Bloomberg News

Women Would Travel for Abortions If Roe Falls, Study Says

January 21, 2013

Women will venture hundreds of miles to obtain abortions even if the U.S. Supreme Court overturns Roe v. Wade, its landmark decision that legalized the procedure in every state 40 years ago today, a study showed.

As many as 31 states would outlaw abortion under that scenario, increasing by 157 miles (253 kilometers) the average distance residents would need to travel to reach the nearest legal provider, according to a working paper from the National Bureau of Economic Research in Cambridge, Massachusetts. That would cause a 15 percent drop in abortions nationally and as much as a 4.2 percent rise in the birth rate, the study showed.

“The vast majority of women in states without legal abortion would access services in states where abortion remained accessible,” wrote Theodore Joyce, the report’s lead author and a New York-based research associate at the private, nonpartisan group of academic economists.

The paper drew criticism from abortion opponents as a political ploy. David Grimes, a University of North Carolina obstetrician and former U.S. Centers for Disease Control official, said: “These statistical excercises must be viewed with circumspection.” Still, he said its essential message rang true: Without Roe, fewer women would have access to a procedure now legal and safe.

Four-Decade War

With a Democratic president who favors abortion rights and 26 states with both legislative chambers controlled by Republicans, many of whom oppose them, controversy over the issue continues unabated. The court’s Roe decision changed a secret and sometimes dangerous practice to a legal option. Yet it also set off a 40-year political war.

Abortion-rights groups and providers planned to mark today’s anniversary with events including a “Roe on the Rocks” cocktail fundraiser in Des Moines, Iowa, and a documentary screening in Memphis, Tennessee. Opponents said they would picket in Jackson against Mississippi’s sole clinic, while the annual March for Life on the National Mall in Washington was put off to Jan. 25, after President Barack Obama’s inauguration.

“Roe v. Wade grows more vulnerable, year by year,” said Clarke Forsythe, senior counsel at Americans United for Life, a legal arm of the antiabortion movement.

The court ruled in 1973 that state laws criminalizing the procedure violated a constitutional right to privacy. It isn’t likely to be overturned soon, given the panel’s ideological makeup, while Obama’s re-election all but ensures the appointment of at least one abortion-rights supporter.

Tightening Up

Still, the decision is far from secure, Joyce said, and in some states, its relevance is being tested as the number of providers declines and restrictions increase.

Most, if not all, clinics in states including Michigan, Virginia and Pennsylvania may shut because of laws that treat them more like hospitals than doctors’ offices. A measure mandating that physicians who do abortions must secure admitting privileges at hospitals may force Mississippi’s last provider to close its doors.

Deb Walsh, who ran the Volunteer Women’s Medical Clinic in Knoxville, Tennessee, for 30 of its 38 years, blamed a similar law when she shut it in August.

“I was unable to bridge the financial gap of paying the monthly lease and operating expenses without knowing when we could resume seeing patients,” Walsh wrote in a letter to fellow independent providers at the time.

State Patchwork

Such laws may yield the same result as overturning Roe, Joyce said in an interview. Should those states succeed, the map of abortion availability would resemble the partisan breakdown of recent presidential elections, with Democratic-leaning states mostly on the East and West coasts that permit the practice and Republican ones in the country’s middle and South that don’t.

The likelihood that a woman will get an abortion even if she doesn’t live in an area where the service is available may come down to personal economics, Joyce said. It may depend on whether she can afford to travel, secure child care, and take time off work, he said.

Soon after the 1973 ruling, providers appeared in all 50 states, with the number peaking at 2,908 in 1982, according to the New York-based Guttmacher Institute, which compiles reproductive health data. By 2008, the most recent figures available, the number had fallen 38 percent to 1,793.

Demand also has declined. The abortion rate fell in 2005 to its lowest level since 1974, according to Guttmacher data. At the current pace, three out of 10 American women will have one by the time she’s 45 years old.

Hypothetical Figures

To examine the link between provider availability and use, Joyce and his team examined data on abortions before Roe in New York state, one of just four where it was then legal. From 1971 to 1972, non-New York residents obtained more than 300,000 terminations in the state. In 1972, that included 15,522 from Michigan alone. Abortion rates fell 12 percent for every 100 miles a woman resided from New York, the study showed.

“Although distance matters, women were willing to travel hundreds of miles to terminate an unwanted pregnancy,” the researchers wrote.

Forsythe of Americans United for Life said the study was a political document, not a scientific one.

“The Joyce paper is pretty worthless except for people who want to scare people,” Forsythe said. It is, he said, “back- of-the-envelope speculation.”

‘Medical Odysseys’

Joyce is a leading scholar in the field, said Grimes, an obstetrician who studied abortion for the U.S. government. Still, it’s hard to predict what might happen if Roe were overturned, he said. One scenario not considered in the study was how accessible abortion drugs -- which chemically induce a miscarriage -- may be on the black market, he said.

Yet, Grimes said there is little doubt that if Roe were overturned, abortion access would be limited by income as well as geography.

“Many desperate women would be put back on the road in expensive medical odysseys,” he said by e-mail. “Some of my abortion patients are so poor that they get ‘trapped’ in the hospital parking garage. They put their last dollar in the gas tank to get to the hospital, and they assumed we offered free parking.”

To contact the reporter on this story: Esmé E. Deprez in New York at edeprez@bloomberg.net

To contact the editor responsible for this story: Stephen Merelman at smerelman@bloomberg.net


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