At least 66 clinics in 15 states have stopped providing abortions since the Supreme Court overturned Roe v. Wade in June, according to a new analysis from the Guttmacher Institute, an abortion rights research organization.
The analysis, released Thursday, found that 26 abortion clinics shut down entirely and that 40 others remained open but no longer provided abortion services through Oct. 2, which marked 100 days since the Supreme Court ruled in Dobbs v. Jackson Women's Health Organization that there is no constitutional right to an abortion, leaving the question of abortion rights to the states.
The findings foretell that "inequities are likely to worsen as clinic-based abortion care disappears in many states, many of them clustered in regions like the South," said one of the authors of the analysis, Rachel Jones, a principal research scientist at the Guttmacher Institute.
14 states have no legal abortion providers
Researchers focused on 15 states that were enforcing total or six-week abortion bans on Oct. 2. The analysis notes that those states had 79 total clinics that provided abortions before the Dobbs decision, compared with 13 today.
All of the remaining open clinics are in Georgia, where a law prohibits abortions once a "detectable human heartbeat is present." An ultrasound scan can detect electrical activity in the cells of an embryo, which could eventually become a heart, as early as six weeks, before many pregnancies are even detected. The law includes exceptions for rape and incest if police reports are filed, and it allows for a later abortion when a woman's life is at risk or a fetus is unviable.
The closings leave 14 states with no legal abortion providers, according to the analysis, which adds that those states accounted for more than 125,700 abortions in 2020.
The most closings were in Texas, where at least a dozen clinics shuttered, the Guttmacher analysis says. Texas has both a pre-Roe ban and a six-week ban, with an exception for the life of the woman.
At least three clinics closed in Louisiana; two clinics each closed in Tennessee and Oklahoma; and one clinic each closed in Alabama, Arkansas, Arizona, Georgia, Idaho, Kentucky and Mississippi, Guttmacher found. All of those states have total abortion bans, except for Georgia, which has a six-week ban.
“When clinics close down or stop offering abortion care, it represents a lost source of health care for their community,” Jones said.
Some remain open for (other) business
In addition to the more than two dozen clinics that shut down entirely after Dobbs, 40 others remain open but can no longer provide abortion services, the analysis says.
While Guttmacher researchers didn't survey the clinics about the other services they're providing, they could include providing birth control or helping people access abortion in other states, according to the organization.
Planned Parenthood also provides STD testing, pregnancy testing, transgender hormone therapy and primary care services, according to its website.
Texas has the most former abortion clinics — 11 — that remain open for other services, according to Guttmacher.
All of the clinics that once provided abortions in West Virginia, Wisconsin, South Dakota and Missouri — seven in total — have stayed open to provide other services, according to the analysis.
The 15 states that Guttmacher analyzed are home to almost 22 million women of reproductive age, or about a third of the national population of that demographic, according to the organization’s analysis of census data. The figures don’t include an untold number of transgender, nonbinary and gender-fluid people who may not identify as women but could get pregnant and seek abortions, the organization notes.
Guttmacher researchers conducted the analysis by building on their earlier research that surveyed more than 1,600 health care facilities across the country that provided abortions in 2019 or 2020, analyzing those findings alongside state abortion bans that took effect after Dobbs and conducting additional research to find out whether clinics remained open and what services they were providing.
'We are in a very chaotic legal situation'
Experts who weren’t involved in the Guttmacher study said the findings reveal the scope of the Dobbs decision’s fallout and the vastness of the affected population.
Carole Joffe, a professor of obstetrics and gynecology at the University of California, San Francisco, and a co-author of “Obstacle Course: The Everyday Struggle to Get an Abortion in America,” said the findings “confirm the extraordinary difficulties that women and others” face in accessing abortion, she said.
Ushma Upadhyay, who also works at the University of California, San Francisco, as an associate professor in the department of obstetrics, gynecology and reproductive science, said that "distance barriers force people to either self-manage their abortions or carry unwanted pregnancies to term," adding that such barriers affect pregnant people of color the most, who also have the highest risks of complications in pregnancy and childbirth.
Significant distance from abortion providers imposes particular burdens for low-income women seeking abortions, including travel and child care costs, according to Upadhyay's 2018 research on the barriers pregnant people face when they live more than 100 miles from an abortion provider.
Joffe pointed to data from the Turnaway Study, a landmark long-term study led by her UCSF colleague Diana Greene Foster, which found that people denied wanted abortions had almost four times’ greater odds of being below the federal poverty level than those who received wanted abortions and that people who couldn't obtain abortions were more likely to stay in contact with violent partners and struggle to bond with their children.
For people in states with abortion bans who can afford to travel to states where abortion remains legal, the situation remains bleak, said Jones, the Guttmacher researcher. States where abortion remains legal “are being inundated with people from states with abortion bans seeking care,” she said, adding that the influx results in longer wait times for appointments and stretches clinic staffers to their limits.
Joffe added that more closings are likely in the face of increasing abortion restrictions. The Guttmacher analysis notes that several states — including Indiana, Ohio and South Carolina — have abortion bans that are temporarily blocked in court and could take effect soon.
“The take-home for me is we are in a very chaotic legal situation post-Dobbs,” Joffe said.