Tara Romano, executive director of Pro-Choice North Carolina / Designed by Lara Witt

One year post-Roe is an as-told-to series led by Prism’s Editor-at-Large Tina Vásquez, marking the milestone by featuring new and veteran advocates and organizers, abortion storytellers, providers, clinic directors, abortion fund volunteers, and reproductive justice organizers. You can read the complete series here

Tara Romano is a mainstay of North Carolina’s abortion rights movement. If there is a protest, she is there. If there is an anti-abortion bill coming down the pike, she’s battling it. If there’s misinformation circulating, she’s correcting the record. Of course, this is all part of her work as executive director of Pro-Choice North Carolina, a small grassroots organization that disaffiliated with NARAL Pro-Choice America in 2021. But Romano is also known as someone who cares deeply about abortion access in North Carolina—where abortion rights are regressing. 

On July 1 a new law went into effect banning medication abortion after 10 weeks and procedural abortion after 12 weeks. Known as Senate Bill 20, the legislation comes with a host of new restrictions, including an additional in-person appointment for patients that is required at least 72 hours before they can access care. A provision of the law requires the North Carolina Medical Care Commission to rewrite regulations on clinics by Oct. 1, allowing the state to impose further restrictions that will potentially force some of the state’s smaller, independent clinics to close because they are unable to comply with burdensome, unnecessary building requirements. 

Historically, North Carolina has been an outlier in the South with less restrictive abortion laws than other states in the region. Prior to SB 20, abortion was accessible up to 20 weeks. A single lawmaker helped seal the abortion ban deal for Republicans in the state, who quickly pushed the legislation through in May. 

Rep. Tricia Cotham switched to the Republican party in April. The move gave Republicans a supermajority in the House of Representatives, allowing them to override Democratic Gov. Roy Cooper’s veto of SB 20. Cotham voted for the ban, and her actions have enraged and confounded abortion advocates. The state legislator from Mecklenburg County once publicly shared her own abortion story and was reelected this year as a pro-choice Democrat. Earlier this legislative session, Cotham even co-sponsored legislation to codify Roe v. Wade.

Romano said she doesn’t like to “waste a lot of breath” talking about Cotham and chooses instead to focus on the fight for abortion rights moving forward. The executive director recently spoke to Prism about SB 20, how a lack of understanding around pregnancy and abortion leads to misinformation, and why voting is particularly important in North Carolina. 

Here she is, in her own words: 

Over the last year, I think the biggest change we’ve seen is that more people understand what’s at stake—people who maybe weren’t as tuned in before. It’s a perennial issue with this work that the majority of people in this state and in this country support abortion, but people don’t really think about access until they need an abortion or someone close to them does. So I think last June, when the Dobbs decision came down, many people were surprised by it. We were devastated by the decision, and we basically knew it was coming. There were signs—in Texas, when the Supreme Court let SB 8 go into effect when they took up the Dobbs case from Mississippi even though it was unconstitutional, the stacked, hyper-partisan Supreme Court. Maybe people weren’t paying attention to the signs then, but now they seem to be more invested, and more people want to try to help restore reproductive rights and abortion access in the state.

Abortion access in North Carolina has always been precarious; it’s really dependent on what happens politically in our General Assembly. Since 2011, in addition to seeing anti-abortion restrictions come from the General Assembly, we’ve also seen voting rights restrictions and political and racist gerrymandering. It’s been attack after attack on our democracy, which includes attacks on abortion access.

Until SB 20 came along, we’ve been able to stop abortion restrictions in North Carolina since the 2015-16 legislative session. When they voted to override the veto, they only needed one person—one more Republican in the House—to uphold it. It wasn’t like we didn’t have a chance of upholding the veto. We did. And I remember when Rep. Cotham switched parties and became a Republican, there were a lot of questions about what it would mean for abortion access in the state. At the time, I didn’t think it would come down to her because we have Democrats in the state who have not supported abortion access in the past. But for the first time, all of the Democrats stood strong on abortion. They listened to their constituents and to experts who didn’t support the ban. So in a sense, it did come down to Cotham because if we had a person in her seat who actually represented the interests of her majority pro-choice constituents and delivered on the pro-choice platform she ran on, we wouldn’t have this ban. 

This is a sad illustration of how precarious things are in our state. Upholding the veto was down to one person—and this was after all of the secret, months-long backroom negotiations that led to the bill. The veto was scheduled for 8 p.m. on a Tuesday, without any public input. [And now] it’s over. We have a 12-week ban.

But it’s really not just a 12-week ban. The law has added a new requirement for an extra, in-person visit. They’ve cut off medication abortion at 10 weeks. Saying this is a 12-week ban doesn’t tell the whole story because you’re not accounting for clinic wait times and how long it will take to be seen multiple times by a clinic. When you account for that, people have less than 12 weeks to make this decision and access care—and this is intentional. 

I worry that people may hear “abortion ban” and think they can’t access care at all in North Carolina. They can.

There are challenges in how we talk about these things, and not everyone in the movement agrees with certain messaging. There is a whole ecosystem around abortion access work—there are clinics, clinic escorts, and defenders, abortion funds, activists, people who focus on advocacy. We’re not going to agree on every detail, and that’s OK. Having a big coalition of stakeholders who are fighting for abortion access is necessary and wonderful. It’s also natural for there to be tensions. 

For example, Planned Parenthood is a key partner that does a lot of great advocacy work, particularly around the challenges clinics face. But their clinics operate very differently than independent clinics, and Planned Parenthood has very different access to resources. They can more easily pivot to different ways of providing access to reproductive health care. Small clinics don’t have the ability to really do that. Right now is a very good time to ensure we are also listening to the perspective of smaller, independent clinics, who have typically seen the majority of abortion patients in our state, have a unique perspective on abortion care, and may see the effects of SB 20 more acutely. 

We just have to be increasingly careful about how we talk about things. I worry that people may hear “abortion ban” and think they can’t access care at all in North Carolina. They can. Something I’m cognizant of is how anti-abortion folks take advantage of the confusion. They stand outside of clinics and tell people they’re breaking the law, especially if the patients are here from out of state. They spread misinformation all day. This is why helping people understand the details of state abortion laws is critical.

This also extends to health care providers. Sometimes they act out of an abundance of caution; sometimes they are also misinformed—especially as it relates to things like abortion medication or self-managed abortion. They don’t know everything about the law, they are nervous about losing their license, and they may report people [for self-managed abortion]. The other thing is that anti-abortion laws often target providers. I think the rationale is really to scare providers out of providing care. For the part of the anti-abortion movement that identifies as “pro-life,” one of their biggest lies or forms of misinformation is that they don’t go after patients. Maybe not technically, but if you are going after providers—people who help patients—or if you are isolating patients from providers, then you are harming patients. 

Destigmatizing abortion would go a long way to pushing back against restrictions, but so would understanding pregnancy.

Misinformation also kind of festers because abortion is still so mysterious to people. It wasn’t that long ago that I would mention medication abortion, and people had no idea what I was talking about. It was really eye-opening a number of years ago when I spoke to a focus group about abortion. The people in the group identified as pro-choice, and they would say things like, “Most abortions happen later in pregnancy.” That’s not true. If you get into even more technical information about medication abortion or gestation limits, people are really confused. 

Many people don’t even really understand everything about pregnancy, particularly potential complications. That’s very clear with lawmakers and some men who craft anti-abortion legislation. Sometimes you read the bills, and you think, “What? This isn’t really how things work.” Destigmatizing abortion would go a long way to pushing back against restrictions, but so would understanding pregnancy. Since the Dobbs decision, we’ve heard a lot of stories about people being denied care they needed because health care providers worried it would be interpreted as an illegal abortion. That’s in part because many people who write anti-abortion legislation have a misunderstanding and misinformation about pregnancy and what can go wrong during pregnancy or what complications could arise that require abortion care. 

It feels important to say that voting is still critical, although it doesn’t solve everything, and people are very intentionally excluded from the electoral process. Again, abortion is precarious in our state, and headed into 2024, we’re going to be up against a lot of anti-abortion and anti-democratic forces. Voting isn’t an immediate fix; it doesn’t solve things overnight, but it provides a concrete opportunity to make a difference at every level—the federal level, the state level, the local level, at the courts. By the time of our next election, lawmakers will have heard countless stories about the horrors of what happened post-Dobbs—stories about people almost losing their lives after being denied care, stories about people forced to carry pregnancies to term, reporting on the rise of violence at clinics. We cannot let them think this is acceptable. We cannot let them hear these stories and then continue pushing bans. There needs to be accountability. 

Tina Vásquez is the editor-at-large at Prism. She covers gender justice, workers' rights, and immigration. Follow her on Twitter @TheTinaVasquez.