Cumberland, in Allegany County, is beautiful—rural and relatively isolated, set in the foothills of the Appalachians. I practiced here for 25 years and still live here. Allegany is also one of the least healthy counties in Maryland, ranking 21 of 24. We are relatively poor and there is almost no public transportation. It’s been difficult to access any specialized care.

The new Women’s Health Center of Maryland held its ribbon-cutting this week. It promises to bring a greatly needed range of services to the region, including abortion. The clinic is being launched by the Women’s Health Center of West Virginia staff, which was forced to stop doing abortions in West Virginia after a near-total abortion ban there. The decision to relocate abortion services to western Maryland was very strategic—the clinic is south of Cumberland, a few miles from Keyser, West Virginia. It will fill an abortion desert, serving women from our state, southwestern Pennsylvania, and Ohio, which also now is restricting women’s access to care. The clinic notes it will provide a phased approach to gradually increase services, beginning with medical and surgical abortions, contraception, and STI testing and treatment. They will add breast and cervical cancer screening and gender-affirming hormone therapy soon.

In the first 100 days after the June 24, 2022, Dobbs v. Jackson Women’s Health Organization decision overturning Roe v. Wade, the Guttmacher Institute found that at least 66 clinics across 15 states stopped performing abortions. Now, “22 million women and girls of reproductive age in the US now live in states where abortion access is heavily restricted, and often totally inaccessible,” according to Human Rights Watch.

Even with MD Governor Moore declaring Maryland as a “safe haven” for those seeking an abortion, it’s not been easy for women here. While Maryland will have a constitutional amendment vote next year enshrining the right to abortion, our local representatives oppose this — even standing in opposition to allowing their constituents to vote. (McKay is also known, however, for wanting a vote in the western counties to secede from Maryland and join West Virginia). State Senator Mike McKay is ardently anti-choice; he and local commissioners have made their opposition to the clinic known. There were about a dozen all male protesters standing along the edge of the road holding signs and yelling at times. The clinic was well-prepared for this and there was no disruption.

On the other hand, Rep. David Trone spoke passionately at the ribbon cutting about our need to vote in light of the rightward shift of the Supreme Court. He emphasized that “Abortion rights are human rights.”

The president of Mountain Maryland Alliance for Reproductive Freedom, a nonpartisan, grassroots group of people from Allegany and Garrett counties. Cresta Kowalski, said, “This day is a day of celebration. The Women’s Health Center of Maryland will be a beacon of hope and light to people who’ve been in darkness for way too long.

She became teary as she noted that the LGBTQIA+ community, including her child, will now have “opportunities to receive gender-affirming health care by professionals in a non-judgemental and compassionate manner. They will no longer be wanting for care, in the darkness, but will have a place of hope and dignity in our rural community.”

Physician’s perspective

As a practicing physician, because of aggressive protesters in Hagerstown, I preferred referring women to clinics in Baltimore for safe abortions. But that is a several-hour drive, and Hagerstown’s clinic, with its more limited services, is almost 70 miles away and is very difficult for poor women without a car.

As a physician, I have cared for women who have had serious infections from a botched abortion. I am also aware of women forced to carry and deliver fetuses with fatal abnormalities (e.g., anencephaly, where part of the skull and brain are missing) because local hospitals refused to allow a late-term termination.

Some years ago, I strongly opposed the merger of the two local hospitals—Sacred Heart and Memorial Hospitals— because that would have put all health care in western Maryland under the restrictions of the Catholic church, with no accessible options. The proposed merger would have prohibited not only abortions, but vital contraceptives, tubal ligations, administration of Depot Provera (a long-acting contraceptive), and distribution of condoms, as well as affecting end-of-life care. (The prohibition on tubals would have forced women to go out of town and have a 2^nd anesthesia and operation after their delivery). Counseling about HIV and STD prevention would have been prohibited. Due to the need for women study participants to be on effective contraception, many clinical trials for new medications would not have been allowed, severely limiting patients’ access to state-of-the- art care.

Wayne Goldner, MD, a retired abortion provider I have known for decades, applauded the decision to open a full women’s reproductive health clinic in Cumberland. He reiterated that by “Making abortion illegal or hard to obtain, the number of abortions does not go down, but morbidity and mortality goes up.

Women will have abortions no matter what the law says.” These restrictions “hurt the poor, single and minorities the most.” And, Goldner stressed, we should remember that such clinics save women’s lives each day.

For decades, my stance has been that healthcare decisions should be a medical decision between a patient and their physician and not dictated by anyone else’s personal or religious beliefs. It is great to see that coming to fruition in Maryland—particularly in our relatively depressed and isolated rural area.