• Anya Fonstein

"Abortion Deserts" and the Disproportionate Effect of Dobbs on Poor Women

Trigger Warning: This article contains mentions of rape which may be disturbing to some readers


Now that the right to an abortion is not a federally protected right in the United States, legal experts have voiced concerns about the rise in "abortion deserts" in the American South and Midwest. These are areas in which women cannot access reproductive care without undertaking arduous and expensive travel. Many states have already enacted "trigger laws" that ban abortion entirely while others are planning on instituting sweeping bans in the near future. This article will first discuss the recent Dobbs decision and the opinions of Justices Samuel Alito and Brett Kavanaugh.

In 1973, the Supreme Court of the United States decided in a landmark ruling that a woman’s right to an abortion before the point of viability was protected by the Fourteenth Amendment of the US Constitution. As a result, women in the United States were able to obtain legal abortions at reproductive clinics across the country. Under the federalist system of the United States, however, individual states were able to adopt their own laws on abortion as long as those laws did not violate the federal Constitution, as interpreted by the Supreme Court. A number of conservative state legislatures adopted laws that had the effect of restricting access to abortions by decreasing the number of clinics allowed in the state, mandating wait periods and banning abortions entirely after ever-shorter periods of time. Nevertheless, many abortion clinics functioned in spite of these efforts. Planned Parenthood, for example, served as both an abortion provider and a powerful advocacy group for reproductive rights as lawmakers chipped away at the rights granted in Roe v Wade.


On 24 June 2022, the Supreme Court, in a 6-3 decision in Dobbs v Jackson Women’s Health, reversed Roe v Wade. In his majority opinion in Dobbs, Justice Samuel Alito argued that the Court’s ruling in Roe v Wade was wrongly decided. His reasoning was that the Constitution does not mention a right to an abortion and the interpretation of the Fourteenth Amendment in the Roe decision was, therefore, too broad. As a result of the Dobbs decision, a woman’s access to abortion is now entirely up to the discretion of the states. Alito’s opinion is ambiguous and does little to address key concerns for American women. Rape and incest, for example, are not outlined as exceptions in the ruling.


In anticipation of the ruling, seven states (South Dakota, Wisconsin, Missouri, Kentucky, Oklahoma, Arkansas and Alabama) had set up "trigger laws" that would automatically ban abortion except in medical emergencies. These laws were designed to take effect immediately after Roe was overturned. In some of these states, abortion providers will be held criminally liable if they continue to provide the procedure. For example, the Texas trigger law states that anyone who performs the procedure can be charged with a first-degree felony and be fined US$ 10,000. In Alabama, a pre-Roe ban states that anyone who "aids and abets" an abortion can spend up to 12 months in county jail. In South Carolina, according to state law, a woman who tries to end her pregnancy using alternative methods can face a fine of US$ 1,000 and a two-year prison sentence.


Other states are still debating a woman’s right to choose and may likely impose bans and strict limitations in the near future. Kansas, for example, is bordered by three states that are poised to ban abortion or have already done so - Oklahoma, Missouri and Nebraska. While the Kansas state Constitution protects a woman’s right to obtain an abortion, state legislature has proposed an amendment that would allow for a total ban. Other states, such as Ohio and North Carolina, may also impose bans and restrictions in the near future, potentially widening the abortion desert.


In a concurring opinion, Justice Brett Kavanaugh noted that the Supreme Court’s decision would not prevent women from traveling outside state lines to receive a safe and legal abortion. While this is technically true, is it a viable option for most women?


The answer is not as simple as Justice Kavanaugh implies and highlights the geographic implications of the Dobbs decision for economically disadvantaged women in the United States. For women living close to states that allow abortions, state bans may be a minor inconvenience, as suggested by Kavanaugh's opinion. However, other women live in regions buried by states which have banned or severely restricted abortion access, making the journey even more daunting and unrealistic. These women live in what have been dubbed "abortion deserts" which are predominantly concentrated in the Southern and Midwestern regions of the country.


In 2017, a public health study concluded that roughly half of American women have access to abortion clinics within 11 miles of their home, while 20 per cent of women live within 43 miles of a clinic. Now that the right to an abortion is not protected federally, many American women will be more than 500 miles from the nearest clinic. With rising rates of inflation and the record-high gas prices, taking time off work, traveling to another state and paying for accommodation are not in the realm of possibility for many women. A woman living in east Texas, for example, would have to travel over 12 hours to the New Mexico border to receive a safe procedure.


Many large companies, such as Accenture, Tesla, Meta and Bank of America, have committed to covering the travel costs of female employees seeking reproductive services if they are unable to access them in their own state. Only time will tell if these promises will be upheld. However, for women who do not work for companies capable of using their resources to secure reproductive travel costs, the future of their reproductive care access is uncertain.

Ultimately, Justice Kavanaugh's concurring opinion fails to take into account the geographical and socio-economic implications of the Dobbs decision on women across the country. The Dobbs ruling will most affect women who happen to live in abortion deserts and those who cannot afford the travel costs. The United States already faces the highest maternal mortality rate in the industrialised world. Now that Roe has been overturned, experts speculate the maternal mortality rate to rise, as women seek out alternative and unsafe ways of having abortions.



For further exploration, Planned Parenthood has created a useful resource to help visualise abortion deserts in post-Roe America. View it by clicking here.