Abortion deserts could come with Supreme Court’s next case

The U.S. Supreme Court agreed to hear an abortion rights case from Mississippi that would ban abortion after 15 weeks’ gestation, except for medical emergencies or fetal anomalies. Dobbs v Jackson Women’s Health Organization is the third abortion rights case that the court has considered in five years, but the first that could truly undermine the standard set by Roe v Wade almost 50 years ago.  

Legal precedent in previous cases has established that states cannot impose abortion bans before viability, which is typically around 24 weeks’ gestation. Based on this, the Supreme Court should affirm that abortion later in pregnancy, but prior to viability, is essential health care that cannot be obstructed by restrictions. Now that the court has a conservative majority — including three justices who were appointed largely because of their opposition to abortion — the outcome is anyone’s guess.   

As researchers who have studied abortion in the South, including Mississippi, for nearly a decade, we have seen how abortion access has eroded with the proliferation of state-level restrictions. If the Supreme Court upholds Mississippi’s law, the decision could open the door for states — beyond the South — to impose bans earlier in pregnancy, putting abortion care much further out of reach.   

The potential domino effect of upholding Mississippi’s law would mean large parts of the country would become vast abortion deserts. People would have to travel enormous distances to get the care they need. We would see a pre-Roe era patchwork of states where people can obtain abortion care only if they have the resources to cover the thousands of dollars that may be needed to travel and pay for services in Florida, Illinois or the District of Columbia. Even then, people may have difficulties obtaining care because not all facilities will be able to meet the increased demand from those traveling from states with pre-viability bans.  

The same year that Mississippi passed its 15-week ban, neighboring Louisiana passed an identical law that would only go into effect if Mississippi’s law was upheld. States that have thus far been unable to enforce laws limiting abortion at 12 weeks (Arkansas), six weeks (Georgia, North Dakota, Ohio) or all together (Alabama and Utah) might now be able do so. 

The court’s decision would largely impact Black patients and those living on low incomes. It is already difficult for many in these communities to pay the financial and logistical costs of abortion care, in part because Black women are disproportionately represented in low-wage jobs. This is made worse by the fact that they have to travel long distances to get to one of the few in-state facilities offering abortion or to a facility out of state. People in parts of Mississippi, and in states like Kentucky, Missouri and Texas, need to travel more than 100 miles one way to get to care. 

Proponents claim that the law will protect women from the harms of abortion later in pregnancy. Such claims are not supported by scientific evidence that demonstrates that abortion later in pregnancy is safe and the risks are lower than those of childbirth.  

Even if the Supreme Court allows additional exemptions for survivors of rape or incest rather than upholding the ban outright, these exceptions can be hard to implement — and are not enough. People need later abortions for many reasons, including late recognition of pregnancy, non-life-threatening complications that are diagnosed after 15 weeks, and structural barriers, such as bans on insurance coverage for abortion, that lead people to delay care as they try to secure sufficient funding. 

Regardless of the outcome of this specific case, we need federal legislation that guarantees abortion care across stages of pregnancy is accessible when needed. This would mitigate the geographic, racial and income inequities that have resulted from abortion policy being left to the states — inequities that could be exacerbated by this decision. Such federal protections would enable people regardless of where they live or how much they earn to have reproductive autonomy.  

Kari White is an associate professor in the Steve Hicks School of Social Work and Department of Sociology at The University of Texas at Austin.   

Whitney Rice is an assistant professor in the Rollins School of Public Health at Emory University.