Even as access to any form of reproductive health care is threatened by the Trump administration’s latest rule on Title X, which blocks federally funded health care providers from making referrals to or even informing patients about abortion providers, state lawmakers are continuing their forward march on abortion restrictions. (Planned Parenthood, which serves 1.5 million, or 40 percent, of the low-income people who receive birth control, pregnancy tests and screening for sexually transmitted infections under the rule, announced Monday that it would withdraw from the program rather than comply with the so-called “gag rule.”)
And in the conservative war against reproductive rights, each new law comes closer to unraveling Roe v. Wade: In recent months, state legislatures have passed so-called “heartbeat bills,” which bar abortion once a fetal heartbeat becomes detectable; bans on abortion based on the anticipated race, sex or disability of the fetus; and various regulations on clinics that make it near impossible for them to operate. Some state lawmakers are looking beyond just restricting abortion in their communities and are passing laws in anticipation of an eventual Supreme Court repeal of Roe’s brittle constitutional framework.
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Kentucky Gov. Matt Bevin, the self-proclaimed most pro-life governor in the country, recently signed a so-called trigger law — one of several preemptive anti-abortion laws that would ensure that, once Roe falls, the state will automatically erect a full-fledged ban on all abortions. Trigger laws may mostly be symbolic for now, but they portend a bleak post-Roe future, when abortion is unmoored from federal constitutional protections and abortion rights default to a patchwork of regressive state restrictions. Women will then face abysmal gaps in abortion care, with outright bans in eight states and severe restrictions in many others, even as the federal government (and, presumably the states) make birth control harder for the poorest women to access.
Still, abortion won’t go away; it will simply cost women more, forcing many into deeper hardship and greater risk in order to end an unwanted pregnancy, and leaving others priced out of their basic reproductive rights.
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A new study on abortion in a “Post-Roe world” projects that, were the decision to be repealed, women would immediately face outright abortion bans in eight states — Arkansas, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, South Dakota and Tennessee — and extreme restrictions in many others, which would dramatically lengthen the distance women would need to travel to an abortion clinic. About 4 in 10 women ages 15 to 44 would have to travel farther, some up to nearly 800 miles from home. The average additional distance traveled would be nearly 250 miles, which would compound the existing “abortion deserts” that already sprawl across many cities and rural regions.
If Roe is overturned, a woman in Kentucky, for instance, might be faced with the burden of a half day’s drive to and from a clinic in another state, as well as a potentially onerous 24-hour wait between her initial clinic visit and the actual procedure, thanks to mandatory waiting periods that some states have imposed.
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In numerical terms, perhaps abortion opponents could then claim a notional victory: The year following Roe's reversal, according to the study, would see an estimated one-third decline in abortions nationwide because increased travel distances would prevent an estimated 93,546 to 143,561 women from terminating their pregnancies.
Some might be surprised that nearly 1 in 3 women would be deterred under these abortion restrictions. But according to Caitlin Myers, co-author of the study, the decline “is not so implausible when you consider that women seeking abortions tend to be at a particularly vulnerable time in their lives… For some women, a clinic that is a couple hundred miles away might as well be on the moon.”
Yet two-thirds women who want an abortion will probably manage to get one, even if it costs them a job or disrupts their family lives. Their desperation will be measured in the de facto abortion tax they will pay: not just the added time and cost of driving to a faraway clinic, but also the risk of secrecy that a teenager takes on when she borrows a bus fare and vanishes for a weekend, or the psychological stress an undocumented single mother endures when she spends the last of her savings and takes risks of traveling across state lines while trying to avoid exposing herself to immigration authorities.
But behind the numbers, the deep social toll of abortion restrictions will only exacerbate the hardships that drive many to seek abortion in the first place. The study notes that, among women who have abortions, three quarters are low-income or poor, and over half already have children. The majority “have experienced a recent disruptive life event.” For them, the cost of dealing with a pregnancy they do not want or cannot afford still exceeds the cost of navigating a maze of dehumanizing abortion restrictions.
The evidence bears out women's choices; the long-term effects of abortion restrictions could be economically devastating for low income women. According to the Institute for Women’s Policy Research, in the decades following Roe, abortion access has been correlated with increased labor force participation, as women who can choose whether and when to have children also have more freedom to pursue career goals. Abortion access is also linked to decreased teen births and in turn, increased college attainment, with an especially pronounced effect for black women. And their children did better economically and academically, with lower rates of poverty and higher college graduation rates.
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Conversely, this new study warns of the negative consequences of the mounting restrictions on abortion access. With 338 anti-abortion laws passed between 2010 and 2016, the growing thicket of state-level restrictions on reproductive rights could undermine women’s ability to participate in the workforce and earn college degrees, and lower the future prospects for their kids.
The setbacks for women and families parallel a general disinvestment in family planning services by the Trump administration. Fortunately, some states such as Illinois and New York are working to expand abortion access, with additional laws strengthening state-level abortion rights and reaffirming reproductive choice in healthcare programs.
But if Roe unravels and abortion bans are unleashed around the country, women will face a legal and economic precipice, their reproductive futures chained to an ideology that strives to “protect the unborn” at any cost. The cost is always meted out on their bodies and minds, forcing them to travel impossible distances, eroding their bodily autonomy and stripping away their dignity in order to uphold someone else’s idea of the “sanctity of life.”
