Overturning Roe v. Wade will strip millions of their right to abortion. Some abortion clinics are bracing for an influx of patients; many others will shut down completely.
A decision in Dobbs v. Jackson Women’s Health Organization is due out any day, one that feminist organizers are now sure will reverse Roe v. Wade and strip millions of their longstanding right to abortion. With 26 states set to partially or completely ban abortion if Roe is overturned, clinics in protected areas are bracing for an influx of patients while those in anti-abortion states are preparing to operate in a hostile environment—or shut down completely.
Since Roe, states have continuously attacked reproductive rights through unnecessary and burdensome clinic regulations, so-called “personhood bills” that undermine women’s rights and “trigger bans” that would immediately ban abortion if the Supreme Court overturns Roe. Prosecutors in anti-abortion states have criminalized miscarriages and used surveillance technology on pregnant people to enforce existing bans.
“There is no debate when it comes to healthcare, when it comes to science,” said Physicians for Reproductive Health (PRH) director Dr. Jamila Perritt at a press briefing earlier this month organized by PRH and Abortion Care Network. “The claim that anti-abortion politicians have continuously made, that bans on abortion are intended to improve the health and well-being of our families and our communities, is blatantly false.”
Reproductive health clinics offer other critical services in addition to abortions. In Charleston, W. Va., the Women’s Health Center offers STI screenings and treatment, birth control and cervical cancer screenings, and will soon be adding gender-affirming hormone treatment.
“If we cannot provide abortions, our revenue is slashed by 40 percent,” said Katie Quiñonez, executive director. Roe is the only law protecting abortion in West Virginia, and without it, the nonprofit might be forced to shut down and leave thousands of patients without access to any of these life-saving services.
In North Dakota, Tammi Kromenaker, owner and clinic director of the Red River Women’s Clinic, said her team plans to tirelessly provide abortions for as long as they legally can. But because of a trigger ban passed in 2007, Kromenaker warned, “If the Supreme Court does overturn Roe, we will be forced to close our doors within 30 days.”
Red River Women’s Clinic has been North Dakota’s only abortion provider since 2001. Those seeking abortions in North Dakota already travel an average of 165 miles—about two and a half hours—one way to receive care, according to the Guttmacher Institute. The impending total ban on abortion in North Dakota would increase average driving distances to 355 miles—over five hours—to the nearest clinic out of state.
Unsurprisingly, clinics in states where abortion will remain legal anticipate an overwhelming increase in out-of-state patients, leading to appointments delayed by weeks or even months.
Mercedes Sanchez at Cedar River Clinics in Washington anticipates a 385 percent increase in patients when Roe falls. States such as Illinois will face as high as an 8,651 percent increase in patients for whom they have the nearest abortion provider.
Sanchez’s clinic is now focused on getting the necessary funding and staff to prepare for such an influx. “We need to think bigger, better, different,” she said. In some pro-abortion states, lawmakers are passing bills allowing other healthcare providers like nurses, nurse-midwives and physicians’ assistants to provide abortions to prepare for this increase.
Clinics also continue to fight anti-abortion laws in the courtroom, but resources are draining. “We have been in near-continuous litigation against the state for the last 10 years,” said Kromenaker. Providers will likely file more lawsuits after Dobbs is decided—but clinics must balance these expenses with funds for patients who cannot pay for services.
If we cannot provide abortions, our revenue is slashed by 40 percent.Katie Quiñonez, executive director of the Women’s Health Center
As it stands, even Roe has not ensured accessible abortion care for marginalized communities. Since 1976, the Hyde Amendment has prevented federal dollars from covering abortions except in cases of rape or incest. The restriction applies to anyone insured by the federal government including people on Medicare/Medicaid and most Native Americans.
“It is the result of centuries of institutional and structural inequity and racism in our healthcare systems,” said Peritt. “Those with increasingly limited access to abortion care are the same communities who are most heavily impacted by state violence, by inequitable maternal morbidity and mortality.”
Experts say a lack of abortion coverage reinforces existing inequalities. “When pregnant people don’t get a wanted abortion, their families are kept in poverty for years,” said Sanchez.
Quiñonez agrees—in a state like West Virginia where 16 percent of the population lives below the poverty line. “Make no mistake: Dismantling abortion rights is an attack on West Virginia parents, domestic violence survivors, children, working class families and so many more.”
Those with increasingly limited access to abortion care are the same communities who are most heavily impacted by state violence, by inequitable maternal morbidity and mortality.Dr. Jamila Perritt, director of Physicians for Reproductive Health
Because in-clinic abortion can be unaffordable, restricted and leave people vulnerable to prosecution, many seeking abortions have bypassed the medical system in favor of self-managed abortions by obtaining and taking abortion pills.
Medication abortion uses two FDA-approved oral medications to end a pregnancy: mifepristone and misoprostol. Mifepristone interrupts the flow of the hormone progesterone that sustains the pregnancy and misoprostol causes contractions to expel the contents of the uterus.
Abortion pills are highly effective—with an over 95 percent success rate for pregnancies up to 10 weeks—and they are extremely safe. Serious adverse events are rare, occurring in less than one-third of one percent of cases. When patients before 10 weeks obtain in-clinic abortions, they are often medication abortions.
“People should be free of stigma and criminalization, no matter what method of abortion that they choose,” said Dr. April Lockley, a fellow with PRH and administrator of the Miscarriage + Abortion Hotline. Her service provides callers with free, real-time, anonymous answers about abortion pills from medical professionals. “While self-managing abortion is safe,” Lockley said, “it should not be the only option.”
“We are aware that Washington and other states where abortion is legally protected are being seen as the safety net,” said clinic director Sanchez. “And honestly, the safety net has holes in it.”
Sign and share Ms.’s relaunched “We Have Had Abortions” petition—whether you yourself have had an abortion, or simply stand in solidarity with those who have—to let the Supreme Court, Congress and the White House know: We will not give up the right to safe, legal, accessible abortion.