Laws Revive ‘World Before Roe’ as Abortions Require Arduous Trek

In the year since Carrie Klaege moved to Arizona and started a non-profit program to help poor women afford abortions, she’s watched access to the procedure get tougher for her clients.

Following a rash of new laws, abortions are no longer available at clinics outside Tucson and Phoenix and women must wait 24 hours after required ultrasound tests before terminating pregnancies -- forcing some to travel hundreds of miles and stay overnight. Klaege said she’s now making connections in other states where she could send women if the courts allow a ban on later abortions to take effect.

“Abortion is legal, but when you have to travel 300 miles to get to a clinic that provides the services you need, you don’t really have access,” says Klaege, co-founder of the Abortion Access Network of Arizona and the former clinic director for Dr. George Tiller, a Kansas physician murdered in 2009 for performing abortions. “The availability and access to services is being severely impacted, and it is starting to cause some real difficulty for women.”

Over the past two years, state lawmakers across the U.S. have been passing new abortion restrictions at a record pace. Dozens of laws stipulating who can perform abortions, how abortion pills can be administered, tighter building standards for abortion clinics and what women need to do before abortions have been enacted -- helping create a patchwork of access to the procedure that the U.S. Supreme Court deemed a constitutional right almost 40 years ago.

New Requirements

In Mississippi, new requirements on doctors threaten to shutter the state’s last remaining abortion clinic. In Virginia, a Board of Health decision this month to make existing clinics meet building standards for new hospitals, may force facilities to close, make costly renovations or move. In Utah, women must wait 72 hours after counseling -- the longest delay in the nation -- before they can get an abortion. And nine states since 2010, including Arizona, have banned abortions after 20 weeks, around the same time many women learn about fetal abnormalities.

The laws, some of which are tied up in court challenges, have created a disparity in access to abortion that hark back to the days before the Supreme Court’s landmark Roe v. Wade decision, said Wendy E. Parmet, associate dean at Northeastern University School of Law in Boston.

“We are moving back to the world we had before Roe,” she said in a telephone interview. “We are moving toward a world where some women have fairly ready access to abortion and other women have a really difficult time accessing abortion. We’re seeing some of the same kind of barriers and some of the same divisions we saw back in 1973 playing themselves out again.”

More Regulation

Court decisions after Roe have permitted more regulation of the procedure by states, Parmet said. Lawmakers have responded by pushing the envelope of what they can do, including laws that make it more difficult on clinics and doctors who provide abortions and measures intended to shame women and make abortions more of a hassle, Parmet said.

New laws requiring counseling, ultrasounds and waiting periods are showing some success in helping women choose not to abort, said Michael New, an assistant professor of political science at the University of Michigan-Dearborn and adjunct scholar with the anti-abortion Charlotte Lozier Institute in Washington.

New, who wrote in, an online publication, that clinic restrictions like those in Mississippi and Virginia are “a wise strategy for pro-lifers,” said the intent is to protect women, not necessarily close clinics or increase the economic barriers to getting an abortion.

‘Unborn Children’

“We’re interested in protecting the safety of the women and the safety of the unborn children,” New said in a telephone interview. “The vast majority of what pro-lifers have done is trying to change the hearts and minds of the women. The end game is not necessarily the closure of the clinic as such, it is protecting the health and safety of the women.”

The pace of abortion regulation accelerated after widespread statehouse victories by Republicans in 2010. Last year, states passed a record 92 abortion restrictions -- almost three times the previous high of 34 in 2005, according to the New York-based Guttmacher Institute, a compiler of reproductive-health data that supports abortion rights. In the first half of 2012, states enacted 39 additional limits.

“We are seeing the number of providers decrease and the number of restrictions increase,” said Elizabeth Nash, state issues manager at Guttmacher. “Clinic regulations, waiting periods, ultrasounds -- you keep adding these things and it becomes really difficult.”

Paperwork Hassle

Tanya Rollins said she had no idea how much paperwork she faced when she decided on an abortion last month in Texas. Rollins, 35 of Frisco, said mandatory counseling included a warning of a disputed link between abortion and breast cancer.

“Risk factors are much larger for other surgeries that you are not given this kind of counseling for -- and you don’t need it,” Rollins said in a telephone interview. “Because I disagree with you morally, you are going to make me jump through hoops? You can look down the road and fear that one day it won’t be accessible and it won’t be legal.”

The new laws are increasing regional disparities with women in the South, Midwest and Mountain West facing more barriers than those in the Northeast or on the West Coast, Parmet said.

Access outside major metropolitan areas is limited. Fewer U.S. counties have abortion providers than when the Supreme Court decided Roe v. Wade: 87 percent in 2008, compared with 83 percent in 1973, according to Guttmacher’s most recent data.

Five states now have one clinic, including Mississippi, which had 14 in 1981.

Limited Access

“Access basically depends entirely on where you live,” said Julie Rikelman, litigation director for the New York-based Center for Reproductive Rights. “Even though it is supposed to be a constitutional right available to all Americans in the United States, it is really a right only available to a minority of American women.”

Bans on later abortions, new requirements for clinics providing the procedure after the first trimester and a decrease in providers have made access difficult further along in pregnancy.

“There are a number of states where you really can’t get an abortion after the first trimester,” said Stephanie Poggi, executive director of the Boston-based National Network of Abortion Funds.

Not Here

When Kimberly O’Brien, a 35-year-old married attorney, sought an abortion last year after tests found brain development problems in the fetus, she discovered that she couldn’t get the procedure done in New Orleans, where she lives.

O’Brien, then 22 weeks pregnant, and her husband drove six hours to Houston. While the travel wasn’t a financial burden, she said, she thinks it would be hard for low-income women to pay for gas and a hotel and take time off work.

“It made me aware of a situation I would have never known about otherwise,” O’Brien said in a telephone interview. “My assumption was, if you need to get one, you can make it happen in your home town or a few towns away.”

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