As states like Texas and Oklahoma restrict abortion access ahead of a pivotal Supreme Court decision, Americans are being forced to travel farther from home to access care. But leaving town to escape restrictive laws is neither an easy solution nor an equitable one.
Texas is a case in point. Following the signing of a law that bans abortion after about six weeks, an average of 1,400 Texans a month are traveling outside the state for abortions, according to a March study from the University of Texas at Austin’s Texas Policy Evaluation Project. The majority head for New Mexico or Oklahoma — a plan that has now been complicated by the Oklahoma legislature’s April 5th passage of a total abortion ban.
Traveling to access abortions is not new. In 2017, for example, about 12% of pregnant people living in states with restrictive abortion laws sought care elsewhere in the U.S., according to a study in The Lancet. That included over half the patients living in Mississippi, Missouri, South Carolina, and Wyoming.
Patients traveling out of state face additional obstacles: clinics can be booked weeks in advance and costs — for childcare, time off work, gas, and travel — can be prohibitive, exacerbating inequality of access.
A 2018 study published in the Journal of Medical Internet Research found that people living in 27 cities with populations above 50,000 would need to travel more than 100 miles to reach the nearest abortion clinic, a distance commonly referred to as an “abortion desert.”
Fifteen of the 27 cities cited are located in Texas. With the U.S. awaiting the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, such deserts could widen. Ohio residents, for example, would have to travel up to 300 miles to reach the nearest clinic, assuming they could obtain an appointment at all.
Here’s a brief overview on the current state of abortion deserts, and why the concept is far more complex than a simple square-mile radius:
What is an abortion desert?
As the 2018 study illustrated, abortion deserts exist where people have to travel 100 miles or more to reach the nearest clinic. But other factors, including cost and availability of appointments, are also barriers to access.
“Distance is definitely a crude measure of people’s access that is relatively easy to collect and model,” said Alice Cartwright, one of the study’s authors. “We know that people’s lives are much more complicated.”
Cities cited in the study tend to be in states that do not cover abortion costs through Medicaid, another reason patients are forced to leave home.
“Sometimes the closest clinic might be right across the border,” said Mikaela Smith, a research scientist at The Ohio State University. “But sometimes it can mean having to travel really, really far.”
Of the seven states where Texas residents currently travel to receive an abortion, only New Mexico covers abortion services through Medicaid. In the past five months, people have had to wait as many as 22 days for an appointment at one of the seven clinics available, the University of Texas at Austin study found. Roughly half of women in New Mexico live in counties that don’t have a clinic at all.
Who can travel to receive an abortion, and who can’t?
According to the Guttmacher Institute, 59% of people seeking abortion care already have at least one child, and three-quarters have incomes that are near or below the federal poverty line. “What those distances mean really depends on the resources of the person who’s seeking abortion care,” said Liza Fuentes, a senior research scientist with the group.
