If Donald Trump’s Supreme Court of the future moves to overturn Roe v. Wade, access to legal abortion in the United States wouldn’t vanish. But it would likely become staggeringly unequal — an option only for women who happen to live in a liberal state or have the money to travel to one.
For a glimpse of this possible fate, look to the recent past. In 1970, New York became the first state to allow any woman to end a pregnancy without proving she’d been raped or that her health would fail if gestation continued.
“Women flocked there,” said Katha Pollitt, author of Pro: Reclaiming Abortion Rights. “But low-income women, disproportionately women of color, were trapped in anti-abortion states.”
Before the Supreme Court decided to guarantee a woman’s right to seek a legal abortion in 1973, making Roe the law of the land, the procedure was banned in 30 states. At the time New York struck down its abortion limitations, allowing women to terminate a pregnancy up to 24 weeks, only Hawaii offered similar access — but solely to residents.
New York, however, upheld no residency requirement. In the two years after the law changed, 60 percent of women who had abortions there came from another state. By 1972, roughly women 100,000 had left their state to get a legal procedure in New York City, according the Guttmacher Institute, a reproductive health research organization. An estimated 50,000 traveled more than 500 miles to reach an abortion provider in the metropolis, and nearly 7,000 trekked double that distance.
”We were living in a time of enormous change,” Manfred Ohrenstein, former Democratic senator from Manhattan, told the New York Times on the New York law’s 30th anniversary. “There was the war. There was the women’s movement, which was really bringing the abortion issue to a crescendo. It was the end of the civil rights era, and we viewed this as a civil right.”
In an interview Sunday with CBS’s Leslie Stahl, Trump doubled down on his vow to appoint judges who oppose abortion to the Supreme Court, a process he has said would gradually chip away at abortion access and eventually overturn Roe v. Wade.
“Having to do with abortion,” he said, ” if it ever were overturned, it would go back to the states.”
“But then some women won’t be able to get an abortion,” Stahl said.
“Yeah, well,” Trump said, “they’ll perhaps have to go — they’ll have to go to another state.”
“And that’s okay?” she asked.
“Well, we’ll see what happens,” Trump said. “It’s got a long way to go.”
Mike Pence, Trump’s running mate, announced clearer intentions for the country’s reproductive destiny at a town-hall meeting in July. “I’m pro-life and I don’t apologize for it,” he told a Michigan crowd. “We’ll see Roe vs. Wade consigned to the ash heap of history where it belongs.”
The Guttmacher Institute estimates that, in the years prior to Roe, as many as 1.2 million American women annually attempted to have an abortion without a licensed physician. Some tried with coat hangers or by throwing themselves down stairs. Others sought back-alley procedures. These clandestine methods sometimes resulted in death or infertility.
In 1962 alone, eight years before open access hit New York, about 1,600 women ended up in New York City’s Harlem Hospital Center for “incomplete” abortions, Guttmacher found. In 1968, the University of Southern California Los Angeles County Medical Center admitted 701 women with septic abortions, or procedures that caused severe uterine infections.
Since women of color were disproportionately more likely to live in poverty, they were also more likely to attempt a dangerous abortion and suffer the physical consequences. In New York City during the early 1960s, a quarter of childbirth-related deaths among white women stemmed from abortion, while the procedure accounted for half of such deaths among minority women.
Today, the World Health Organization estimates the number of unsafe abortions that occur each year in the U.S. is “none” or “negligible,” compared to areas of the world where the procedure remains illegal or more difficult to obtain. (Guttmacher also lacks recent data on the number of yearly self-induced abortions on American soil.)
But it’s harder in conservative states to obtain an abortion, thanks to a constellation of regulations meant to quash access to the procedure and a scarcity of clinics in rural areas. Some Texas women, for example, have told advocates they must drive hours to reach an abortion provider or trek to Mexico for over-the-counter abortion-inducing pills. Some say they’ve carried a pregnancy they did not want because they couldn’t afford to pay for gas or lodging.
“Trump’s statement that women could go to another state — well, that’s incredibly difficult for many abortion patients, because a typical first trimester abortion costs about $500, and women typically pay out of pocket,” said Elizabeth Nash, Guttmacher’s senior state issues manager. “And if you’re traveling a long distance, you’re talking about taking multiple days off of work, and many women are not working in jobs where they get paid time off.”
Roe protects the right to an abortion until a fetus can live outside the womb. Twenty-seven states have at least one additional regulation, including mandatory waiting periods, restrictions on health insurance coverage and bans after 20 weeks of pregnancy.
Carol Tobias, president of National Right to Life, a prominent anti-abortion group, said ending abortion anywhere would be a victory. “I expect the states to have varying laws, and some will have exceptions,” she said. “Our position is abortion should be allowed only if the mother’s life is in danger.”
Louisiana, Mississippi, North Dakota and South Dakota have laws to automatically outlaw abortion if justices overturn Roe. Eleven states have retained their pre-Roe bans, which would again take effect in such an event. Seven states, meanwhile, have laws that protect the right to obtain an abortion prior to viability or when necessary to protect a woman’s life:
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