"Thank you, Chair Sanders, Ranking Member Cassidy, Senator Murray and the members of the
Committee for the opportunity to highlight the clear and growing evidence that the Dobbs
decision is harming reproductive health and freedom. My name is Destiny Lopez, and I am the
acting co-CEO of the Guttmacher Institute, a leading research and policy organization committed
to advancing sexual and reproductive health and rights worldwide.
"For decades following the 1973 Roe v. Wade decision, anti-abortion advocates worked
strategically to make abortion harder to get and highly stigmatized. Public support for abortion’s
legality has remained high and consistent. But the sheer number of state-level abortion
restrictions ensured that abortion became inaccessible for many—even with Roe in place.
The Dobbs v. Jackson Women’s Health Organization decision was an inflection point,
unleashing chaos and fear across the nation. Our experts are constantly assessing this changing
landscape and the increasingly robust body of evidence that illustrates the harms caused and
exacerbated by Dobbs. Two years after the decision, here is what we know.*
"Access to abortion care is severely restricted in many parts of the country. Fourteen states are
now enforcing total abortion bans with very limited exceptions, and many more have other new
restrictions in place. The total number of brick-and-mortar clinics providing abortion care in the
US declined by more than 40 between 2020 and early 2024.
"Banning abortion does not stop the need for abortion access. Which is why many people seeking
abortions post-Dobbs must overcome huge financial and logistical barriers to get care, especially
those in states with total or early gestational bans. The number of Americans traveling out of
state for abortions doubled from 81,000 in 2020 to more than 170,000 in 2023. States that border
states with total abortion bans saw the sharpest increases in out-of-state patients.
"No one should have to travel to another state to access basic healthcare. And in fact, those who
can’t overcome the burdens of travelling for care, which for some might mean crossing multiple
state lines, may be forced to stay pregnant against their will. Others may decide to self-manage
their abortion. Decades of research have documented that the majority of people obtaining
abortions have few financial resources, are people of color, and are already parenting. They are
the ones most harshly impacted by bans and restrictions.
"We also know that providers are resilient and adapting to meet patient needs. While brick-and mortar
facilities provide more than three-quarters of all abortions, online clinics are expanding
care options by offering medication abortion services via telehealth. Research by the Society for
Family Planning shows that virtual-only telehealth abortions accounted for almost one in five
abortions from October to December 2023.
"There are many other important ways Dobbs is interfering with reproductive health care across
the nation that I don’t have time to discuss in detail today, from current and future OB-GYNs not
wanting to practice in ban states to impacts on maternal health and people facing obstetric
emergencies.
"So what does all this mean? Overturning Roe did not resolve the debates on abortion that have
characterized US politics for the past 50 years. Instead, it enabled policies that have significantly
worsened the harms faced by individuals who are most marginalized in our health care system.
Still, despite these immense hardships and many people being denied care, there were more than
one million clinician-provided abortions in 2023—a 10% increase from 2020. This is a testament
to the heroic efforts of providers, abortion funds and other support networks, to the resilience and
determination of people seeking care, and to the centrality of abortion in peoples’ lives. And it
explains why the anti-abortion movement and their political allies are doubling down on even
more repressive policies.
"For instance, this year four states introduced legislation—and one passed a law—criminalizing
adults who support adolescents seeking abortion care in another state. Earlier in the year, the
Alabama Supreme Court’s decision to classify frozen embryos as “children” wreaked havoc on
fertility treatment services while advancing the anti-abortion movement’s long-term goal to
enshrine fetal personhood in both law and policy. These attacks on bodily autonomy, coupled
with two major abortion cases currently before the Supreme Court, signal that the policy and
legal landscape will continue to shift.
"The full damage caused by Dobbs will not be clear for years to come, but the evidence suggests
it will not be easy to repair. That’s why it is imperative that policymakers at all levels of
government champion a bold vision of abortion care that goes beyond what Roe promised.
Only policies rooted in evidence and human rights will guarantee that all people have meaningful
access to high-quality, affordable abortion care where they live and via the method they choose. Thank you."
Footnotes
*Information throughout this testimony is referenced here: Baden K, Dreweke J and Gibson C. Clear and Growing Evidence That Dobbs Is Harming Reproductive Health and Freedom, Guttmacher Institute, 2024, https://www.guttmacher.org/2024/05/clear-and-growing-evidence-dobbs-har…