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Supreme Court ruling triggers maze of state abortion laws

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The U.S. Supreme Court overturned Roe v. Wade on Friday, forcing women seeking abortions to navigate a labyrinth of laws and restrictions ranging from near-outright bans in more than a dozen states to provisions in a few states not only guaranteeing access to abortion but funding to pay for them.

Within a year of the court's decision eliminating federal abortion rights, as many as 75,000 women won’t make it to a provider, according to one estimate. They will be forced to give birth instead, marking just the start of the fallout from a ruling whose implications will stretch far beyond reproductive health care to encompass suppression of female participation in the workforce and the amplification of racial and economic inequities.

States are set in some cases to revert to laws from the 1800s,  allowing abortions only in the direst of conditions, such as when the mother is on the brink of death. Other states have passed more recent laws anticipating the court would overturn Roe v. Wade. In 13, so-called trigger laws will go into effect banning abortion in nearly all instances and only sometimes offering exceptions for rape and incest.

Women born before Roe v. Wade organize politically on abortion rights
Baby boomer women are working to codify abortion into law and elect candidates who support abortion.

In wide swaths of the country – across the South and plains of the Midwest – abortions will be banned or made more difficult to access, a USA TODAY review of laws in each state found. In the Northeast and Northwest, as well as a few states in the middle, states are positioning themselves as havens where abortion rights are protected and enshrined.

Some 16 states have codified the right to an abortion, and in 10 others, abortion rights have state constitutional protection.  Several states previously moved to bolster abortion rights to counteract the loss of Roe. Connecticut passed a first-of-its-kind law in May, increasing protections for women seeking abortions from out of state and for those who help them, as well as providers who perform the procedures. New York passed a similar law this month.

Among other states, a litany of restrictions falls short of banning abortion but places conditions on the procedure, narrowing access. The limits include requiring women seeking abortions to undergo an ultrasound or other exam, to get parental consent in some cases, and to submit to a waiting period before the procedure.

“Up until about 10 years ago, no one really questioned that Roe could be overturned. And then we have seen this, we've seen this all-out assault at the state level,” said Elizabeth Nash, state policy analyst at the Guttmacher Institute, a think tank that supports abortion rights. Before Friday's decision, she said such a ruling would "cause utter disruption in accessing abortion care across the country.”

Even in states where abortion rights are protected, experts predict providers will see an influx of patients from other states that could overwhelm capacity and force women to wait days or weeks. Already, Nash said, “we're seeing clinics across the country have delays in appointments where the next appointment is in three or four weeks.”

May 14 2022: People rally for abortion rights at the Capitol in Austin, Texas. Thousands of people form around Texas attended the Bans Off Our Bodies rally.
May 14 2022: People rally for abortion rights at the Capitol in Austin, Texas. Thousands of people form around Texas attended the Bans Off Our Bodies rally. Jay Janner, Austin American-Statesman

One researcher predicted that in the first year alone after Roe is overturned, as many as 100,000 women won’t be able to reach an abortion provider. Caitlin Knowles Myers, a Middlebury College economist who researches gender, race and reproductive policies, has estimated that 75,000 of them will be forced to give birth as a result. The remaining pregnancies would be cut short through miscarriage or self-induced abortion.

The impacts will be felt far and wide, experts predict.

Treasury Secretary Janet Yellen has said a ruling stripping federal abortion rights would damage the economy and “set women back decades.”

"Roe v. Wade and access to reproductive health care, including abortion, helped lead to increased labor force participation,” Yellen, former Federal Reserve chair, said during a Senate Banking Committee hearing in May. “It enabled many women to finish school. That increased their earning potential. It allowed women to plan and balance their families and careers."

State restrictions on abortion already have resulted in 505,000 fewer women age 15 to 44 in the labor force, according to a study last year by the Institute for Women’s Policy Research. The institute estimated the country’s gross domestic product would be 0.5% larger without the state curbs. That impact roughly doubles as Roe is overruled and half the states institute abortion bans as expected, the head of the institute, Nicole Mason, predicted. 

Those who will be hit the hardest are those who already are systemically oppressed, Nash said.

“Black and brown people, low-income individuals, LGBTQ individuals and young people will have the hardest time navigating this new environment,” she said.

Although the number of abortions performed in the United States declined in recent decades, at least 629,898 abortions were reported in 2019, according to the Centers for Disease Control and Prevention.

A separate survey by Guttmacher found the number ticked up to 930,160 abortions in 2020, a nearly 8% increase from 2017, when it was 862,320.

Nicole Mason, president and CEO of Institute for Women’s Policy Research
Black and brown people, low-income individuals, LGBTQ individuals and young people will have the hardest time navigating this new environment.
Congress members

“People have generally not thought about abortion until they needed one, and then they were confronted with this maze of legal and financial logistics,” Nash said. “Now, people will be confronted with abortion bans, which makes accessing abortion potentially harder. And they will have to figure out how to get care and how to pay for it.”

There are some who say the trigger laws and other state abortion restrictions won’t be as effective as anti-abortion advocates expect, particularly since abortions can be induced by medication – now a safe and commonplace method. In 2020, medication accounted for more than half of abortions, one survey found. 

Jonathan Mitchell, Texas’ former solicitor general, crafted the state’s law that enforces a ban on abortion as early as six weeks by allowing private citizens to sue those who help women get them. He told USA TODAY that because states do not run the U.S. Postal Service, it's difficult to detect and prosecute those who distribute pregnancy-ending pills on the black market.

Demonstrators rally during the 'Bans off our Bodies' abortion rights rally in New York City on Saturday, May 14, 2022.
Demonstrators rally during the 'Bans off our Bodies' abortion rights rally in New York City on Saturday, May 14, 2022. Robert Deutsch, USA TODAY

“Laws of this sort worked in 1970 or 1960, when every state banned abortion; they didn’t have abortion pills and didn’t have one of our two major political parties committed to the ideology of legal abortion. Also, they didn’t have widespread internet access," Mitchell said. "What worked in the United States in 1970 is not necessarily going to work in the United States in 2022.”

In 2015, Amelia Bonow shared her abortion story online and it went viral, leading her to co-found the group Shout Your Abortion. It strives to normalize abortion and increase safe access to the procedure.

Recently, the group has moved to strengthen "pathways to access" for abortions and has been in contact with grassroots activists in some 40 states so far. Bonow said the group's goal is to paint abortion access as a community responsibility and to show women that even if abortion is illegal, there will still be ways to seek one out.

"Just because abortion is illegal doesn't mean that you can't have one," she said. "There are people ready to dedicate the rest of their lives to helping facilitate care, regardless of legality. That will never stop.”

Contributing: Nada Hassanein, Tami Abdollah, Paul Davidson

Nicole Carroll, right, and her brother and sister.
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