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100 Days Post-Roe: At Least 66 Clinics Across 15 US States Have Stopped Offering Abortion Care


October 2, 2022 marked 100 days since the US Supreme Court overturned Roe v. Wade, a decision that has resulted in states across the nation severely restricting access to abortion. New Guttmacher research found that 100 days after the June 24 Dobbs v. Jackson Women’s Health Organization decision, 66 clinics across 15 states have been forced to stop offering abortions.


Prior to June 24, these 15 states had a total of 79 clinics that provided abortion care. As of October 2, that number had dropped to 13, and all of them are located in Georgia. This means there are no providers currently offering abortions in 14 of the 15 states.


Among the 66 clinics where abortion is no longer available, 40 are still offering services other than abortion, while 26 have shut down entirely.


Our analysis, which builds on research we conducted 30 days after Roe fell, focuses on the 15 states that were enforcing either total or six-week abortion bans as of October 2. While most of these bans include very limited circumstances when an abortion may be allowed, those exceptions are designed to be difficult to navigate and are often unusable in practice.


States Where Clinics Stopped Offering Abortions or Closed Entirely

In the 13 states that had implemented total abortion bans as of October 2, all clinics were forced to stop offering abortions. In the other two states, Wisconsin and Georgia, the situation is precarious. Clinics in Wisconsin have faced legal uncertainty around the state’s pre-Roe total abortion ban, leading providers in that state to stop offering abortions out of fear of future prosecution. In Georgia, which is enforcing a ban on abortion starting at six weeks of pregnancy, clinics have been affected by the shortened timeframe to offer abortion services.


At the 40 clinics that have remained open for services other than abortion, our research did not ask about the scope of activities they are undertaking, but it may include providing other sexual and reproductive health services (e.g., prescribing birth control) or helping patients find abortion care in other states. However, 26 clinics have been forced to close their doors. When clinics close down or stop offering abortion care, it represents a lost source of health care for their community.


Changes to Abortion Clinic Services

Our research tracked the following changes to abortion services at clinics in 15 states as of October 2, 2022, compared with the situation right before Roe was overturned.

  • Alabama (previously 5 clinics)

    • 0 clinics offering abortion care

    • 1 clinic closed entirely, 4 open for other services

  • Arizona (previously 8 clinics)

    • 0 clinics offering abortion care

    • 1 clinic closed entirely, 7 open for other services

  • Arkansas (previously 2 clinics)

    • 0 clinics offering abortion care

    • 1 clinic closed entirely, 1 open for other services

  • Georgia (previously 14 clinics)

    • 13 clinics offering abortion care

    • 1 clinic closed entirely

  • Idaho (previously 3 clinics)

    • 0 clinics offering abortion care

    • 1 clinic closed entirely, 2 open for other services

  • Kentucky (previously 2 clinics)

    • 0 clinics offering abortion care

    • 1 clinic closed entirely, 1 open for other services

  • Louisiana (previously 3 clinics)

    • 0 clinics offering abortion care

    • 3 clinics closed entirely, 0 open for other services

  • Mississippi (previously 1 clinic)

    • 0 clinics offering abortion care

    • 1 clinic closed entirely, 0 open for other services

  • Missouri (previously 1 clinic)

    • 0 clinics offering abortion care

    • 0 clinics closed entirely, 1 open for other services

  • Oklahoma (previously 4 clinics)

    • 0 clinics offering abortion care

    • 2 clinics closed entirely, 2 open for other services

  • South Dakota (previously 1 clinic)

    • 0 clinics offering abortion care

    • 0 clinics closed entirely, 1 open for other services

  • Tennessee (previously 7 clinics)

    • 0 clinics offering abortion care

    • 2 clinics closed entirely, 5 open for other services

  • Texas (previously 23 clinics)

    • 0 clinics offering abortion care

    • 12 clinics closed entirely, 11 open for other services

  • West Virginia (previously 1 clinic)

    • 0 clinics offering abortion care

    • 0 clinics closed entirely, 1 open for other services

  • Wisconsin (previously 4 clinics)

    • 0 clinics offering abortion care

    • 0 clinics closed entirely, 4 open for other services


Impact on People Needing Abortions

The new reality of clinics no longer offering abortions or closing down entirely is having a devastating impact in states with abortion bans—and far beyond.

  • The 14 states where abortion is currently unavailable accounted for 125,780 abortions in 2020. Individuals who can no longer obtain an abortion from a clinic in these states are now forced to travel to another state for abortion care (facing additional direct and indirect costs associated with travel logistics, child care and time off work), self-manage their abortion or continue their pregnancy (and accept the significant associated health risks).

  • Likewise, 41,620 abortions were obtained in Georgia in 2020. Under the state’s six-week abortion ban, which prohibits abortion before many people even know they are pregnant, anyone needing an abortion faces an extremely limited time frame for scheduling and obtaining care. This means many people in Georgia will be left with the same options as people in states with total bans.

  • Altogether, these 15 states are home to almost 22 million women of reproductive age (aged 15–49), in addition to other people who may not identify as women but are capable of becoming pregnant and may need an abortion. That means almost one-third (29%) of the total US population of women of reproductive age are living in states where abortion is either unavailable or severely restricted.

Importantly, the loss of clinics is felt in all states—even those where abortion remains legal. Ample anecdotal evidence shows that abortion clinics in these states are being inundated with people from states with abortion bans seeking care. These dramatic increases in caseloads mean clinic capacity and staff are stretched to their limits, resulting in longer wait times for appointments even for residents of states where abortion remains legal.


More Chaos, Confusion and Harm to Come

Even before Roe was overturned, getting an abortion was difficult or outright impossible for many people, especially those who were already facing steep barriers to accessing health care, including people with low incomes, Black and Brown people, immigrants, young people, those with disabilities and rural populations. These inequities are likely to worsen as clinic-based abortion care disappears in many states, a number of them clustered in regions like the South.


An already precarious abortion access landscape is likely to continue to deteriorate. Our state legislative tracking predicts that a total of 26 states are certain or likely to ban abortion within a year of Roe being overturned. Already, several states—including Indiana, Ohio and South Carolina—had total or six-week abortion bans go into effect briefly before they were temporarily blocked in court. These bans could go into effect again as soon as the court cases are resolved. These disruptions to service provision—even when temporary—affect the ability of established providers to quickly resume abortion care. Further, rapidly changing laws may make it unclear to some patients whether they can legally seek an abortion in their state.


Much more research will need to be conducted to grasp the full extent of the chaos, confusion and harm that the US Supreme Court has unleashed on people needing abortions, but the picture that is starting to emerge should alarm anyone who supports reproductive freedom and the right to bodily autonomy.

Methodology

Starting September 20, we generated a list of clinics known to have provided abortion care in 2020 in the 17 states that implemented total or early gestational age abortion bans following the Supreme Court decision in June. We checked our list of 2020 facilities against other sources to remove clinics that had not been providing abortion care as of June 24, 2022. The number of states was adjusted based on changes in state laws and their implementation through October 2, including the removal of Indiana and Ohio after court action temporarily suspended their bans.


Between September 20 and October 2, we used multiple sources—including clinic websites, news stories, social media and information from colleague organizations—to track the status of abortion services. For each clinic, we determined if the facility was open or closed; if open, if it was providing abortions or other sexual and reproductive health care; and, if providing abortions, whether abortion care was available past six weeks’ gestation. In cases where online information was seemingly out of date (e.g., a clinic indicated it provided abortion care even though there was a state ban in effect), we conducted one or more mystery calls using the phone number listed on the clinic’s website. If a phone line was not answered after two or more calls during business hours, we considered the clinic to be closed. Data were imported into Stata17 to systematically count the number of clinics that had closed or had stopped providing abortions and were continuing to offer other services.


We analyzed American Community Survey data from 2020 in Stata17 to calculate the number and percentage of women of reproductive age living in the 15 states we investigated.


The authors thank Ava Braccia, Christina Geddes and Tammy Lever for collecting the data used in this analysis.

 

(c) 2022, Guttmacher Institute

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