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How Abortion Bans Will Ripple Across America

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At the start of the month, nearly all women in America lived within a few hours’ drive of an abortion clinic. Clinics are closing rapidly across the country, despite Roe v. Wade being overturned and the constitutional right of an abortion ending.

The new political battles are now underway in the state legislatures and courthouses of America. A quarter of U.S. women could have to travel over 200 miles to obtain legal abortions by the time they’re done.

This number could increase to almost half in the most extreme scenarios.

Research has shown that women who travel longer distances to get to the nearest clinic are less likely to make it, as evidenced by research.

The new analysis of clinic closures — performed by Caitlin Myers, an economist at Middlebury College — underscores how the effects of each state’s decisions will spill over borders.

In the post-Roe world, a woman’s ability to get a legal abortion will depend not only on what is happening in her state, but what happens in surrounding states, too.

[Click here for more coverage on the Supreme Court’s decision to overrule Roe v. Wade.]

Jim Olsen, a Republican Oklahoma legislator, has helped to pass several abortion restrictions this past year. He said that even if some women left the state to get abortions, many wouldn’t. “Our laws will still save lives,” he said.

Because of the increased number of out-of state patients, abortion may become more difficult even in states that have it legal. And states like Colorado, Kansas and Illinois — which will be surrounded by states with bans — could become major destinations, seeing a surge of patients. “We’re going to see enormous numbers of women funneling into these states,” Professor Myers said.

Interviews with doctors at clinics that plan to stay open throughout the country revealed that they were concerned about how they would manage.

“I think we will end up over the next months with waiting lists and more patients than we can schedule,” said Dr. Erin King, executive director of Hope Clinic for Women in Granite City, Ill.

Where access to abortion will decline

Before the decision is made 716,000 women of reproductive age — or about 1 percent — live more than 200 miles from the nearest abortion clinic. This number will rise in the coming months.

Thirteen statesExisting laws, known as trigger bans to outlaw abortion, are already in place.


Clinic locations as at June 1. Sources: Caitlin Myers, Census. Note: Childbearing is defined as between 15-44 years of age.

Once all the bans on triggers have been put into effect, the number women who live so far from a clinic should increase. 9 Million.

Six of these bans were in effect as of Friday’s end. Others will start 30 days later or require approval from a government official. Texas’ trigger law won’t activate for 30 days, but officials there said they had already begun enforcing another law banning abortion from before Roe was decided.

Even under Roe, there were restrictions in some states that made it difficult to run clinics. Until recently, every state had at most one clinic. This changed when a draft Supreme Court opinion was leaked in May, indicating that the court intended not to overturn Roe. In anticipation of the decision, clinics in Oklahoma, South Dakota, and elsewhere have stopped offering abortions.

Clinics have been closed since TwoAdditional statesBecause these states still had laws in place from before Roe. A ban on abortion is considered probable in another state. Nine states,Either because similar laws exist or because their legislatures have passed stricter abortion restrictions in recent years:


Sources: Caitlin Myers, Census

Bans in these 11 states could increase the number women living more than 200 kilometres from a clinic. 17 millions.

Some of these states prohibited abortion immediately. Wisconsin’s abortion clinics were forced to close after the decision because of an 1849 law that’s still on the books. Alabama’s more recent ban had been paused by a court because of its now-irrelevant conflict with Roe.

While abortion may be legal in some states, it is more likely that bans will pass in others. It may take months to resolve the legal status of Arizona and Iowa’s anti-abortion laws. Two votes were lost in Nebraska’s recent attempt to ban abortion. However, legislators in Arizona and Iowa are now poised to try again, after one of those who voted against was killed.

There are also Three states that could have an outsize impact, where abortion’s future is uncertain:


Sources: Caitlin Myers, Census

If these three states ban abortion, the number would rise for women who live far from a clinic. 24 million.

In this new post-Roe world, each of these three states could become linchpins of access, making their legislatures’ choices particularly consequential. The legal uncertainty could also make it harder for clinics to expand capacity for out-of-state patients; providers may be wary of investing in larger clinics or new staff if they don’t know for how long they’ll be allowed to operate.

Florida recently passed a law that prohibits abortions after 15-weeks of pregnancy. But some legislators want to go even further. Virginia’s abortion laws are currently in place with Democrats controlling the State Senate. However, this could change if Republicans win the next election. Kansas’ Supreme Court ruled that abortion is protected by the state Constitution. However, a constitutional amendment to amend that decision is up for vote this summer.

Tory Marie Blew (a Republican legislator in Kansas) said she was partially motivated by the fact that women from the Midwest might turn to Kansas if their state bans abortion. When several states close to Kansas closed their abortion clinics due to public health concerns, many out-of-state women flooded into Kansas. This led to an increase of nearly 10 percent in abortions in the state by 2020.

“​​I personally don’t want Kansas to be an abortion destination state, as it currently is,” she said, adding that her district was peppered with purple signs saying “Value Them Both” — referring to mothers and children — in support of the amendment.

Interactive: See How Each State’s Ban Affects Driving Distances in Nearby States

The tool below will allow you to see the effects of any state ban on driving distances.



13 states have trigger law

11 states where bans may be implemented

It is unlikely that 20 states and D.C. will ban this.


Measuring Impact

Due to the fact that abortion is time-sensitive and high demand, having a clinic nearby may not be enough to guarantee a woman gets an appointment.

American Family Planning, Pensacola, Fla., was the closest clinic to many South women before the decision. It was the only abortion provider in Florida Panhandle and it regularly served patients coming from six states. The state closed the clinic at the end May after three women were hospitalized with complications from second-trimester abortions. The state claimed that the clinic had not filed the required paperwork. The nearest clinic is in Tallahassee, which is approximately 180 miles away.

“If it doesn’t reopen, all those women are going to have to travel that much further,” said Julie Gallagher, the clinic’s lawyer.

Even in large cities, it is possible to find only a handful of clinics. A six-hour duration Drive once bans go into effect:


Highlighted countiesAre located in states that will likely ban abortion under each scenario.

Research has shown that abortions are less common when clinics close or driving distances decrease.

Professor Myers believed that An increase of 100 miles Driving distance reduces abortion rates 20%:






Change IN DRIVING DISTANCE

Change IN DRIVING DISTANCE


Sources: Caitlin Myers

Research shows that most of the reductions would occur among poor women who cannot travel long distances because they are less capable of overcoming the obstacles of cost, transportation and other logistics.

If there is not enough legal abortions available, the number could drop further. There is no precedent that more than one state can be closed at once.

Nevertheless, abortions might not decline as much it may seem. Some women will seek out other methods to end their pregnancies. Pills that can legally end a pregnancy can be purchased illegally online from other countries or sent by mail from states where they are legal. Around 1,100 women began ordering pills from abroad after Texas banned all but the first abortions last year.

But, there will be fewer abortions in the end, which is the long-term goal the anti-abortion movements.

“​​We’ve always been very hopeful,” said Kristan Hawkins, the president of Students for Life of America, adding that it would result in “thousands of lives saved.”

Surging Demand for the Clinics that Remain

Even before Roe was repealed, the effects of declining abortion capacity were evident. Patients fled Texas to seek treatment in neighboring states, mainly Oklahoma, after Texas’s restrictions came into effect in the autumn. Oklahomans were then unable to get appointments and some moved to other states. Oklahoma banned abortion in May.

“Think of a pond when you throw a rock in it and you see those ripples — that’s what’s happening,” said Dr. Kristina Tocce, the medical director for Planned Parenthood of the Rocky Mountains, which operates clinics in Colorado, New Mexico and Nevada, and is already treating a growing number of patients from out of state. “You have so many patients competing for a finite number of appointments.”

Some Illinois clinics already had a majority patient base from Missouri, where abortion has been almost impossible since 2019. These Illinois clinics are now seeing patients from Texas every day.

“We have been preparing for this for a long time,” said Dr. Colleen McNicholas of Planned Parenthood in Fairview Heights, Ill., just across the border from St. Louis. “We opened it with the need to serve Missouri, but we really did so with an eye toward this moment.”

The clinic will now be open for 10 hours a days instead of eight. It will also be open one to two Sundays per month. Nearby, Hope Clinic for Women in Granite City, Ill., hired twice as many doctors and reworked the clinic’s space to build more exam rooms. The two clinics formed an information center that can assist patients with all aspects of their journey to Illinois, including lodging and child care. Neither clinic will turn away women who can’t pay.

“Do I think that’s going to be enough to see all the patients who need to come?” said Dr. King, the director at Hope. “No, but we had to start somewhere.”

Doctors are beginning to consider a new future in areas where abortion is still opposed. Dr. John Lee, who has been practicing obstetrics and gynecology at the Santa Rosa Women’s Center in Milton, Fla., for 33 years, says when patients ask about abortion, he first suggests counseling and talks to them about other options. He then directs them to the clinic if they decide to proceed. Now, he said, he’s not sure where to send them.

He’s most concerned about those who cannot travel, for economic or logistical reasons. “Will you have these backwoods deals people used to do?” he said. “I hope not, because people would get hurt. You know the old saying: Desperate people will do desperate acts. What I would want to do is if they’re still adamant about going the abortion route, counsel them to do it in a safe way.”

June 1 was the first day of recording abortion clinic locations. Oklahoma clinics stopped offering abortions after a May state law bans nearly all abortions. It also prohibits abortions in cases of rape, incest, or to save the mother’s life.

Distances are calculated driving distances from the county’s center to the nearest clinic. Distances in Hawaii, Alaska, and other states are shown as the crow flies.

Source: NY Times

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