In August 2022, a longstanding abortion clinic in Bristol, Tennessee closed and a new clinic opened in Bristol, Virginia—just one mile away. That move made visible what the overturn of Roe v. Wade made law: state lines now determine whether abortion care is legal or accessible.

Bristol quickly became a focal point in the fight for abortion access—drawing national media attention and targeted harassment from anti-abortion extremists. Geographically, it is the closest point of abortion access for a vast stretch of the South and Greater Appalachia, while also sitting in a deeply conservative region. In both the 2020 and 2024 elections, Bristol and much of the surrounding region remained a conservative stronghold, with strong electoral support for anti-abortion candidates and policies.

Still, Appalachia is not a monolith.

In the years leading up to and following the fall of Roe, a network of committed pro-abortion activists and volunteers began organizing in and around Bristol—showing up publicly, supporting patients, and pushing back against extremism. To better meet the growing needs of our region, State Line Abortion Access Partners (SLAAP) was founded in 2023 as a 501(c)(3) organization.

Since then, SLAAP has grown into a trusted, volunteer-powered regional resource. We support abortion access across Southwest Virginia, Northeast Tennessee, and beyond through a combination of direct support, community outreach, clinic escorting, and advocacy. Over the past two and a half years, we have distributed tens of thousands of free reproductive health supplies—including period products, emergency contraception, condoms, pregnancy tests, and after-abortion care kits—through partnerships with schools, mutual aid groups, clinics, and community organizations.

We show up where access is threatened and where care is needed: escorting patients at clinics, countering anti-abortion extremism on college campuses, tabling at community events, and building relationships with partners serving youth, unhoused neighbors, and people living in poverty. Our work has been recognized locally, nationally, and internationally, with coverage from outlets including BBC, The Independent, USA Today, The 19th, and The Virginia Mercury.

SLAAP’s mission is to promote and protect abortion access and reproductive health care in our region by distributing free reproductive health supplies, supporting patients, sharing accurate information, advocating for access to medication and procedural abortion, and confronting misinformation and extremism. While SLAAP is not a reproductive justice organization, our work is informed by principles of bodily autonomy, dignity, and equity—and by listening to the communities we serve.

With your support, we continue building a visible, intersectional, and resilient movement for abortion access and reproductive health care—rooted in care, dignity, and real access across Appalachia.