The US town of Bristol, population around 44,000, is a divided community.

Split between Virginia and Tennessee, the state line runs literally down main street. While both sides have much in common, there is one major difference – abortion is illegal in Tennessee. This has been the case since the 2022 Supreme Court ruling which gave individual states, rather than the federal government, the power to legislate abortion, triggering 12 states to pass near-total bans.

So the city’s only abortion clinic, Bristol Women’s Health, moved less than a mile down the road to continue practising legally in Virginia.

But just because abortion is legal in Virginia it doesn’t mean the battle for abortion access is over.

“It’s like whack-a-mole,” said Barbara Schwartz, the co-founder of SLAAP, the State Line Abortion Access Partnership. They assist people travelling into Virginia to get an abortion at Bristol Women’s Health Clinic.

“As soon as one approach doesn’t work, the anti-abortion crowd pops up in Bristol and tries another.”

On 22 December, Bristol’s Circuit Court will hear the clinic’s case against an eviction notice served by their landlords, brothers Chase and Chadwick King in April 2024.

Lawyers for the clinic argue it has the right to renew its lease for a total of six more years. But if the judge rules in favour of the building’s owners, the clinic will be forced to find a new home.

This is not the landlords’ first attempt to remove the clinic from their property. The brothers claimed that the clinic fraudulently concealed that they perform abortions, to which they maintain to be “adamantly opposed”. The case was dismissed in September last year, with Judge Sage Johnson ruling:

“If [the landlords] had conducted a simple internet search on their tenants, as any reasonably prudent landlord likely would, they would have discovered that the clinic did, in fact, provide abortion services as is plainly stated on their website.”

Clinic owner Diana Derzis, who declined to comment on the hearing, previously stated that she hopes to keep the clinic in the city, even if they are evicted. However, she noted there are few other suitable facilities in Bristol, Virginia.

The clinic leaving Bristol would be a “blow” to abortion access, according to Barbara Schwartz, the co-founder of SLAAP, the State Line Abortion Access Partnership.

Since Roe v Wade was overturned, states where abortions are legal have become destinations for out-of-state abortion seekers, with 155,000 people crossing state lines last year, according to the Guttmacher Institute (GI).

The organisation also found that over 9,200 people travelled to Virginia alone to have the procedure done last year.

“Bristol’s position means the clinic is the closest place by several hours to get a safe and legal abortion for millions of southerners.”

Victoria Cobb, the director of anti-abortion lobbyist the Family Foundation, also notes that Bristol’s location places it at the “epicentre of the debate”.

Ms Cobb launched the first of several efforts to restrict abortion in Bristol by making use of local bylaws. The tactic is being used by anti-abortion campaigners in states which permit abortion. The logic is simple: If you can’t win at Capitol Hill, why not fight at City Hall?

“Locals don’t want to see their town turn into an abortion destination location,” Ms Cobb states. “We’re happy to help them.”

The Family Foundation has argued in the past that the existence of the clinic goes against zoning regulation, which prohibits buildings from being used in a way that could endanger life.

“Why would this not extend to unborn life?” asked Ms Cobb.

Their ordinance said no new clinics should be allowed to open in Bristol, and expansion of the existing clinic should be blocked.

Similar rules have been used in other parts of the US to restrict abortion, including nearby Washington and Russell counties. But Prof Laura Hermer, an expert on abortion regulations in the US, says these efforts are largely “virtue signalling”.

“I’d be surprised if many of these towns have any healthcare, let alone abortion, providers,” she said.

The debate became heated in Bristol, as the council agreed to look into the matter.

“It has been more stressful than dealing with a parking lot. It’s not something that has really come to the local level before,” Jay Detrick, the city’s planning director told the BBC.

Ultimately, the city’s attorney found that imposing restrictions on a medical facility was not in their remit.

Soon after the city decided not to intervene, another group decided to try and shut the clinic down – this one spearheaded by Texas pastor Mark Lee Dickson.

The pastor has lobbied councils across the US to enforce the Comstock Act, a 152-year-old federal law that prohibits sending or receiving material via post which might induce an abortion.

Ninety-three local authorities have passed ordinances to enforce the Comstock Act, even closing a Planned Parenthood clinic in Lubbock, Texas.

Pastor Dickson is hopeful his ordinance filed in Bristol will have the same result. It has not yet been considered by the Council, but he remains optimistic.

“A local government’s tabling or rejecting of such a measure doesn’t by any means mean the initiative is dead,” he told the BBC.

Kimberly Smith, SLAAP’s co-founder, anticipates further campaigns. She says anti-abortion activists target Bristol due to its unusual political make-up:

“They come here because we were a red part of a blue state. If they chip away here, then that weakens the entire framework of a state’s rights.”

Indeed, even if the clinic wins its case this week and can remain in place, its opponents are undeterred, Pastor Dickson tells the BBC.

“As long as the cries of unborn babies are silenced in Bristol there will be an effort to push the City Council to fulfil their obligation to protect unborn Bristolians.”