Latest News

Access to abortion clinics declines sharply


 

FROM JAMA

Estimated travel time to abortion facilities in the United States has increased significantly since the Supreme Court overturned Roe v. Wade, according to results from an original investigation published online in JAMA.

In the wake of the ruling, many clinics have closed and now 33.3% of females of reproductive age live more than an hour from an abortion facility, more than double the 14.6% who lived that far before the Dobbs v. Jackson Women’s Health Organization court ruling, the paper states.

A 2022 study found that when people live 50 miles or more from an abortion facility they “were more likely to still be seeking an abortion on a 4-week follow-up than those who lived closer to an abortion facility,” wrote the authors, led by Benjamin Rader, MPH, from the Computational Epidemiology Lab at Boston Children’s Hospital.

Of 1,134 abortion facilities in the United States, 749 were considered active before the ruling and 671 were considered active in a simulated post-Dobbs period.

More than 15 states have total or partial bans

The researchers accounted for the closure of abortion facilities in states with total bans or 6-week abortion bans, compared with the period before the ruling, “during which all facilities providing abortions in 2021 were considered active.” The authors noted that more than 15 states have such bans.

Researchers found median and mean travel times to abortion facilities were estimated to be 10.9 minutes (interquartile ratio, 4.3-32.4) and 27.8 (standard deviation, 42.0) minutes before the ruling and used a paired sample t test (P < .001) to estimate the increase to a median of 17.0 (IQR, 4.9-124.5) minutes and a mean 100.4 (SD, 161.5) minutes after the ruling.

The numbers “highlight the catastrophe in terms of where we are,” Catherine Cansino, MD, MPH, professor, obstetrics and gynecology at the University of California, Davis, said in an interview.

Behind those numbers, she said, are brick walls for people who can’t take off work to drive that far or can’t leave their responsibilities of care for dependents or don’t have a car or even a driver’s license. It also calculates only land travel (car or public transportation) and doesn’t capture the financial and logistical burdens for some to fly to other states.

Dr. Cansino serves on the board of the Society of Family Planning, which publishes #WeCount, a national reporting effort that attempts to capture the effect of the Dobbs decision on abortion access. In a report published Oct. 28, #WeCount stated the numbers show that since the decision, there were 5,270 fewer abortions in July and 5,400 fewer in August, for a total of 10,670 fewer people in the United States who had abortions in the 2 months.

For Dr. Cansino, the numbers are only one measure of the wider problem.

“If it affects one person, it’s really the spirit of the consequence,” she said. “It’s difficult to wrap your mind around these numbers but the bottom line is that someone other than the person experiencing this health issue is making a decision for them.

“You will see physicians leaving states,” she said, “because their hands are tied in giving care.”

Pages

Recommended Reading