About a third of women of childbearing age in the US now live more than an hour away from the nearest abortion facility after the Supreme Court struck down the constitutional right to abortion earlier this year, a study found.
When more than a dozen states enacted full or partial abortion bans following the Supreme Court ruling, the number of facilities actively offering abortion care was reduced by about a tenth, from 749 facilities to 671, according to the study, published this month in the Journal of the American Medical Association.
With this decline in amenities, the average travel time to get abortion care has more than tripled, from about 28 minutes in 2021 to 100 minutes after the Dobbs v. Jackson Women’s Health Organization ruling, according to the study conducted by a team of researchers from the Boston Children’s Hospital; Boston University School of Public Health; University of California, San Francisco, Harvard University; and Harvard Medical School.
In states with total abortion bans and laws prohibiting abortions as early as six weeks of pregnancy, commute times increased by more than four hours on average, the study found.
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The southern states were hardest hit. While they could once travel 15 minutes for an abortion before the Dobbs decision, women in Texas and Louisiana now have to commute more than six hours on average.
“We need to understand the reduced access to this essential health service to better understand the resources we need to invest to regain that access,” Yulin Hswen, assistant professor of epidemiology and biostatistics at the University of California, San Francisco, and senior author of the study said in a statement.
Terry McGovern, a professor at Columbia University’s Mailman School of Public Health, said the study’s results were not surprising and “are consistent with the very dire consequences we all expected after Dobbs.”
“The Supreme Court of the United States has deprived women, girls and pregnant people of a right, and it is clearly causing severe hardship in every way,” she said.
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Longer commutes create a number of other barriers, including requiring people seeking an abortion to spend more money on travel, take extra time off and seek childcare, McGovern said. She said these obstacles only get worse for marginalized communities and for people who are uninsured or on lower incomes.
“Obviously people who have money, access and resources and don’t have to deal with structural racism and transphobia will have an easier time,” McGovern said. “What this kind of research shows us is that the Supreme Court has placed additional burdens on a population that already faced many structural barriers on an ongoing basis.”
According to the survey, about 40% of black women must travel more than an hour for abortion care, compared to 15% before the Supreme Court ruling. More than half of American Indian and Alaska Native women must travel more than an hour for abortion care.
Women without health insurance or on lower incomes were also disproportionately faced with longer trips for abortion care, the study found.
“Abortion is out of reach for too many people, especially people of color, low-income people, rural communities,” said Hillary Schneller, senior attorney at the Center for Reproductive Rights. “After the Dobbs decision, that has only gotten worse.”
Many of the remaining active clinics in states where abortion remains legal are now seeing an influx of patients traveling long distances for care, Schneller said. Clinics can’t keep up with demand, creating long wait times for “highly time-sensitive abortion care,” she added.
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McGovern and Schneller both expressed the hope that abortion bans in certain states could be appealed. They would also like to see Dobbs’ decision overturned.
McGovern also suggested ballot initiatives to entrench access to the procedure and “become more creative in thinking about where health services are located and easier ways to provide services,” including telemedicine and medicine.
Schneller also said telehealth and mail-in abortion pills are ways to increase access to abortion care, but said “some of these avenues are inaccessible to the communities most affected by abortion bans.” For example, both options often require Internet access, which may not be available to many rural communities, she said.
“None of these will be a complete solution,” she said. “But great work is happening on all these fronts to help people access healthcare in their communities, whether it’s through telehealth, getting the abortion pills in the mail, or going to a clinic to see a doctor.”