Half of U.S. women could face losing abortion access

NEW YORK » Around 64 million women and girls of reproductive age live in the United States, and more than half of them live in states that could seek to ban or further restrict access to abortion if the Supreme Court were to overturn Roe v. Wade.

Many of the millions of people who live in these states would be able to seek legal abortions elsewhere, but the barriers to access — including financial resources, time off work and child care — may be hard for some to overcome.

This analysis includes 28 states that could ban or further limit abortion if the Supreme Court were to end Roe v. Wade, a decision it appears prepared to make, according to a leaked draft opinion from the court. But there is a lot of uncertainty about which states would be able to enforce bans, and experts disagree on how quickly they could take effect.

For example, the analysis includes four “uncertain” states — Kansas, Michigan, North Carolina and Wisconsin — that either have pre-roe bans or other gestational limits on abortion but whose Democratic governors are working to protect abortion rights or have pledged to oppose anti-abortion bills while they are in office.

Of the 33.6 million women of reproductive age at risk, many live in Texas, which last year banned most abortions after about six weeks of pregnancy, and in Florida, which recently enacted a 15-week ban that will take effect July 1. (The Centers for Disease Control and Prevention defines reproductive age as 15 to 44, though younger girls and older women can get pregnant.)

If Roe is overturned and states set their own limits on abortion, the effects will not be felt equally even within the restrictive states. Some women will cross state lines or order abortion pills online.

But out-of-state travel will pose financial challenges for women living on lower incomes, as well as teenagers, who may depend on family members or friends to drive them or pay for lodging. Immigrants living in the country without legal permission and who cannot risk traveling past checkpoints in states like Texas may also face steep barriers.

“Middle-income and wealthier women will always find a way, whether it’s traveling to another state or even another country,” said Melissa Flournoy, a women’s health advocate.

Facilities at risk

Many women who lose access to an abortion in their home state still will travel to get the procedure, but they may have to travel farther: More than 200 abortion providers — nearly 30% of those providing abortion services in the United States — are in the states that may ban or further restrict abortion if Roe is overturned.

“If you look at women in the Deep South, there’s not going to be any access to abortion across the Gulf Coast,” Flournoy said. “Traveling to get an abortion in another state may require going as far north as Illinois.”

In Florida, where there are 55 abortion providers, it is unlikely that most providers would have to close, because they still could perform abortions up to 15 weeks under the state’s new law. But if legislators moved to restrict abortion further, that could change.

And in states where access remains, an influx of patients would put pressure on abortion providers and could make it even harder for people living in those states to get appointments. Many of these states are planning for additional patients by opening new health centers, building out call centers and launching telehealth programs.

Illinois, for example, could see up to 20,000 outof-state patients annually if all surrounding states lose access, said Jennifer Welch, president and CEO of Planned Parenthood of Illinois.

Losing access

The 28 states that could ban or further restrict abortion have a larger share of White women and girls and a higher level of women in poverty than the states where abortion bans are less likely.

Although their numbers are smaller, Black women and girls make up a larger share of the population in these same 28 states than in the remaining states, in part because a majority of the country’s Black population resides in the South.

Most women getting abortions are living in poverty or on lower incomes, according to the most recent survey of abortion patients by the Guttmacher Institute, a reproductive health research group that supports abortion rights.

“People seeking abortion services are disproportionately poor and are more likely experiencing disruptive life events like losing a job,” said Caitlin Knowles Myers, an economics professor at Middlebury College.