March 12th, 2006
LAST week, Gov. Michael Rounds of South Dakota signed a sweeping new ban on abortion. Some abortion-rights advocates raised an alarm: soon women in particular states will have to board buses and airplanes to have their pregnancies terminated, the way they did in the era before Roe v. Wade.
The concern is understandable. But the truth is that for many poor women living in remote areas, the dark predictions have already come true — and they did so some time ago.
Consider Wyoming. In 1988, according to Stanley Henshaw of the Alan Guttmacher Institute, 61 percent of women who had abortions traveled out of state to get them. By 2000, the figure had climbed to 95 percent.
In Mississippi, where the number of places that offer abortion services has shrunk from six to one, 60 percent of women traveled to neighboring states to terminate their pregnancies in 2000, up from 33 percent 12 years earlier. In Kentucky, the percentage jumped from 22 percent in 1988 to 41 percent in 2000. In South Carolina, the rate also nearly doubled, to 35 percent from 19 percent.
Limits on access to abortions — and long distances separating the dwindling number of providers — are increasingly the norm in rural areas and much of the heartland. Even with Roe in place, the number of hospitals and doctors performing abortions has diminished nationwide, to the point where 87 percent of counties in America have no abortion providers at all. In South Dakota, only one abortion provider remains, and it is a Planned Parenthood in Sioux Falls.
The women most affected by this situation are the same ones who would feel the brunt of the impact were Roe v. Wade overturned: those who have little money, are geographically isolated, and happen to live in states where the social climate is hostile to reproductive rights. Often they are single mothers for whom having to buy a bus or plane ticket may mean not being able to afford an abortion. Many must scrape together their savings in states where Medicaid does not cover the procedure.
To point this out is not to suggest that nothing would change were Roe overturned. Without Roe, the socioeconomic and geographic divisions that now mark the abortion landscape would undoubtedly grow more pronounced. While states like Texas and Louisiana would most likely ban the procedure, more liberal states would become magnets for women throughout their surrounding regions. In this sense, America would return not to the 1950′s, when abortion was illegal, but to the early 1970′s, when places like New York, which decriminalized abortion in 1970, were besieged by women from Ohio and Pennsylvania.
My father began an obstetrics-gynecology medical residency in Buffalo in 1973, a few weeks after Roe. What he and other doctors witnessed after the Supreme Court decision was not a sudden influx of women seeking abortions but a temporary reduction in demand as women from other states were able to turn to local providers. Later, he would hear stories about how, prior to Roe, Buffalo was so inundated with out-of-state patients that hospitals worried about how to accommodate them, and a local abortion clinic had to stay open seven days a week.
Although things have not come full circle just yet, the news from South Dakota is the latest indication that, with or without Roe, access to abortion is increasingly limited in states that have never accepted the decision’s legitimacy. For that reason, it seems that abortion-rights advocates ought to focus less on the specter of a Supreme Court reversal than on the reality of who is — and is not — able to exercise choice under current laws. We’d do better to view South Dakota’s action not as transformative, in other words, but as an effort to formalize what for many women already exists in practice.