Dr. Yashica Robinson is an optimist — and that, she says, is fortuitous. As one of the last abortion providers in Alabama, a willingness to see the bright side is practically a job requirement.

For much of the past year, Robinson, who is the medical director at the Huntsville-based Alabama Women’s Center for Reproductive Alternatives, and her staff have fought to overcome the challenges posed by COVID-19, while simultaneously battling a state effort to suspend all abortion services during the pandemic. “We will continue to be innovative and be creative and find ways that we will make this work,” she says, with characteristic resolve.

But there’s one topic that clouds Robinson’s confident disposition: her clinic’s limping finances. The truth, Robinson says, is that the economic fallout resulting from the coronavirus, combined with Alabama’s increasing restrictions on abortion, has hurt the clinic’s financial stability “tremendously.” When Alabama suspended “elective” medical procedures, including abortions, in late March, the Alabama Women’s Center cancelled a week of appointments. Even after a federal appeals court ruled that Alabama couldn’t block all abortions, Robinson had to file paperwork to justify each abortion she provided for the month the state’s emergency public health order was in place, adding time and costs to every appointment.

Most independent abortion clinics across the country are in a similar boat. Keeping clinic doors open during COVID-19 has required spending much more money — on on cleaning and personal protective equipment, and on hiring more staff to facilitate social distancing rules that also reduced the number of patients who could be seen. At the same time, 11 states temporarily suspended abortion services this spring, amid the growing pandemic. While all of those orders were blocked by courts or expired, the temporary closures and legal battles were financially devastating for independent abortion clinics. Meanwhile, as layoffs have spiked and businesses have gone under, patients have been less able to pay for their care, putting clinics even more in the red.

The result of this confluence of factors is that a growing number of independent clinics have closed their doors, according to a new report from the Abortion Care Network, a national association for independent abortion providers. This wave of shutterings continues a longer-term national trend. The number of independent abortion clinics in the U.S. has fallen 34% in recent years, from 510 in 2012 to 337 as of November. A total of 41 clinics have closed in the past two years alone. These closures have significant consequences for abortion access, as 58% of people seeking abortions get them at independent clinics.

While large, national abortion providers, like Planned Parenthood, are buffeted by similar headwinds, they typically have more resources and flexibility than independent clinics. Planned Parenthood, for instance, is a nonprofit organization, and so it’s eligible for some grants that independent clinics, which often operate as businesses, are not. National organizations also employ lawyers and lobbyists to influence politicians, while many independent clinics worry about meeting payroll for their frontline staff….

The above comes from a Dec. 2 story in Time magazine.