By Lily Sexton
Abortion clinics across the map have been forced to shut their doors following the U.S. Supreme Court’s decision to overturn Roe v. Wade, leaving many without access to critical reproductive healthcare services.
In the past year and a half, 12 states have been able to enact complete bans on abortion. Prior to the bans, these states had 71 clinics. Now there are less than 28 left, according to data published by the Guttmacher Institute and collected by Abortion Care Network, an association of community-based abortion providers. Texas had the most clinic closures, with 23 in total.
“It’s about women having the right as to what to do with their body and with family planning,” said Carol Brooks Ball, a volunteer clinic escort at a Planned Parenthood in Massachusetts.
In Massachusetts where abortion rights have been upheld, women regularly visit Planned Parenthood clinics to receive healthcare services. Brooks Ball has been a clinic escort since 2014, volunteering each week to bring patients into the building safely and acting as a barrier for the protestors outside.
“These patients are coming in–it could be for abortion services, it could be for pap smears, it could be for gender medication they’re taking,” she said “They get all of it from Planned Parenthood and we escort them in the door as best we can.”
But since the Dobbs decision in June 2022, Brooks Ball said she’s witnessed a surge of patients coming from out of town. She said that she noticed some license plates on cars from the Midwest, but acknowledged that many more patients probably flew there.
In Massachusetts, the clinics are in a safe haven state and are not at immediate risk of closing down like the clinics in other states with strict abortion bans. However, research is showing that even in the states where abortion is protected, the number of out-of-state patients is making available appointments harder to come by.
U.S. Senator Elizabeth Warren (D-Mass.) published an investigation that looked at how the anti-abortion laws affected healthcare in her state. In that report, the National Nurses Union highlighted that in states where abortion is legal and protected, the healthcare providers are strained because they’re dealing with additional patients who are forced to travel to receive the reproductive health care they need.
“Put simply, state abortion bans are deadly for pregnant women,” Warren wrote in the report.
Other researchers came to the same conclusion. According to data available on FiveThirtyEight, a publication that focuses on opinion poll analysis, there were points over the past year and a half where several states had no available appointments for an abortion for long periods of time.
That data was collected by a group of volunteers led by Caitlin Myers, professor of economics at Middlebury College. They called 737 abortion clinics in 46 states, as well as the District of Columbia, to ask for the date of the next appointment for an abortion. Through this research, they found that women were put on a three to four week waiting list if they wanted the procedure–even in regions where abortion access was not threatened.
The data suggests that the long wait times are a result of the dozens of clinics that closed down, causing women to have to travel to new clinics that were not equipped to handle the influx.
Even today in Massachusetts, the next available appointment for an abortion with Planned Parenthood is over two weeks away. When most abortion clinics won’t operate past 10 to 11 weeks gestation, a weeks-long waiting list is not always an option
And in states where abortion is banned, not even a waiting list is an option for women who don’t have the means to travel. As a result, they are forced to miss out on basic healthcare services. For activists in those states, this is a reality.
“There are so many words I can use to describe what a clinic means to a community, but if I were to keep it short, I would just say it’s absolutely essential,” said Tyler, a volunteer for a women’s health clinic in Texas who asked to go by her first name.
“I’ll never forget the morning that the ruling went into place and we had to tell this long line of women that we were not able to help them,” Tyler said. “I actually thought that it was some kind of crazy, dystopian nightmare. I didn’t realize at the time that I would still be living in that nightmare all this time later.”
Before the ban, the clinic Tyler volunteered at saw about a hundred patients every month who had an appointment for an abortion procedure, according to her estimates. A few months after they had to stop offering abortions, the volunteers were told that the clinic would be closing its doors.
“You can also call it a war on women,” said Tyler.
Activists point out that women who want an abortion and can afford to cross state lines, will–but not everyone has that option. This creates a system where people with a lower income are at a serious disadvantage.
Research backs this argument. According to a study, published in the Journal of Women’s Health, greater travel distance for an abortion is associated with higher out-of-pocket costs, delayed care, and negative mental health effects. According to a Kaiser Family Foundation study, one in three low-income women depend on clinics for their health care. But with travel not accessible to everyone, and medical deserts spanning entire states those low-income women will no longer have access to the care they relied on.
Tyler said she witnessed this inequality deepening in the weeks before the clinic she volunteered at closed down. She said they would try to direct women to neighboring states–namely Colorado and Nevada–but that traveling out of the state or country to obtain abortion services was out of reach for some people.
“What am I supposed to say in that situation? Taking off from work and traveling hundreds of miles isn’t something everyone can do on a Tuesday afternoon. But at the same time, having a baby isn’t something everyone can do either,” she said.
Clinics have taken steps to reduce wait times — such as adding more telehealth appointments, staying open for longer, and sometimes expanding their staff. But activists are saying this isn’t the answer to the growing inequalities caused by the Supreme Court decision.
“None of this is okay, and I truly hope that soon enough the people in charge start to realize that.”