A Doomed Decision: The Unequal Consequences for Women’s Abortion Access

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Jessica Miller and Guangqing Chi has published an op-ed piece at the Slate based on their ongoing research about the impact of Texas SB 8 on the unequal access to abortion clinics.


The Americans Already Suffering Most From the Fall of Roe

As demographers and rural sociologists from Penn State who have studied social inequality for more than 20 years, we’re practiced in observing the ways public policies and events shape people’s lives—and particularly attuned to the impacts on historically marginalized groups including racial and ethnic minorities, people with low incomes, children, and women. When the COVID pandemic happened, we studied how it impacted the health and income of Alaskan Indigenous fishing communities. When Russia invaded Ukraine, we studied its impacts on Central Asian labor migrants in Russia. When it comes to abortion, the data couldn’t be clearer: limiting access to abortion increases social inequality and puts disproportionate burdens on women of lower income and minorities.


We know, because we’ve spent the past ten months studying what happened after Texas passed Senate Bill 8, or its “Heartbeat Bill.” Notably, SB 8 was allowed to be implemented even before the Supreme Court struck down the constitutional right to an abortion in Dobbs v. Jackson Women’s Health Organization, which means there are months of data about who is affected most by abortion bans in the United States. Our findings offer a devastating glimpse at what’s in store across the country as more and more states adopt draconian measures to limit abortion access after the fall of Roe.


­We designed our study to compare women access to abortion clinics before and after the implementation of SB 8, and between Texas and its neighbor state Oklahoma, where abortion was not yet outlawed at the time of the study period. We used clinic visitation data from eight months before and eight months after the SB 8 implementation, that is, from January through August 2021 and from September 2021 through April 2022. From the University of California San Francisco’s Advancing New Standards in Reproductive Health’s abortion facility database, we analyzed 21 open clinics in Texas and 4 in Oklahoma that provided abortion services. The clinic visitation data were derived from cell phone data that were provided by the SafeGraph. Here is what we found: Texas SB 8 was associated with a 34 percent reduction in abortion visitation compared to Oklahoma. But we also found a 59 percent increase in Texas residents traveling to Oklahoma abortion clinics in September 2021, immediately following the implementation of SB 8.


Further, there are big discrepancies between high-income and low-income areas to access legal abortion clinics in the aftermath of bans. Our data shows disproportionate increases in Texas women from high-income areas, or with a median household income of more than $70,000, that traveled to Oklahoma after SB 8 was implemented. In the eight-month period after SB 8 implementation, abortion travel for low-and-medium income Texas residents declined by around 4 percent compared to a 144 percent increase among high-income Texans.


But statistics never tell the whole story: Ultimately, this is about women’s lives. Unable to travel for abortion services, some women, often low-income, young, and women of color will turn to unsafe methods that place their lives in peril as was common prior to legalized abortion in 1973. Pregnancy is a greater risk to women’s health than abortion and more women will be forced to carry to term, particularly among non-Hispanic Black women who are two to three times more likely to die from pregnancy-related complications compared to non-Hispanic white women. In fact, states with more restrictive abortion policies experience higher maternal mortality rates.


Lack of access to abortion care will also increase the likelihood of unintended births disproportionately for low-income women, rural women, and women of color. Women who have unintended births are also likely to delay education and entrance into the workforce, and to have higher poverty levels. According to one study, women who were turned away from abortion clinics because of gestational limits had increased economic and housing insecurity in the form of bankruptcies, evictions, and court judgments.


Overturning Roe v. Wade will decrease abortion access and widen the socioeconomic gap in society. States that do not allow abortion should be prepared for more hospitalizations from unsafe abortions and risky pregnancies and increasing levels of poverty and inequality in their states. Abortion bans will increase travel distance to abortion clinics and, as seen in Texas, disproportionately harm pregnant people in low-income communities who lack the means to travel for healthcare.


The worst of this societal inequality is yet to be seen.