The closures are concentrated in the South and Midwest, areas that have banned or greatly restricted access to abortion. Guttmacher predicts that the already “dire” state of abortion access will get even worse as more states ban abortions in the coming weeks and months. “We knew bad things were going to come out of the decision when it came out on Friday, the 24th, and unfortunately, we’re not particularly surprised,” said Rachel K. Jones, a principal investigator with Guttmacher who worked on the report. There was one element of the shutdown that was surprising, said Elizabeth Nash, a government policy analyst at the organization who worked on the report. “Even before Dobbs went down, we knew this was going to happen, but I think the speed of the closure is a little surprising to everybody,” Nash said. “It happens in a flash.” The landscape of abortion access has changed dramatically since the Supreme Court issued its opinion in Dobbs v. Jackson Women’s Health late last month. The opinion ended a US constitutional right to abortion, giving states the green light to implement bans or extreme restrictions on the procedure. Since then, several states have sought to impose abortion restrictions that were previously on the books but were blocked by federal court rulings or that were designed to take effect if the Supreme Court overturns its abortion-rights precedent. Abortion providers have had some success blocking these bans in state courts in a few places, but in at least 11 states, laws limiting abortion to about six weeks into pregnancy or banning it have been allowed to take effect. As of July 24, according to Guttmacher, seven states were able to enact complete abortion bans: Alabama, Arkansas, Mississippi, Missouri, Oklahoma, South Dakota and Texas. Four states have implemented restrictions on abortion after about six weeks of pregnancy: Georgia, Ohio, South Carolina and Tennessee. Before the bans, those 11 states had 71 clinics. Now there are only 28 left. Researchers believe it will be difficult for people to access the process even in states with a six-week ban, as there may be long wait times for appointments. At six weeks, experts say, most people don’t even know they’re pregnant. “Obtaining an abortion was already difficult in many states, even before the Supreme Court overturned Roe,” the report states. “Clinic closings resulting from state-level bans and restrictions following the June 24 decision will further deepen disparities in access to care, as the addition of long distances to an abortion clinic in another state will create a barrier to many people .” And it could be a barrier for people who are already vulnerable to poor birth outcomes. “It will be especially difficult for those who feel the greatest impact from these bans, which are low-income people, black and brown patients, young people and LGBTQ people,” Nash said. Studies show that young lesbian and bisexual young women are at greater risk of unwanted pregnancy than their heterosexual peers. Child neglect, family rejection and bullying are important risk factors for teenage pregnancy. Lesbian and bisexual women may be up to three times more likely than heterosexual women to report being sexually assaulted in their lifetime, according to studies. Black women are three times more likely to die from pregnancy-related causes than white women, according to the Centers for Disease Control and Prevention. According to the CDC, black women also had the highest rate of abortions, followed by Hispanic women. Nationally, half of people seeking abortions live below the poverty level. “Wealthier and whiter people have more resources, more connections to the health care system. So they can leave the state to access abortion,” Nash said. The researchers created a list of clinics known to provide abortions as of 2020 in the 11 states that quickly moved to restrict access to abortion. They used news reports, information from other abortion access organizations and social media to determine which clinics were closed. Guttmacher plans to maintain a current list of closures as the legal landscape changes. The legal status of abortion remains in flux in several states, creating a fluid situation regarding access in states beyond the 11 Guttmacher highlighted in his report. In Wisconsin, for example, providers stopped offering abortion care because of a ban before Roe was enacted, but that 1849 law faces a legal challenge. Jones said that if all 26 states Guttmacher expects to ban abortions do so, more than 200 clinics would eventually be closed because of the Supreme Court’s ruling. “Unfortunately, this is probably only the tip of the iceberg,” Jones said. “The situation is only going to get worse for people, especially in the Midwest and South.”
