In the past two decades, anti-abortion activists have strategically dedicated most of their resources toward state-level restrictions, sometimes even targeting individual abortion providers. Events in South Dakota stand out as an example of this tactic: The state legislature attacked the state's single abortion provider, a Planned Parenthood in Sioux Falls, by requiring a 72-hour waiting period and a consultation with an anti-abortion crisis pregnancy center before a woman can have an abortion. Additionally, states such as Oklahoma, Indiana, and Nebraska passed bans on abortion after 20 weeks, in direct violation of Roe v. Wade.
These state-specific anti-abortion efforts have been so successful lately that a few prominent voices have suggested ceding certain embattled states—like South Dakota—to anti-choice forces. Terry O'Neil, the president of NOW, suggested onThe Rachel Maddow Show that pro-choice groups might shy away from challenging the bans on abortions after 20 weeks for fear that a conservative Supreme Court might use the occasion to overturn Roe. There have been such murmurs for years: Pro-choice men Benjamin Wittes and Jeffrey Rosen have argued against Roe v Wade on the theory that withdrawing abortion access in some states would be worth it if it meant ending the abortion wars. Anti-choice terrorism compelled Megan McArdle of the Atlantic to wonder if the price of abortion rights in all 50 states was far too high.
Folding up shop in the reddest red states is a provocative suggestion. It could be a way to de-escalate the abortion wars, which have grown only more heated in recent years. But if clinics close in South Dakota or other red states like Mississippi, what will happen to the abortion patients who would otherwise use these clinics? I took the question to those who know the issue most intimately—abortion providers—as a thought experiment. After considering their experiences with women who must overcome heavy restrictions and geographical limitations, the consensus seems to be that while some women in states that have no clinics will travel long distances for abortions, others will find themselves forced to have children or will attempt self-abortion or turn to illegal abortionists. And for the women who do successfully manage to travel to an abortion provider, the costs are likely to be punishingly high and physically risky.
Of the three options, providers suggested most women would opt for traveling great distances to obtain safe abortions if clinics in their states closed. CDC statistics show an unusually high incidence of women crossing state lines to obtain abortions in regions of the country that have few providers. Over 35 percent of abortions in North Dakota are for women from other states, a direct result of how poor abortion access already is in South Dakota.
Tammi Kromenaker, who runs the Red River Clinic of North Dakota, anticipates women will double the amount of travel time to drive to her clinic in Fargo. Stopping abortion provision in Sioux Falls could mean more clients who need at least two days, maybe more, to get a first trimester abortion.
Traveling long distances creates a major financial burden for patients, especially as the majority of women seeking abortions make less than 200 percent of the poverty line. Many clinics work with nonprofit abortion funds to help women pay for their terminations, but these funds currently cover only part of the clinic's fee, and would be unlikely to have more money to pay for gas and hotel.