The Future of Abortion Rights in the U.S.

In this video, Elizabeth Nash, MPP, principal policy associate of state issues at the Guttmacher Institute in Washington, D.C., offers an overview of the abortion rights landscape — and the barriers many people will face — in the U.S. after the Dobbs v. Jackson Women’s Health Organization decision by the Supreme Court overturned federal abortion protections conferred by Roe v. Wade.

The following is a transcript of her remarks:

When we’re thinking about the landscape of abortion rights, it has changed dramatically since the Dobbs decision overturned abortion rights in the federal constitution. Since then, we’ve seen 13 states ban abortion, primarily in the South and the Midwest, and also we’ve seen a state like Wisconsin, where abortion is unavailable because the clinics are not providing care because the status of the law is unclear.

So you really have 14 states where abortion is unavailable. And then we have another set of states where there are abortion bans, but they’re not in effect because of court cases. So we’re waiting to see how those court cases are going to play out.

Then we have states that are protecting access to abortion rights, and those states are primarily along the West coast and the Northeast. Suffice it to say, we’re still in this bifurcated status where it’s very hard to access abortion in the South, in the Midwest, in the middle of the country, and much easier along the West coast and the Northeast, and the mid-Atlantic.

In those 14 states where abortion is unavailable, that compromises 19.2 million women of reproductive age, and that’s about a quarter of all the women of reproductive age in the country. And that’s an undercount because we don’t have good estimates for transgender individuals, so the numbers are actually higher. In these states, if someone needs an abortion, they generally need to leave the state for care because the exceptions in these laws are so narrowly tailored that even if you should qualify, you don’t.

When we’re thinking about the possibility of leaving a state or traveling far distances, we’re thinking about journeys of hundreds of miles, of days away from home, so the people who are most impacted by these bans are the people who’ve been most impacted by restrictions: it’s low-income individuals; it’s Black and brown individuals; it’s young people; it’s LGBTQ individuals. We’re seeing that those who have been systemically oppressed are the ones who face the most barriers to accessing healthcare.

And when we’re thinking about what these barriers mean, it means things like coming up with not only the $550 it costs for your typical abortion, but it’s the cost of travel — that’s hundreds of additional dollars, right? We’re thinking about gas prices, hotel prices, food, all of those incidentals that add up to travel. We’re thinking about time away from work; 75% of abortion patients are low-income, so if they take time off of work, it is probably not paid. That’s additional money out of their pockets. Sixty percent of abortion patients already have a child, so they’re also looking to arrange for childcare. The logistics of an abortion are also incredibly difficult when you think of all of these circumstances.

We need to show compassion towards providers and patients. For providers, it is understanding the law; the limits of the law and what is possible under the law; and getting involved with the advocates and the lawyers that have been doing the reproductive health work, so that you know the kinds of conversations you can have, and the kind of resources that are available, because probably your patients, if they need an abortion, need information, need some compassion and some real conversations around what it means to access abortion care, and resources to help them pay for that care and where they can travel.

The future of abortion rights is one where we are seeing mobilization and a momentum around protecting access to care. We’re certainly seeing that in the progressive states along the West Coast, the mid-Atlantic, Northeast, and states like Illinois, Colorado, New Mexico, and Minnesota. We’re seeing in more of the conservative states, people showing up to protest [restricted access] to testify to their legislators in ways that we just hadn’t before.

So if we think about what happened in Indiana — Indiana recently passed a near total abortion ban. It’s not in effect because of a court case, but what we saw were providers, patients, the public showing up and telling their legislators that they support abortion rights. What happened in that special session was a real conversation by legislators around the abortion ban and the exceptions in it. Now, the exceptions are minimal in the ban, but it did help start to change the conversation.

In South Carolina, in their special session, it essentially fell apart because of the public outcry around an abortion ban, and the South Carolina legislature didn’t pass one. So the public coming out and speaking up around abortion rights is incredibly important, and then we will see how this translates into this election cycle, and the next one, and the next one.