As anti-choice lawmakers across the country are working overtime to tighten restrictions on abortion, clinic employees in Maryland are seeing an influx in out-of-state patients. Maryland remains a relatively friendly place for reproductive health care because the left-leaning state doesn’t allow lawmakers to set limits on abortion care that contradict physicians’ judgment or fall outside of “established medical practices.”
Women in neighboring states, on the other hand, live under much harsher laws. Virginia requires women to undergo a mandatory ultrasound before having an abortion, and tells women they can receive that procedure at right-wing “crisis pregnancy centers” that try to talk them out of their decision to end a pregnancy. Pennsylvania has a mandatory 24-hour waiting period that forces women to make two trips to the clinic. Both states have passed unnecessary restrictions on abortion clinics that are forcing some of them to close their doors.
“As far as our laws are concerned, Maryland women do not face the same obstacles that women in other states do in accessing abortion care,” Amber Banks, the outreach and communications coordinator for NARAL Pro-Choice Maryland, told the Carroll County Times. And that’s enough to convince many women that it’s worth making the trip.
Even though abortion providers are starting to notice the trend, this isn’t necessarily a new phenomenon. Health care professionals in Maryland say they’ve seen the same thing in previous years, particularly after Pennsylvania — which has been a pioneer in state-level abortion restrictions — first enacted a 24-hour waiting period.
Diane Silas, the administrator for Hagerstown Reproductive Health Services in Maryland, told the Carroll County Times that many people assume women will be able to access the health care they need as long as every single clinic hasn’t been shuttered. Both Virginia and Pennsylvania are still home to several legal abortion providers, for example. But the existence of a few in-state clinics isn’t enough to ensure that women will actually be able to get to them.
“There are just larger hurdles to tackle in order to be able to gain access,” Silas explained. “As long as there [are clinics], you could make the argument that there is access, but the question is, how Herculean of an effort does one have to put forth in order to gain that access?”
Over the past several years, anti-choice lawmakers have attempted to ensure that women must indeed put forth that type of Herculean effort to exercise their reproductive rights. Since 2011, states have enacted record-breaking numbers of new abortion restrictions. The state-level laws are designed to make women drive farther to get to a clinic, require women to make multiple trips to a clinic, force women to pay higher prices for abortion, and ultimately convince women that ending a pregnancy isn’t in their best interest.
Maryland is a good illustration of the situation, but it’s hardly the only example of women needing to cross state lines to access reproductive care. Texas recently enacted harsh restrictions on abortion providers that will force 90 percent of the state’s clinics to shut down; in response, the Dallas Observer published a tongue-and-cheek “travel guide” for women in the state who may need to go elsewhere to obtain reproductive care. But the outlook is bleak. “When we look at the states surrounding Texas — you know, New Mexico, Oklahoma, Arkansas, Louisiana — there are not that many providers in any of them,” Elizabeth Nash, the state issues manager at the Guttmacher Institute, pointed out. Reproductive rights activists actually suspect that Texas women will cross the border into Mexico to obtain abortion-inducing drugs on the black market.
Similar situations are unfolding in other states. The Centers for Disease Control records especially high numbers of out-of-state women seeking abortion care in Alabama, North Dakota, Tennessee, and Rhode Island. However, the agency’s most recent numbers are from 2009, and since then, abortion access in many states — including the states where many out-of-state women sought care — has narrowed even further. Abortion access in many red states may now be worse than it was in the 1960s, before the procedure was legalized under Roe v. Wade.
And not every woman can afford to travel to a different state to obtain health care. Low-income women have trouble saving up for the cost of an abortion in the first place, and they often don’t have the additional funds required to take off work, pay for childcare, and make a long trip. Just as was the case before Roe, women’s abortion access in many states across the country is largely becoming dependent on two arbitrary things: where she lives, and how much economic privilege she has.