Dobbs’s Near-Total Destruction of Abortion Rights Across the South ...Middle East

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Dobbs’s Near-Total Destruction of Abortion Rights Across the South

Thousands of patients across the southeastern United States are now being forced to travel more than 250 miles to access abortion care in North Carolina, according to a study recently published by The Journal of the American Medical Association. The study, completed by Dr. Kelsey Loeliger and her colleagues quantified the South’s increasingly desperate abortion landscape, documenting the out-of-state abortion cases in North Carolina in the first year since the Supreme Court’s Dobbs decision.

Anti-choice lawmakers throughout the southeast have made abortion case inaccessible for tens of thousands of women, and now North Carolina—despite having its own anti-abortion policies—has become something of an “abortion refugee” state, with over 10,000 more people travelling from out-of-state to seek abortion care in the first year since Roe was overturned. Moreover, the study found that the impacts of abortion bans disproportionately impact Black patients, adding to a growing body of research that underlines the racial underpinning of anti-abortion policymaking.

    Georgia, South Carolina, and Florida, all have six-week abortion bans—sometimes referred to as “heartbeat” bans—while Tennessee, and Alabama have near-total bans, except to save the life of the pregnant person (and, notably, not in cases of rape or incest).

    Since the Dobbs decision, North Carolina has received an average of 53 out-of-state abortion patients per day—a monumental increase from just 16 prior to the decision. The largest increase in travel was for Black patients. “The effects of Dobbs on access have not been evenly distributed: Black patients and other minority patients were the most likely to be unable to obtain care locally, to travel farther, and to face obstacles related to childcare, transportation, and time away from work,” says Loeliger, an obstetrician-gynecologist in South Carolina and a researcher, and notes that she is speaking independently and not on behalf of any institution.

    “Abortion is often described as elective, but a range of medical and personal circumstances can lead a patient to seek one even when their situation does not meet the legal criteria for a state’s health exception,” says Loeliger, noting that Black patients are far more likely to experience high-risk pregnancies and complications, including pregnancy-related death (often referred to as a the “Black maternal mortality crisis”). Beyond abortion, cuts to healthcare infrastructure and insurance are posing risks to pregnant people throughout the country; as Loeliger notes, “the number of high-risk pregnancies has been increasing nationwide.” Data on maternal mortality has become harder to come by, as states like Florida have ended their tracking of maternal mortality at the same time as banning abortions.

    Despite its swelling number of abortion patients, North Carolina has its own, prominent anti-abortion camp. At the time of the study, the gestational limit for abortion was 20 weeks. It’s now limited to 12 weeks, after both chambers of the North Carolina General Assembly voted to override then-Governor (and current Senate candidate) Roy Cooper’s veto of the ban. The state currently has a twelve-week abortion ban in place, and requires all patients to wait 72-hours in between an initial consultation and an abortion.

    Waiting periods are a common tactic in abortion-hostile states, meant to give the patient time to “reflect” on their choice, causing unnecessary financial, professional, and logistical challenges for those seeking reproductive care across state lines. Waiting periods have been proven to have little to no impact on feelings of regret or satisfaction for those seeking abortions, and abortion remains one of the lowest-regret medical procedures.

    The Florida Access Network, or FAN, is an organization providing funding and logistical support for Floridians seeking abortion, including supporting hundreds of people in seeking abortions out-of-state, mostly to North Carolina and Virginia. For clients working with FAN, an abortion in North Carolina will cost anywhere from $1000 to $1750, between hotel, meals, travel, and the procedure itself (which costs around $650). Laura Rosado and Lana’e Hernandez, speaking on behalf of FAN, note that these costs do not include any lost wages for the days a patient is unable to work, childcare costs that might be required during the 72-hour waiting period, and other related costs.

    In May of this year, North Carolina’s Republican lawmaker for Beaufort, Rep. Keith Kidwell, sponsored House Bill 1232, which would enact a total abortion ban and reclassify abortion as first-degree murder. The bill was initially sponsored by another Republican lawmaker, Rep. Ben Moss of Richmond, but he removed himself from the bill after public outcry, chalking up his withdrawal of support to an issue of “language” and reaffirming that he was “firmly pro-life.”

    For Hernandez and Rosado, anti-abortion lawmaking in North Carolina creates a bit of déjà-vu: “Florida was previously under a 15-week abortion ban, and in that time, we were the south’s refuge for abortions,” they note. In May 2024, Florida passed a six-week abortion ban, cutting off care for countless Floridians and neighbors, despite the majority of Floridians being against an abortion ban and self-identified Republican and Democratic women having abortions at the same rate. “Now, with so many harmful abortion bans in the region, states such as North Carolina and Virginia are having to carry the weight of the South when it comes to accessing care.”

    For experts like Loeliger, it’s important that lawmakers understand that abortion bans do not reflect the needs of pregnant people, or prevent the need for abortions in the first place. “When patients travel across state lines—sometimes driving 15 hours each way within a 48-hour window, with their children in the car, missing school or work—it reflects a real need that is not being met, or fully understood, in their home state,” she says.

    In another part of their study, which has not yet been published, Dr. Loeliger and her colleagues asked women who had travelled out of state what they wished their lawmakers would know. “Respondents described losing trust in government and institutions, and feeling they were not regarded as valued members of society,” she says, reiterating the racialized impact of anti-choice lawmaking. “Several Black women placed their experience in the context of the sexism and racism they encounter routinely and the challenge of raising their existing children safely without sacrificing their own health; they viewed abortion restrictions as adding to those burdens.”

    In North Carolina, Julia Walker, a spokesperson for Planned Parenthood South Atlantic shares that while “anti-abortion politicians are not going to stop what they’re doing,” reproductive rights organizations like Planned Parenthood “are going to continue to do everything that we can to hold them accountable for the bills they introduce and also to make the public aware.” Across the Southeast, Planned Parenthood South Atlantic has created a Patient Navigation Program to help patients coordinate the increasingly opaque landscape and find care, while abortion funds like FAN exist throughout the South to provide resources for out-of-state care.

    Anti-choice lawmaking in North Carolina is a nightmare scenario for Southeastern abortion workers working with women reliant on states like North Carolina for care. “If a more severe ban were to pass in North Carolina, it would be devastating for the Southern landscape,” say Hernandez and Rosado. While they reaffirm that the work of FAN and other Southern abortion funds will do whatever is needed to ensure safe abortion access, the threat of anti-abortion lawmakers looms.

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