When I step outside our Charlottesville clinic, I see license plates from all over the Southeast: Florida, Georgia, North Carolina, Tennessee, West Virginia, Kentucky. For many of those patients, Virginia is a last, fragile lifeline.
Before the election, you couldn’t turn on the news without hearing what was at stake for abortion if Democrats lost Virginia. In our clinics, we saw something different: the consequences of politicians’ past decisions, already written on our patients’ faces.
Voters did their job. Now the question is whether our leaders will do their job.
As the founder of Whole Woman’s Health — the largest independent abortion provider in Virginia and one of the last still standing in the South — I know what patients need from lawmakers. We need to move beyond rhetoric to concrete action that makes care easier to find and safer to receive.
In Virginia, abortion is legal, and patients can get care well into the second trimester and later when a pregnancy threatens their health. That makes our state a refuge in the post-Dobbs South.
In Charlottesville alone, the number of our out-of-state patients increased from 8% in 2022 to 29% in 2025. We’ve seen similar growth at our Alexandria and virtual clinics. Yet, despite these increases, we are still largely unknown to patients traveling from out of state. Independent clinics, such as ours, provide most abortions in the U.S. But when you’re traveling from a few states away, where your local clinic may have closed, you don’t know how to find that “independent clinic” elsewhere. You just know you’re scared, short on time and hoping the first place you call will actually help you.
First, if Virginia is going to remain a true beacon for patients, people need to know how and where to get real care.
Too many patients begin their search online and end up in places that look like medical clinics but are not. So-called “crisis pregnancy centers” vastly outnumber actual clinics in many communities. ReproRising Virginia estimated nearly 60 such clinics in our state alone in 2020 — a number that has no doubt grown since — compared to only about two dozen actual abortion clinics in the state now.
Virginia’s leaders should invest in statewide abortion navigation — including partnerships with independent clinics and abortion funds — so people can quickly move from “I might be pregnant” to real, evidence-based care. We need public education and visibility to combat the lies our patients are seeing.
Second, abortion care itself must be further protected from political and physical attacks.
On paper, Virginia is a “safe state.” And even with supportive leadership, promises don’t mean much if providers are under siege by protesters and violent threats and clinics can’t expand to meet the demand pouring in from other states.
Anti-abortion extremists are traveling to states where abortion remains legal, bringing harassment and threats to our clinic doors. Out-of-state politicians and prosecutors are exploring ways to punish providers in places such as Virginia for caring for their residents.
If Virginia wants to be a true refuge, we need state leaders to:
Support the Constitutional Amendment for Reproductive Freedom to enshrine strong protections for abortion access in Virginia law,
Enact the previously vetoed shield law to protect Virginia providers, staff and helpers from out-of-state investigations or prosecutions, and
Strengthen and enforce clinic safety measures, including buffer zones, while giving local law enforcement clear guidance that patients and staff deserve safe passage when extremists show up.
It’s time for Virginia’s elected officials to prove that when they say they support abortion rights, they mean it.
If you voted because abortion was on the ballot, this is your moment. Call your state legislators. Ask them to protect abortion in Virginia law, pass a shield law, keep clinics safe and strengthen Medicaid and other health programs. Tell them you are paying attention — and that in Virginia, keeping abortion legal is just where the work begins.
Amy Hagstrom Miller of Charlottesville is the president and CEO of Whole Woman’s Health.
