Amid wave of states restricting abortion, advocates step up efforts to get women to clinics

The future of abortion access in the United States is in a major state of flux, with new restrictive laws or bills from red states in the news virtually every day. The question many are asking: Where will the procedure remain legally permissible if the Supreme Court's 1973 Roe v. Wade ruling is overturned, and will women in states that have passed restrictions be able to access it?

Last week, Missouri became the latest state to pass a so-called "heartbeat" bill, with Gov. Mike Parson passing legislation making it illegal to obtain an abortion after eight weeks. He described the bill, which makes no exceptions for cases of rape or incest, as “a strong message to the nation that here in Missouri, we will always stand for life, protect women’s health and advocate for the unborn.” Earlier in May, Alabama's governor signed a near-total abortion ban, and Georgia's governor signed a law banning abortion after six weeks. The three states join Kentucky, Mississippi and Ohio, which have passed heartbeat laws. Tennessee, South Carolina, Louisiana and Arkansas are considering similar bills. 

In response to the onslaught of bans, lawmakers in blue states and reproductive rights advocates around the country are both stepping up efforts to make sure the procedure remains accessible for all women – even if it means they must travel out of state.

None of the new bills and laws are constitutional: Roe v. Wade, which protects a woman's right to abortion, is still the law of the land. But Alabama's lieutenant governor, Will Ainsworth, has said the state laws “begin a long overdue effort to directly challenge Roe v. Wade." Many see the newest Supreme Court justice, Brett Kavanaugh, as a fifth vote in an anti-Roe majority, and look forward to legal challenges for this reason. Ohio’s law, set to take effect in July, has already been challenged by a lawsuit from the ACLU.

At the moment, abortion is legal everywhere but difficult to obtain in many areas around the country. Six states have a single abortion clinic left: Kentucky, Mississippi, North Dakota, South Dakota, West Virginia, and Missouri (although this last state may see its sole clinic closed by the end of the week). Many more have enacted provisions that make the process deliberately onerous and costly. If Roe falls, seven states with "trigger laws" — Louisiana, Mississippi, North Dakota, South Dakota, Arkansas, Kentucky, and Tennessee — will immediately ban abortion.

But nine states have enacted constitutional protections ensuring abortion would remain legal if Roe v. Wade is overturned. And eight more offer statutory protections; while less ironclad because they can be repealed, these offer some protection as well. For women in states where abortion is restricted, traveling to one of these “protected” states may become the only option, and even that could carry potential legal peril (Georgia's law includes a provision that says residents could be prosecuted for obtaining an abortion out of state).

The Florida Alliance of Planned Parenthood says a new center in Tallahassee, close to the border, will be helpful to Georgia residents in the event that the state's ban goes into effect. In Illinois, women's health advocates are pushing for the passage of the Reproductive Health Act, which would repeal the state's current abortion law and replace it with stronger protections in the event that Roe v. Wade falls. "Governor J.B. Pritzker has said he wants Illinois to be a safe haven for reproductive rights," said Nicole Lopez of the Midwest Access Coalition. New York passed a law of the same name in January. "With the signing of this bill, we are sending a clear message that whatever happens in Washington, women in New York will always have the fundamental right to control their own body," Governor Andrew Cuomo said at the time.

Abortion rights groups plan to continue the work they're currently doing, which includes helping women get to clinics. "We don't fund the procedure itself, but we step in with travel and lodging aid, childcare, food — all the incidental costs that come up in terms of people accessing the procedure," said Lopez. "We service traveling to, from or within the Midwest. If someone shows up at a clinic in Illinois and realizes she's too far along to be served here, we can help get a plane ticket to Albuquerque."

She says networks of support groups like the National Network of Abortion Funds anticipate a huge rise in volume of women seeking their help if state bans proliferate. "In safe states we're probably going to see people traveling from farther away, and more extreme cases," Lopez says. "But I wonder how many people are not going to know we exist, or just not try given the law changes. I really hope that's not the case."

She urges women to shore up their own digital privacy now in the event that it could be used against them for seeking abortion post-Roe. "I'm on a crusade to get everybody to start using (encrypted texting app) Signal, just so we have privacy by default," Lopez says.

Another possibility reproductive rights advocates see is the increased use of medical abortion, which involves using two drugs to terminate a pregnancy and takes clinical care largely out of the equation. "We know that women often prefer the experience of managing their own abortion at home," says Dr. Jen Gunter, an OB/GYN, women's health advocate and author of the upcoming book “The Vagina Bible.” "It gives women a lot of control and gives them privacy. I wouldn't be surprised if new legislation comes up making it illegal to deliver these drugs across state lines."

In the meantime, people like Randi Gregory of SPARK, a Southern-based reproductive rights organization, are pointing out that the state’s law has not taken effect yet: "We've already had patients calling clinics saying, 'Is my appointment still good?'" she says. "Even though it's a signed law, it doesn't take effect till January. As of right now, abortion is still legal in Georgia.”