The chaotic new world of abortion access

If you are in need of an abortion in the United States, you might have to travel cross the country to get one. Or a clinic could be just blocks away.

In the United States alone, one in four women will have had an abortion before they’re 45 years old. But ever since June 2022, when the U.S. Supreme Court overturned Roe v. Wade, a landmark case which gave women a constitutional right to an abortion, many of those women must travel far to get one.

At Mount Sinai Hospital in New York City, Dr. Adam Jacobs provides women reproductive healthcare and contraception. As medical director of the Division of Complex Family Planning, he counsels women on the alternatives they have when it comes to reproductive matters.

“I also see patients presenting for medical and surgical abortion,” Jacobs said.

The overturning of Roe v. Wade has greatly impacted Jacobs’ job. He has seen more patients seeking family planning abortion services who come from states where abortion is now illegal.

Jacobs now helps women from all over the country. “Texas, Ohio, Florida, Georgia, Mississippi and South Carolina,” Jacobs said.

The politicization of a medical procedure

Abortion has been hotly debated in the United States for the last 100 years, dividing the nation in two. Since then, more than 10 states have banned abortions.

The United States had previously opened the doors to abortion, at least since 1973, when the U.S. Supreme Court decided Roe v. Wade. In other places around the world prohibitions are being reversed. Before 2018 for example, Ireland was one of the most restricted countries against abortion on account of a 1983 law that banned it. A historically Catholic country, women have been able to get abortions in Ireland in the first 12 weeks of pregnancy since 2018. Argentina, Mexico and Columbia have also eased restrictions on abortions within the last three years.

With abortion bans being passed in so many states across the United States, doctors like Jacobs find it isn’t enough to provide the abortions in states where it is legal. He also helps the women travel to New York, through an organization that does that.

Jacobs called abortion an “essential healthcare” and said that overturning Roe v. Wade has “taken away a patient’s ability to make their own healthcare decisions and control over their own body.”

Abortions banned in some states are permitted in others

While conducting research, we decided to input an address and zip code into a search engine to find abortion providers near us. We found at least one clinic nearby and another four miles away. All are easy to access and get to within an hour. One can book an appointment privately and easily by telephone, services are open 24/7 and no one is denied.

In New York City, abortions can be covered by insurance. If someone doesn’t have it, they can call a clinic and be able to get financial assistance. Abortions can also be paid for by NYC Care, a healthcare program that promises a low- to zero-cost healthcare service to New Yorkers who don’t have health insurance.

If one can’t come into the city itself to receive an abortion, it is as easy outside the city as well. There are dozens of clinics in the New York metropolitan area. In Westchester County, just north of New York City, there are four abortion clinics. There are at least 13 clinics on Long Island, to the east of the city, for example.

Because of the restrictions in other states, women from all over the country now arrive to get abortions. And those who don’t have access to health insurance still have many alternatives.

People travel to get an abortion.

Many organizations within New York, such as Brigid Alliance, provide women seeking abortions with transportation, meals, childcare, support and a place to live. As of September 2022, according to cable news channel NY 1, an abortion clinic in Queens had seen a rise of at least a 300% of patients from Texas, one of the most restricted states in the country.

In states such as Texas, a woman’s right to choose has been completely removed from the picture. Even before the overturning of Roe v. Wade, Texas was considered an abortion “desert”: 96% of Texas counties were without a single abortion provider.

Even before the Supreme Court overturned Roe, the state government passed a series of limitations on abortion. Today, abortion is completely banned in Texas; women can no longer seek an abortion there and doctors cannot administer an abortion at any stage of pregnancy.

Googling abortion for those living in Texas turns up much different results from the same search in New York. When we searched for ‘abortion in Texas near me,’ all of the websites and locations that previously administered abortion appear. The clinics have all been closed down, and the websites provide a notice of their inability to provide assistance at this time and provide a support hotline.

A legal reversal upended women’s health services.

Only 30 days following the Supreme Court decision that reversed Roe v. Wade, Texas passed a “trigger law” — it would only go into force upon the reversal of Roe — that deemed abortion a felony and asserted that a doctor who performs an abortion could get up to life in prison. The woman who seeks the abortion, however, is protected from prosecution under this ban. It isn’t clear however, whether all women are aware of that protection.

The trigger ban does not give exceptions for cases of rape or incest, nor does it have leeway for mothers with health conditions whose lives are endangered by pregnancy.

The banning of abortions in Texas has not stopped the demand but has only increased the lengths women will go to get one. In the four months after Texas implemented its trigger ban, the number of Texans seeking abortions out of state was 5,500, compared with 500 during the same period in 2019. The process of receiving an abortion, however, is strikingly different between higher-class and working-class families.

If you are privileged enough to have the means, you can buy a plane ticket from Texas to Colorado or Nevada, the states nearest that will administer abortions.

This process is not cheap. After looking into transportation and out-of-state abortion costs, the trip would cost upwards of $700; if you decide to spend a night in a hotel, that drives the price up further.

These costs are not feasible for all Texans. Some women are thus left with a difficult choice: raise a child that you do not have the means to support or put yourself in bodily danger.

Alternatives to abortion for those who can’t get one

For women who cannot travel for an abortion there is a network that smuggles abortion-inducing pills into Texas, said Mary Ziegler, a professor at the University of California, Davis who specializes in the history of reproductive law.

The network has moved an average of 100 doses across the border from Mexico daily, Ziegler said. Unfortunately, this loophole to access is unsafe. The pills, having passed through the hands of many, could be laced or damaged in transit.

Ziegler says that the new law has forced her to change the way she teaches. “You can’t teach abortion as a right currently because it’s not. You’re telling students that those rights exist but also telling students that those rights can be erased. That’s really complicated.”

Ziegler says that even though she knew it was coming, the overturning of Roe v. Wade still surprised her. “It was still shocking, there was a sense in which it was hard to believe what had happened,” she said.

In states without adequate access to abortion, women find it difficult to get help.

“If you get pregnant and you’re in a state that has very narrow abortion exceptions there’s a strong possibility that if you have an incomplete miscarriage or something else goes wrong a doctor may be unwilling to treat you even if they’re allowed to under the law,” Ziegler said. “Because if they make the wrong interpretation or wrong guess, they could go to prison for life without parole or extended period of time.”

Three questions to consider:

1. Why would someone from the state of Texas travel to New York City for an abortion?
2. How did the U.S. Supreme Court change access to abortion in the United States?
3. Why should abortion procedures be treated differently than other medical procedures?

Pénélope Flouret is in the fourth year at The Hewitt School in New York City. During her free time, she enjoys reading and creative writing. She is executive editor of the student newspaper and plans to attend McGill University.

Goldie Zarabi is in the second year at The Hewitt School in New York City. She prefers to spend her personal time with her huge family, and she has recently taken a liking to basketball. In school, she is the head of the current events club and an active member of the debate team.