Closed for Business: The Current Trend of Southern Abortion Clinics

After the wave of abortion bans in the South, physicians may also flee Southern states—and it will not be easy to replace them.

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Abortion rights advocates and lawmakers hold a press conference before debate of a bill that would restrict abortions after six weeks, at the South Carolina State House in Columbia, S.C., on May 16, 2023. (Logan Cyrus / AFP via Getty Images)

new abortion clinic is set to open later this month in Maryland, five miles from the West Virginia border. In the wake of the near-total abortion ban West Virginia passed in September, the Women’s Health Center of West Virginia established it on the other side of the state line. The ban has made West Virginia part of a growing abortion care desert in the South, and Maryland an abortion destination.

Until recently, North and South Carolina were among the last remaining Southern states providing abortion services, but caved to anti-abortion ideology last month, turning the region into a reproductive health desert. 

  • In the North Carolina General Assembly, the Republican supermajority overrode the Democratic governor’s veto, banning abortion at 12 weeks. 
  • In the South Carolina Senate, the six-week abortion ban passed not along party lines, but gender lines. All five women in the 46-member body, including three Republicans, led filibusters against the bill. All 27 of the “yes” votes were cast by men. (Just one day after Gov. Henry McMaster signed it into law, a circuit judge temporarily blocked the law from taking effect until the state supreme court can review the case and determine whether it violates the state’s constitution.)

The new Maryland clinic may help reduce the burden on other nearby clinics, but abortion care is still out of reach for many people living in the South. Some still have to travel upwards of 500 miles to seek services even before 15 weeks of pregnancy.

This raises costs and unduly burdens low-income people. In addition to the procedure itself, patients incur the expenses of travel, childcare and lost wages. 

While an abortion care desert is the intended goal of anti-abortion policymakers, there will also be unintended consequences.

In Idaho, a hospital announced it would have to stop delivering babies due to a physician shortage after Idaho’s near-total abortion ban caused many medical professionals to flee the state. Now, some Idaho residents will have to drive about 50 miles to get labor and delivery care.

If no one fills the growing vacuum left by physicians fleeing criminalization of abortion, reproductive health services will suffer more than they do now.

After the wave of abortion bans in the South, physicians may also flee Southern states, and it will not be easy to replace them. In a recent survey of third- and fourth-year medical students across 32 states, 57.9 percent said they were unlikely to apply to any residency programs in states with abortion restrictions. Another study found residency applications to ob-gyn positions were down 5.2 percent compared to last year across all states, regardless of abortion laws. For states with near-total abortion bans, the decline was 10.5 percent. 

This does not bode well for access to reproductive care of any kind. If no one fills the growing vacuum left by physicians fleeing criminalization of abortion, reproductive health services will suffer more than they do now. The rePROs Fight Back’s 50-State Report Card on reproductive healthcare and rights already gave all Southern states failing grades for 2022. Care options will get even more limited in states like South Carolina, where clinical nurse specialists, nurse practitioners and nurse midwives are prohibited from dispensing meditations for birth control and STI treatment. 

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When it comes to reproductive healthcare access, 26 states received a failing grade: Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Nebraska, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin and Wyoming. (rePROs Fight Back, an initiative of the Population Institute)

Most Americans recognize the need for care and do not support restrictive abortion bans. Just weeks before North Carolina passed its 12-week ban, a survey found that 54 percent of the state’s voters opposed it. In fact, 59 percent said abortion should be legal in all or most cases. This trend holds nationwide, with 61 percent of Americans supporting abortion rights. 

The 2022 Dobbs v. Jackson Women’s Health Organization decision left the abortion rights decision up to the states. But it is clear that constituents’ voices are not being heard by state governments. That is why it is up to Congress to pass the Women’s Health Protection Act and establish a national right to abortion. Without a federal law upholding access to reproductive healthcare as a human right, it will become a luxury reserved for those who can afford it, and a right denied to those who cannot. 

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About

Ashka Shah is a Duke Stanback Fellow at the Population Institute, a nonprofit that supports reproductive health and rights, based in Washington, DC.