Abortion After Roe: Long Road Trips and Crowded Clinics

If Roe v. Wade falls, 26 states will likely ban abortion, forcing pregnant women to travel long distances to reach their nearest abortion clinics—if they can afford it.

If the Supreme Court overturns or weakens Roe, Texans on average will have to travel 525 miles one way to reach the nearest abortion clinic—a 3,017 percent increase. (Flickr / ConwayStrategic)

Before the Supreme Court allowed the Texas six-week abortion ban to go into effect on September 1, pregnant women had to travel an average of 17 miles to get to their nearest abortion clinic. Now, they have to travel 14 times longer—an average of 247 miles one way—to get to the nearest abortion provider, reports the Guttmacher Institute. 

The Supreme Court is now considering Dobbs v. Jackson Women’s Health Center, a direct challenge to constitutional abortion rights established in Roe v. Wade close to half a century ago. If the Court, with Trump’s three anti-abortion Republican appointees, overturns or significantly weakens Roe, Texans will have to travel an astonishing 525 miles one way to reach the nearest abortion clinic—a 3,017 percent increase, according to research just released by the Guttmacher Institute.

“It’s a well-known fact that restrictions don’t stop people from needing abortion. Instead, they push care out of reach for many people by making abortion more expensive and logistically challenging to get,” said Dr. Herminia Palacio, president and CEO of the Guttmacher Institute. 

Researchers at Guttmacher asked two questions: If states ban abortion, where will people find the nearest clinic? And, how far would they have to travel to get there? 

In a policy analysis paper and an easy-to-use interactive map published last Thursday, Guttmacher shows which states are likely to ban abortion and how long people will have to travel to find the nearest abortion clinic if their state bans abortion. 

If the U.S. Supreme Court weakens or overturns Roe v. Wade, 26 states are certain or likely to ban abortion. (Guttmacher Institute)

The report breaks states down into three categories: ban states, destination states and no-impact states. Guttmacher predicts that 21 states are certain to ban abortion if Roe v. Wade falls, and five states (Florida, Indiana, Montana, Nebraska and Wyoming) are likely to do so. These states are concentrated in the South, Midwest and Plains areas of the country. 

Destination states, where people from ban states would find their nearest provider, include 13 states bordering the Ban States. 

No-impact states include nine northeast states along with Alaska and Hawaii, where abortion would likely remain legal, but where people from ban states would not find their nearest provider.

“If Roe v. Wade is overturned, people seeking abortion will have to travel significantly farther to get care,” says Palacio. “Worse, states that are likely to ban abortion are clustered together, especially in the South and Midwest, and people might have to cross multiple state lines to reach the nearest provider.” 

The interactive map shows how far people in each state would have to travel to the nearest abortion clinic under three scenarios: if states enact a total ban, a 15-week gestational ban or a 20-week gestational ban. 

For ban states, viewers can see the number of women of reproductive age in the state, the average one-way driving distance under the current legal status, the average one-way driving distance under the selected ban, the increase in average driving distance and the closest states with no abortion ban. For destination states, viewers can see the increased number of reproductive-aged women who may drive to the state for abortion care, the percentage increase and the states they would come from.

For example, a total ban on abortion in 26 states would increase the average one-way driving distance to the nearest provider by 630 miles in Louisiana—a 1,720 percent increase—and 567 miles in Florida—a 6,803 percent increase.

Red states are certain or likely to ban abortion. (Guttmacher Institute)

The interactive map also indicates what percentage of women in each state banning abortion would go to which destination state. For example, of the 1.1 million women of reproductive age in Louisiana, 59 percent would find their next nearest clinic in Illinois, 22 percent in North Carolina and 18 percent in Kansas.

The destination state of Illinois would experience an 8,651 percent increase in out-of-state women who would find their next nearest clinic in the state—from 100,000 now to 8.9 million if 26 states had total bans on abortion. Two million would be from Michigan; 1.5 million from Indiana; 920,000 from Wisconsin; 740,000 from Ohio; 730,000 from Missouri; 630,000 from Louisiana; 590,000 from Kentucky; 540,000 from Tennessee; 490,000 from Mississippi; 400,000 from Arkansas; 180,000 from Iowa; and 21,000 from Alabama.     

The report notes that clinics in destination states would be unlikely to have the capacity to accommodate all the new patients and that many destination states also have onerous restrictions that increase barriers to abortion, such as waiting periods, two-trip requirements and parental consent.

“Increases in driving distances would pose hurdles for many people,” said Palacio. “However, research shows that some groups of people are disproportionately affected by abortion restrictions—including those with low incomes, people of color, young people, LGBTQ individuals and people in many rural communities.”

At a time when Texas has banned abortion, the Supreme Court has twice allowed the ban to stay in effect and the Court is hearing a case that could overturn Roe v. Wade as soon as this summer, the Guttmacher data is critically important for planning how to help women find the abortion care they need in the worst case scenarios. 

Editor’s note: The use of “women” to refer to the population of people impacted by abortion bans reflects the terminology in the U.S. census, from which the data are drawn.

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Carrie N. Baker, J.D., Ph.D., is the Sylvia Dlugasch Bauman professor of American Studies and the chair of the Program for the Study of Women and Gender at Smith College. She is a contributing editor at Ms. magazine. You can contact Dr. Baker at cbaker@msmagazine.com or follow her on Twitter @CarrieNBaker.