouraging patients to rethink their plans.

She extends this guidance to visitors on her website, LifeBristol, where pregnant people can contact her or learn about alternatives to abortion. She has helped connect some people to local charities and churches.

Schanzenbach acknowledges that the majority of women who visit the Virginia clinic don’t stop to talk to her.

“But we believe that it’s important to speak, to be a voice for those children, whatever their moms decide,” she said.

Big hearts in a small town

Terrie Driver, who lives at the center of Bristol’s new controversy, says raising 13 children had been her life’s work.

She toiled in the food service industry for 43 years to feed and clothe her kids, but the job gave her no joy.

It wasn’t until she accepted a position as a receptionist for Bristol Women’s Health that she found renewed purpose. The job requires more than answering phones, filling out paperwork and scheduling appointments.

Driver spends her days listening to patients’ stories, patting them on the back, holding their hands and hugging them when they need a shoulder to cry on.

“I don’t know anything else but taking care and tending to and that’s basically my job in that clinic is to be a mom,” she said. “They need somebody to be gentle to them in a tough time, and that’s what I do.”