In May, the U.S. Supreme Court announced it will hear Dobbs v. Jackson Women’s Health Organization, a case determining the constitutionality of Mississippi’s 15-week abortion ban, and will specifically address whether a state can ban abortion before viability (generally 24–26 weeks of pregnancy). The Supreme Court taking this case is a stunning development, but the state of Mississippi has gone even further and asked the Court to overturn Roe v. Wade outright—and wipe out almost 50 years of established precedent.

Abortion at and After 15 Weeks Is Important and Necessary

The Mississippi law at issue would ban abortion starting at 15 weeks of pregnancy (currently, enforcement of the ban is blocked by lower courts).  If the Supreme Court allows this ban to go into effect, abortion opponents may try to downplay how many people would be negatively affected by misrepresenting the layers of harm caused by gestational age bans. However, the facts tell a different story.

Guttmacher estimates that between 6.3% and 7.4% of all U.S. abortions are obtained at or after 15 weeks of pregnancy. Based on 2017 abortion incidence statistics, this means that between 54,000 and 63,000 abortions nationwide occur in this time frame. (See Methodology section for additional details.)

The adverse consequences of withholding abortion care are serious and long lasting for each person affected. Forcing someone who wants an abortion to continue a pregnancy is tantamount to requiring them, against their wishes, to accept the risks of pregnancy- and labor-related complications, including preeclampsia, infections and death.

These risks can lead to negative outcomes that affect some communities more than others. The United States has the highest maternal mortality rate among developed countries, with dramatic but preventable racial inequities caused by systemic racism and provider bias. Black and Indigenous women’s maternal mortality rates are 2–3 times the rate for White women, and 4–5 times as high as White women among older age groups. And the risks of serious consequences do not end with a safe delivery. Denying wanted abortion care can have adverse consequences for women’s health, safety and economic well-being.

A Dramatic Increase in Driving Distances

If the newly stacked 6-3 antiabortion majority on the Supreme Court were to agree with Mississippi’s argument and overturn Roe v. Wade, the implications for that state’s residents seeking an abortion would be enormous. Mississippi already has a law in place that is designed to ban abortion immediately if Roe falls.

One of many immediate and severe consequences of an abortion ban in the state would be a substantial increase in how far patients would have to travel for abortion care. As of 2018, there were 599,000 women aged 15–44 in the state of Mississippi. If abortion were banned in Mississippi—and only Mississippi—the average driving distance for a woman of reproductive age to reach any abortion clinic would increase 42%—from 78 miles to 111 miles each way.

In that scenario, the next nearest clinic for 52% of Mississippi women would be in Louisiana, followed by Tennessee (29%), Alabama (17%) and Arkansas (1%)—all states that are not only hostile to abortion rights and access, but are also unlikely to be able to absorb a significant influx of patients.

If Roe were overturned or fundamentally weakened, there are 20 additional states that are certain to attempt to ban abortion as quickly as possible. If Mississippi and these other 20 states all banned abortion, the average driving distance for a Mississippi woman aged 15–44 to reach a clinic would increase 387%, from 78 miles to 380 miles each way.

That would increase the average drive time by nearly 4.5 hours each way (if driving nonstop at 70 miles per hour) and, for the vast majority of people, would necessitate an overnight stay. Someone making minimum wage ($7.25 an hour in Mississippi) would have to put more than nine hours’ worth of earnings toward the cost of gas to cover the additional travel for a round trip (for a car that gets 25 miles per gallon, with gas prices around $2.80 per gallon in Mississippi in mid-August 2021).

The greater the increase in travel distance, the greater the hardship it causes, and the more likely it becomes that some individuals will not be able to get abortion care at all. The burdens of extended travel can be incredibly difficult to overcome for people seeking abortion care. Such burdens include time away from work, lost wages, and the added costs and challenges of securing child care, lodging, and adequate and accessible transportation, to name just a few.

As is the case with all abortion restrictions, the harm of dramatically increased travel distances and related logistics would fall hardest on those already facing oppression in various and overlapping ways—whether because of their lack of financial resources, young age, disability, immigration status or because they are Black, Indigenous or other people of color.

What Needs to Happen

Given the dire threat posed by the Supreme Court potentially overturning Roe v. Wade and the onslaught of state abortion restrictions already enacted in 2021, it is long past time for Congress to step up, including by passing the Women’s Health Protection Act.

This legislation would protect access to abortion—whether someone lives in Mississippi, Ohio, Texas or Idaho—by establishing federal statutory rights to both provide and receive abortion care free from medically unnecessary restrictions and bans. The bill explicitly protects against some of the most common and burdensome restrictions, including many that are in effect in Mississippi and those that could be allowed to go into effect should Roe be overturned.

Methodology

The Centers for Disease Control and Prevention (CDC) is currently the only source of national data on abortion incidence by gestational age. Notably, the CDC’s relevant categorization is 14–15 weeks, meaning information cannot be examined for 15 weeks separate from 14 weeks.

In 2019, four states generally regarded to have accurate abortion data published the number of abortions statewide by week of gestation at last menstrual period (LMP): Alabama, Arizona, Kentucky and Minnesota. The proportion of abortions at 15 weeks and later in those states ranged from 7.0 to 7.4%.

These four states had clinic facilities offering abortions at 15 weeks and all had at least one facility that provided abortions at 20 weeks or later. Several other states do not have any clinics that provide abortions at these gestational ages. Thus, while the estimates of abortions at 15 or more weeks LMP for the four states are similar, they cannot be assumed to be nationally representative. According to CDC data, 4.7% of all abortions in 2018 were at 16 or more weeks LMP; 3.2% of abortions reported to the CDC were at 14–15 weeks. If it is assumed that half of these were at 15 weeks, the CDC data suggest that 6.3% of abortions nationally took place at 15 weeks or later. The proportions of abortions at later gestations have remained relatively stable over the last few decades.