Abortion Access in the U.S.: A Year After Roe vs. Wade Overturned

A little over a year after the United States Supreme Court overturned Roe vs. Wade, eliminating federal protections for abortions, nearly a quarter of women have no access to an abortion facility within 90 minutes, putting their lives at risk.

And researchers predict that number could almost double if additional abortion bills being considered in states are passed.

A Significant Gap in Abortion Access

A study published in the journal Obstetrics and Gynecology, one of the first to create more exact travel times using actual road and geographical data, found 23.6 percent of women of reproductive age, 15 to 49 years old, have no access to an abortion facility within a 90-minute drive. Twenty-nine percent do not have access within a 60-minute drive, and 41.4 percent do not have access to a facility providing abortions within a half-hour drive.

When combined with women at risk of losing access to an abortion facility due to potential new laws, those numbers increase to 43 percent within 90 minutes, 45.6 percent within 60 minutes, and 53.5 percent within 30 minutes.

Mapping Actual Distances

While previous studies on abortion access have only used estimated distances to clinics, this study used isochrones, lines on maps that depict an area accessible from a point within a certain time, and data from multiple government, state, and local agencies to create travel times using actual roads, meaning this study mapped actual drives women have to make.

Additionally, because of the ever-changing landscape of abortion rights in the US, researchers had to reanalyze their data three times as more bills were passed or challenged in court.

The Impact of Roe vs. Wade Overturn

In June 2022, 49 years after Roe vs. Wade guaranteed the right to an abortion, the decision was overturned in the Dobbs vs. Jackson case, which challenged the constitutionality of a 2018 Mississippi state law that banned most abortions after the first 15 weeks of pregnancy. In the decision, the Supreme Court ruled the US Constitution did not guarantee the right to an abortion.

Following the ruling, 14 states made abortion illegal, meaning they have banned the procedure entirely and enforce bans through civil and criminal penalties, including fines and jail time.

State-Specific Challenges

In states like Arkansas, Louisiana, Mississippi, and Oklahoma, where abortion is illegal, access to abortion clinics within 30, 60, or 90 minutes is virtually non-existent. Even in states like Texas, where severe restrictions are in place, only three percent of women have access to a clinic within 90 minutes.

In contrast, states like Washington, DC, Rhode Island, Connecticut, and Delaware, which protect abortion rights, have significantly better accessibility to abortion clinics.

Research Methodology

For the study, researchers from Washington State University, University of California, Davis, and University of North Carolina at Chapel Hill used publicly available data to identify the addresses of 750 abortion clinics in the US. They used the 2020 census to determine the population of women between the ages of 15 and 49 years old. To determine geography and distance, the team obtained road network information from OpenStreetMap and GeoFabrik. Researchers then used isochrones to determine distances.

Increasing Travel Times

Previous studies have also found that travel times to abortion access have increased since the Dobbs decision. Before the decision, women traveled an average of 27.8 minutes to the nearest facility. Following the decision, that average time rose to more than 100 minutes.

Additionally, before the 2022 decision, 14.6 percent of women had to travel at least 60 minutes, compared to 33.3 percent now.

Complex Factors at Play

According to Dr. Dawn Kopp, vice chair for OBGYN at Washington State University Elson S. Floyd College of Medicine and senior author on the recent study, access to abortion is about more than just laws. It's also about facility availability and location relative to where people live.

Kopp emphasized that "this study adds to the stories patients and clinicians have already shared by giving objective data on how pervasive the difficulty to access comprehensive reproductive health care is in a post Roe v. Wade America."

Health Consequences and Maternal Mortality

Regardless of the reason for limited access, the barrier to traveling to a clinic can have real health consequences. Studies show that maternal and neonatal mortality rates increase in states with more abortion restrictions. Women with lower incomes face even greater risks due to the cost and time it takes to reach an abortion care facility.

Data from Texas in 2022 revealed a significant spike in infant mortality after the state enacted strict abortion bans.

In another study, researchers from the University of Colorado Boulder estimated that if abortions were completely banned in the US, there could be a 24 percent increase in expected maternal deaths nationwide, with a 39 percent increase for Black women. These estimates were based on 2020 statistics on national and state abortion incidences, incidence of births, and updated statistics on maternal mortality for all pregnancies.