- One year after Roe V. Wade fell about 1 in 3 women in U.S. live in a state where abortion is not accessible.
- Thirteen states have banned abortion, the vast majority of which are located in the South and Southeast.
- States that allow abortions are now serving their own residents along with people traveling from out-of-state.
It’s been one year since Roe v. Wade, the 1973 precedent that protected the right to get an abortion in the United States, fell.
In the case Dobbs v. Jackson Women’s Health Organization, the United States Supreme Court ruled on June 24, 2022 that there’s no constitutional right to abortion.
In the months following the Court’s decision, several states enacted restrictions tightening access to abortion.
Thirteen states currently ban abortion in most cases and many other states enacted laws making it challenging, if not impossible, to access abortion care.
It’s estimated that one in three women live in a state where abortion isn’t accessible.
States that allow abortions are now serving their own residents along with people traveling from out-of-state.
“This has also increased the wait time for abortion services — sometimes by weeks. Which, when you are talking about abortion, can mean the difference between an easy versus more complicated procedure,” Alison Gash, PhD, an associate professor in the Department of Political Science at the University of Oregon, told Healthline.
Thirteen states have banned abortion, the vast majority of which are located in the South and Southeast.
Many of these bans have civil and criminal penalties for anyone who helps a pregnant person get an abortion.
For example, in April 2023, Idaho passed legislation that makes helping a pregnant minor get an out-of-state abortion a crime that can get up to five years in prison.
States have also challenged the availability of medication abortion, which, historically, has accounted for over half of all abortions in the United States.
As a result, there’ve been news reports of pregnant people who’ve been unable to terminate their pregnancies.
Some of these people are suing the states that prevented physicians from providing life-saving care, Gash said, while other people were forced to carry their dying fetus to term or no longer have the ability to get pregnant because the lack of care resulted in a hysterectomy or permanent reproductive health complications.
Pregnant people seeking an abortion have to jump through multiple hoops, often traveling long distances and enduring lengthy wait times, for care.
“Essentially, states have simply shifted their responsibilities to their residents onto other states and out-of-state providers to offer these services,” Gash said.
Data from the Society of Family Planning, which has been tracking the shifts in abortion access since Dobbs v. Jackson Women’s Health Organization, shows that number of abortions in the U.S. dropped significantly.
In the six months after Dobbs, there were 5,377 fewer abortions provided each month in the U.S. compared to before Roe fell.
Meanwhile, many states attempted to prohibit the use of medication abortion and some lawmakers tried to get the pills banned nationwide.
The health effects of such bans are greatest among the most vulnerable and marginalized communities, which includes Black, Brown, Native American, immigrants, LGTBQ, people who are non-binary and the poorest of our communities, says Dr. Josie Urbina, MD, an ob-gyn and a complex family planning specialist with the University of California, San Francisco.
For these individuals, these restrictions have introduced more barriers to medical care.
This means more people will die because, for some communities, pregnancy is a life-threatening condition, says Urbina.
“Decreasing access means putting low-income mothers and women of color in even greater harm’s way,” Gash said.
On the opposite end of the spectrum, several states, such as California and New York, expanded access to abortion.
Seventeen states in addition to the District of Columbia now have laws in place to protect the right to abortion.
“In fact some clinics in abortion-supportive states serve more out-of-state than in-state patients on any given day,” says Gash.
Despite the crackdown on medication abortion in certain states, more facilities rolled out programs that offer medication abortion in an effort to meet the increased demand from out-of-state patients.
Abortion provided by telehealth services in states where abortion is permitted has grown, representing about 9% — a higher percentage of abortion compared to pre-Dobbs—of abortions in the six months after Dobbs.
The sweeping restrictions haven’t just affected the people carrying unwanted pregnancies.
Physicians who do abortions are leaving states where the procedure is no longer allowed, creating a decrease in the number of OB/GYN doctors in states with bans, according to Urbina.
“The criminalization of physicians who do abortions has led to an exodus of them leaving abortion-restricted states due to fear of either losing their medical licenses, being fined or being criminally charged and prosecuted,” says Urbina.
In addition, because abortion is a component of sexual and reproductive health care, obstetrics and gynecology residents and trainees living in restrictive states are traveling out of state to other institutions for abortion training.
It’s crucial for doctors-in-training to get this education because OB/GYNs are required to do abortions in emergency settings.
This requirement was introduced by the Accreditation Council for Graduate Medical Education in 1996.
According to Urbina, this is not an uncommon occurrence in the field.
“Here in California, we’ve hosted a number of OB/GYN residents from states where abortion is either severely or completely restricted,” says Urbina.
Reproductive health experts are monitoring the short and long-term impacts that have and will take place due to the fall of Roe.
For example, it’s unclear how the restrictions will affect the quality of pregnancy care, says Gash.
In addition, many people — such as low-income women, women of color, uninsured women, and women with substance abuse problems — may fear seeking traditional health care.
Before Roe was enacted, people could be penalized even if they had a miscarriage, and the same may be true in the future.
“Under this kind of situation, already vulnerable women will be less likely to voluntarily seek out health care — even if they are most likely to need it,” Gash said.
In the year since Roe v. Wade, the 1973 precedent that protected the right to get an abortion in the United States, fell, many states have banned or restricted access to abortion, creating numerous hurdles and barriers to care. At the same time, a number of states have expanded access in an effort to support an increased demand from out-of-state patients. Researchers are actively monitoring the many ways in which the fall of Roe has impacted abortion services, but it’s clear the effects are vast.