25 Million Women Affected by Abortion Bans and Restrictions in Post-Roe Era

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Exactly one year ago on Saturday, the U.S. Supreme Court made a landmark decision to revoke the long-standing right to abortion, causing significant shifts in the ongoing debates surrounding politics, values, freedom, and fairness.

Currently, there are 25 million women of childbearing age residing in states where access to abortions has become more challenging than it was prior to the Supreme Court ruling.

The authority to regulate abortion laws predominantly lies in the hands of state lawmakers and courts. Many states led by Republican majorities have implemented restrictive measures, with 14 states banning abortion in most cases at any stage of pregnancy. Conversely, 20 states, leaning more towards the Democratic party, have sought to protect and maintain access to abortion.

Let’s examine the changes that have taken place since the Dobbs v. Jackson Women’s Health Organization ruling.

IMPLEMENTATION OF LAWS BANNING OR RESTRICTING ABORTION IN 25 STATES

During the past year, as women and medical professionals grappled with the absence of legal protection for abortions, numerous individuals, including Nancy Davis, found themselves facing difficulties accessing the necessary healthcare services. Davis, who resided in Louisiana, was advised by her doctors to terminate her pregnancy due to severe fetal abnormalities. However, due to a newly enacted law prohibiting most abortions throughout pregnancy, she was unable to receive the care she needed.

Davis is among the many women who have shared their stories in various media outlets, shedding light on the changing landscape and the challenges faced by doctors and patients alike.

Meanwhile, anti-abortion advocates, who have tirelessly fought to abolish what they perceive as a practice of murder, celebrated the Supreme Court’s decision in the Dobbs case. They argue that the 1973 Roe v. Wade ruling, which legalized abortion nationwide, undermined democratic principles by preventing individual states from enacting their own bans.

“The Dobbs decision represents a triumph for life that generations have fought for,” said E.V. Osment, a spokesperson for Susan B. Anthony Pro-Life America, a prominent anti-abortion organization.

While some states swiftly enacted new restrictions, others had pre-existing laws in place, designed to be implemented if Roe v. Wade was overturned, though not all of them are currently enforceable.

Many laws allowing exceptions for medical emergencies lack clear definitions for such situations. After Nancy Davis went public with her challenges last year, Louisiana lawmakers engaged in debates about whether doctors in the state were justified in denying her an abortion under a law that includes exceptions for “medically futile” pregnancies and cases where there is a substantial risk of death or impairment for the pregnant woman. However, the legislature did not make any changes to clarify the law.

Davis, like numerous other women, had to travel to a different state to obtain a legal surgical abortion. She received assistance from a fund that provides financial support for women traveling for this purpose. In September of the previous year, Davis flew to New York, accompanied by her fiancé, when she was approximately four months pregnant. She described the experience as heart-wrenching, highlighting the emotional toll it took on her.

PROTECTION OF ABORTION ACCESS IN 20 STATES

As some states have restricted abortion, others have actively worked to safeguard and maintain access to this healthcare service. Abortion clinics have relocated across state lines, expanded their staff, and extended their operating hours to accommodate women who travel from their home states to terminate their pregnancies.

In 25 states, abortion remains legal up to at least 24 weeks of pregnancy. Among these states, 20 have solidified protections for abortion access through constitutional amendments or laws. Officials in many of these states, such as California, Colorado, Minnesota, New Mexico, and New York, have explicitly welcomed women from states with restrictive abortion laws to seek the procedure in their jurisdictions.

Consequently, women have flocked to states where legal access to abortion is available.

The CHOICES Center for Reproductive Health, a clinic in Memphis, Tennessee, has treated patients seeking abortions for decades. However, after Tennessee implemented an abortion ban last year, the clinic established a second facility in Carbondale, Illinois—a state that has positioned itself as a safe haven for abortion access and a destination for women from neighboring states.

Jennifer Pepper, CEO of CHOICES, stated that approximately 80% of their patients continue to come from the communities they have served, but now they must travel much farther, hailing from Tennessee, Mississippi, Arkansas, and even Texas.

Kansas has become one of the closest locations for individuals in parts of Missouri, Arkansas, Oklahoma, and Texas seeking abortion services. Shortly before the Dobbs ruling, a new clinic opened in Kansas City, Kansas. However, within weeks, the facility became overwhelmed. Despite efforts to expand operating hours, hire additional staff, and bring in out-of-state physicians, the clinic can only accommodate around 10% to 15% of those seeking abortions.

Dr. Iman Alsaden, the medical director of Planned Parenthood based in Kansas, reported that the majority of patients at Kansas clinics now come from out of state, underscoring the dire circumstances faced by individuals who must endure arduous journeys to access essential reproductive healthcare.

In anticipation of out-of-state patients, states like Hawaii have passed laws enabling more healthcare professionals, such as nurse practitioners, to provide abortions. In New Jersey, officials have announced grants to train additional medical professionals to perform abortions.

PRECISE NUMBER OF ABORTIONS REMAINS UNCLEAR

Due to reporting delays and gaps in data, the full impact on the number of abortions performed across the United States is not yet apparent. However, according to the #WeCount survey conducted for the Society of Family Planning, a nonprofit organization advocating for research and abortion access, the monthly average of abortions provided by clinics, hospitals, and other providers in states with bans has decreased significantly after the Dobbs ruling.

The #WeCount data reveals that the number of abortions provided in states with bans has dropped to nearly zero. Although the tracking effort collects monthly data, providing a snapshot of abortion trends since the overturning of Roe v. Wade, it does not encompass self-managed abortions, relies on estimates in regions where providers do not share data, and does not fully account for seasonal variations in pregnancies or abortions.

Nonetheless, it currently provides the most comprehensive national overview. The Centers for Disease Control and Prevention is not expected to release data for 2022 until late 2024, and even then, the picture will not be complete as not all states collect abortion data, and self-managed abortions that occur outside of clinical settings are not included.

In Louisiana, where abortion was legal until 22 weeks of gestation before the Dobbs ruling, the state reported over 7,400 abortions in 2020, the last year for which complete data is available. According to #WeCount, there was an average of 785 abortions per month in April and May 2022, and since the ban took effect, there have been fewer than 10 abortions per month.

Similar trends are observed in other states. For example, Idaho reported 1,700 abortions in 2020, but recent #WeCount data reveals fewer than 10 abortions per month. In Texas, state data shows a sharp decline in monthly abortions from August 2022 to January 2023, with only a handful reported. Prior to the implementation of restrictions in 2021, the monthly abortion rate was often over 5,000.

The #WeCount survey of abortion providers indicates that, while the overall average number of abortions performed at clinics and hospitals decreased in the months following the Dobbs ruling (from July 2022 to March 2023), there has been a significant rise in abortion numbers in states neighboring those with restricted access. States such as Illinois, Kansas, New Mexico, and North Carolina have witnessed a surge in abortions. For instance, the survey recorded around 5,600 abortions in Illinois in April 2022, increasing to over 7,900 in March 2023.

GROWING PROMINENCE OF MEDICATION ABORTIONS

Even before the Supreme Court ruling, the majority of abortions in the United States were already performed using a two-pill regimen rather than surgical procedures. Now, organizations are employing medication to facilitate access to abortion, albeit illegally, in states where abortion is prohibited.

For instance, Aid Access collaborates with doctors overseas and in states with shield laws that protect them from abortion-related investigations. These doctors prescribe medications, which Aid Access then ships to individuals. Requests for medication abortion in a sample of 30 states more than doubled from the time a draft of the Dobbs ruling was leaked until it became official and bans started taking effect.

Rebecca Gomperts, the founder and director of Aid Access based in the Netherlands, believes that most women in the United States who seek abortions are still managing to access the necessary medications. She contends that the availability of the abortion pill reduces the tragic consequences of restricted access.

However, Gomperts emphasizes that women who face the greatest struggles in accessing abortion services are often those who are poor and Black.

The shift from surgical to medication abortions has frustrated abortion opponents, leading them to challenge the abortion drug mifepristone’s FDA approval, which has been in place for 23 years. For now, the Supreme Court has preserved access to the medication.

INCREASING SUPPORT FOR MOTHERS AND CHILDREN IN CERTAIN STATES

One consequence of overturning Roe in conservative states has been a newfound willingness to adopt measures aimed at improving foster care and providing benefits for postpartum women.

Mississippi, the state at the center of the Dobbs case, serves as a prime example. Republican Governor Tate Reeves signed off on several proposals that he deemed the “next phase” of the “pro-life agenda.” These measures included expanding a tax credit from $3.5 million to $10 million annually for individuals or businesses that donate to anti-abortion centers. These centers offer assistance such as diapers, clothing, and support for pregnant women but have faced accusations of providing misleading information to deter women from choosing abortion.

Reeves also approved the creation of an income tax credit of up to $10,000 for adopting a child from Mississippi and $5,000 for adopting a child from outside the state. Additionally, he extended Medicaid health insurance coverage for low-income women until one year after giving birth, rather than the previous two-month period.

In February, the state’s two Catholic bishops sent a letter to lawmakers and Governor Reeves, urging them to expand Medicaid in line with the Dobbs decision. Jackson Bishop Joseph Kopacz stated that this expansion aligns with the intent of the ruling, emphasizing that the commitment to support mothers should extend beyond birth.

Shannon Bagley, the executive director of the Center for Pregnancy Choices, an anti-abortion center located near Jackson, believes that this new era necessitates increased efforts and resources. The center has started offering more parenting classes and focusing on assisting eligible women in signing up for Medicaid, finding employment, and providing donated items such as car seats and cribs.

PLETHORA OF LAWSUITS

Since the Dobbs ruling, over 50 lawsuits have been filed challenging various abortion policies. Lawsuits have long played a crucial role in the abortion debate, but now the burden rests on abortion rights advocates to prove that restrictions are unduly harsh, rather than anti-abortion groups having to justify their validity.

Many of these legal challenges revolve around arguments concerning personal autonomy or religious freedom. For example, a lawsuit in Texas alleges that women were denied abortions even when their lives were at risk.

While bans or restrictions are currently on hold in at least six states pending resolution by the courts, only Iowa and South Carolina have permanently rejected restrictions since the Dobbs ruling. South Carolina subsequently adopted a new ban, but its enforcement has been temporarily suspended due to a legal challenge.

In Utah, a ban on abortions throughout pregnancy went into effect almost immediately after the Dobbs ruling. However, the state’s Planned Parenthood affiliate promptly challenged the law, asserting that it violates the state constitution. A judge has temporarily halted the ban while the case progresses.

CRIMINAL PROSECUTIONS REMAIN LIMITED

There is little evidence to suggest that doctors, women, or those who assist in obtaining abortions are facing criminal charges.

In Mississippi, the state attorney general’s office reports that no charges have been filed under the new law carrying a penalty of up to 10 years in prison for providing or attempting to provide an abortion outside of circumstances where the woman’s life is at risk or the pregnancy is a result of rape or incest.

Progressive prosecutors across the country, including those in states with abortion bans, have stated that they will not pursue abortion-related cases or have made them a low priority. A Florida prosecutor was suspended from his job by Republican Governor Ron DeSantis for such a stance.

James Bopp Jr., general counsel to the National Right to Life committee, finds it concerning that prosecutors are not actively pursuing abortion cases. He contrasts this with the period before Roe v. Wade when most states had restrictions in place and enforced them vigorously, asserting that it was their duty to do so. However, prominent anti-abortion groups like his oppose measures that would punish women seeking abortions, considering them victims of a culture that promotes abortion, particularly at the behest of wealthy men.

ABORTION CONTINUES AS A PROMINENT POLITICAL ISSUE

Abortion remains a significant political issue, with Republicans entering a new election season grappling with how to navigate the desires of their base, which often advocates for the strictest possible bans, while also considering the preferences of the broader electorate.

Polling consistently reveals that the majority of Americans believe that abortions should be available in at least some circumstances, particularly during early stages of pregnancy. However, most also support restrictions as the pregnancy progresses. A survey conducted by The Big Big News-NORC Center for Public Affairs Research found that the majority opposes banning abortions within the first six weeks of pregnancy but supports prohibiting them after 24 weeks. Only six states have no gestational limit, and abortions after 21 weeks are infrequent.

In the previous year, voters sided with abortion rights advocates in all six states where abortion-related ballot measures were introduced, even in traditionally conservative states like Kansas and Kentucky. The issue also played a significant role in the better-than-expected performance of Democrats in the 2022 elections.

Several states, including Ohio, are considering ballot measures to protect abortion access.

Notably, in Indiana, South Carolina, and West Virginia—states that have enacted abortion bans since the Dobbs ruling—legislative battles have not revolved around Democrats versus Republicans arguing over whether to impose restrictions, but rather among Republicans debating how far they should go.

Susan B. Anthony Pro-Life America believes that framing the issue correctly could benefit conservative candidates. The organization announced its collaboration with Kellyanne Conway, a former adviser to President Trump, to support “pro-life candidates on offense” in the 2024 election cycle.

CONCERNS ABOUT OTHER RIGHTS AMONG PROGRESSIVES

Justice Clarence Thomas’ concurring opinion in Dobbs has raised concerns among progressive advocates

Frequently Asked Questions (FAQs) about Abortion bans

More about Abortion bans

• Supreme Court Decision on Abortion Rights
• Overview of Abortion Laws by State
• Impact of Abortion Bans on Women’s Access to Care
• Medication Abortion and Self-Managed Abortions
• State Efforts to Support Mothers and Children
• Public Opinion on Abortion Rights
• Legal Challenges and Lawsuits After the Dobbs Ruling
• Clarence Thomas’ Opinion in the Dobbs Case