Residents of the Midwest and the South Would Be Most Affected



If Roe v. Wade were overturned or weakened, increases in travel distances would likely prevent 93,500 to 143,500 individuals from accessing abortion care, according to “Predicted changes in abortion access and incidence in a post-Roe world,” a new analysis by Caitlin Myers of Middlebury College and collaborators from the Guttmacher Institute and Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, San Francisco.

The authors found that in 2019, the average woman aged 15–44 lived 25 miles from the nearest abortion facility. They then estimated the changes in distance to the nearest facility that would occur because of anticipated changes in the legality of abortion if Roe were overturned. Specifically, they assumed facilities would close in 21 states: Eight states have “trigger laws” that would immediately ban abortion if Roe were overturned, and an additional 13 states were deemed to be at high risk of enacting new laws to ban abortion. The authors found that 39% of the United States population of women aged 15–44 would experience an increase in travel distances ranging from one to 791 miles. Residents of some counties in affected states—most of which are located in the Midwest and the South—would face an average predicted increase in travel distance of 249 miles. Because of the burden of increased travel, the overall abortion rate would fall by 33% in the year following a Roe reversal, the authors predict.

“A reversal of Roe would mean about 100,000 individuals, most of them residents of the South and Midwest, would find the increase in travel distance an insurmountable barrier to accessing abortion care,” says lead author Caitlin Myers. “Undermining or overturning federal protections for abortion would dramatically increase regional disparities in who is able to access an abortion.”

The authors used data from ANSIRH’s abortion facility database and found that nationally, the average distance to the nearest facility would increase by 97 miles, from 25 to 122 miles. Some residents in states that are not likely to ban abortions would nonetheless experience increases in travel distances because their nearest facility is in a neighboring state that is likely to enforce a ban. For example, residents of Minnesota had to travel an average of 37 miles to reach the nearest abortion facility in 2019, and this distance would increase to 46 under the more extreme post-Roe scenario, which would include outlawing abortion in the 13 additional states at high risk. The New York Times recently published findings from this analysis online as a series of maps, including an interactive map that allows users to visualize driving distances to the nearest abortion clinic by county.

“Beyond the immediate impact on people seeking care in states that would ban abortion, we anticipate the effects would spill across state boundaries,” says Guttmacher researcher and coauthor Rachel Jones. “In the long run, even if new clinics opened near borders of states where abortion was outlawed, it is unlikely that many residents in the South would be able travel long distances across multiple states to get to these facilities.”

The researchers note that this study predicts changes in abortions obtained from health care facilities, and the analysis cannot predict changes in self-managed abortions.

“Predicted changes in abortion access and incidence in a post-Roe world,” by Caitlin Myers et al., is currently available online and will appear in a forthcoming issue of Contraception.