Following the new decision from the Supreme Court, some states will be friendlier to abortion than others. For those people living in a hostile state, there is going to be a new hurdle for accessing care: traveling.
On Friday, the Supreme Court release an opinion in the case Dobbs v. Jackson Women's Health Organization that overturns the landmark court case Roe v. Wade.
"The Constitution does not confer a right to abortion; Roe and Casey are overruled; and the authority to regulate abortion is returned to the people and their elected representatives," said the opinion document written by Justice Samuel Alito.
This means that in Georgia, access to an abortion will be largely banned after 6-weeks, following the implementation of the so-called "heartbeat bill."
This abortion ban is current caught up in federal court, so abortions will not be banned overnight in Georgia.
For now, Georgia is a sort of “safe haven” of the South, said Y. Bekele, clinic director of the Feminist Women’s Health Center in Atlanta. Bekele declined to give her full name due to safety concerns.
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Bekele said her clinic sees patients from Tennessee, Alabama, Mississippi, Louisiana, and more recently, Texas. The Centers for Disease Control and Prevention shows that 18% of women who had an abortion in Georgia came from out of state.
But what happens when the South’s safe haven gets severely restricted?
North Carolina seems to be the answer, at least for now.
Lack of access
Not every person lives in a city with an abortion clinic, something that 19-year-old Jen Nelson found out when she fell pregnant during college. She was lucky enough to live an hour away from a clinic and so did not travel far.
In 2002, Nelson was a freshman in college living in Statesboro, Georgia when the symptoms started. She was on birth control, but despite this, her friends knew immediately what was wrong.
At her friend’s urging, Nelson took a pregnancy test. And then another. And another.
When it came time for an abortion, her boyfriend split the cost.
“By the time I was able to afford it I was, I think, 11 weeks,” said Nelson
Nelson had to drive an hour to Savannah to get to her clinic, which was the closest available to her at the time. She called it an “all-day affair.”
At an hour’s drive, Nelson was not faced with the struggles many abortion travelers must endure.
As of 2017, 26 facilities offered abortions in Georgia, with only 15 of those being clinics, according to the Guttmacher Institute. Of those clinics, most are centralized in the Atlanta area.
With most of the clinics in the state’s capital, the Guttmacher Institute found that 95% of Georgia counties had no clinics and that 55% of Georgia women lived in those counties.
Emily C. is one of those women. Emily requested partial anonymity due to safety concerns.
In 2018, Emily had her abortion while living in Macon as a junior in college. At the time, she was dating her future husband and fell pregnant.
Emily was not on birth control. She opted for tracking her fertile days and using protection then. But her math was wrong.
Immediately, Emily knew she wanted an abortion and also knew that the nearest clinics were in Atlanta, which was about two hours away. She went to the Feminist Health Center in Atlanta and at six weeks and three days, Emily had her abortion.
The trek took all day, waking up early in the morning to go to Atlanta before heading home that afternoon.
“That drive was tolerable because my husband's car had seat warmers. So that helped with the cramping,” said Emily.
The Lancet, a medical journal, published an article in 2017 that looked at the distance women would need to travel to have an abortion — even with Roe still intact. It showed that in 2014, people would have had to travel a median distance of 10 miles to their nearest clinic, with 20% of people having to travel more than 43 miles.
In Georgia, the article reported that the median distance traveled to the nearest clinic was above average, at 18 miles. For Emily, from Macon to Atlanta, it was more than 80 miles.
North Carolina an emerging hub
North Carolina is bracing right now for an influx of patients with only 14 abortion clinics, according to the Guttmacher Institute. Amber Gavin is a clinic director for one abortion clinic in North Carolina, called A Woman’s Choice.
Gavin explained that in her state, only a physician can provide abortions and does not allow nurse practitioners or midwives to perform the procedure.
So with limited availability of clinics and people able to perform abortions, the influx of patients will stress an already limited system, and A Woman’s Choice in particular is looking at finding more doctors and having more clinic hours.
People living on some of Georgia’s borders will be able to access abortions more easily. Gavin said that the clinic group she works for also has a clinic in Jacksonville, Florida, which is an option for women in southern Georgia.
For people closer to the Carolinas, Charlotte is a viable option. North Carolina, however, has a state-mandated 72-hour wait period. During this time, an abortion seeker is required to have state-mandated counseling over the phone from a registered nurse, according to Gavin. Since the counseling does not require abortion seekers to be in North Carolina, it can be done before they have to travel for their procedures.
An in-person appointment, however, is required for the procedure itself, even when that is being done via a pill. The state’s laws prohibit telehealth for abortions, so even if a person is not having surgery, they will still have to travel.
Gavin called this law “unnecessarily delayed care” and explained she has seen instances of the three-day wait period pushing a person outside of the legal limit for when they can receive an abortion.
“Sometimes it's like literally a day passed and we no longer can help them,” said Gavin.
But in Florida, things become more difficult.
Gavin explained that a new state law in Florida requires two in-person visits with a physician, one of which is for counseling.
“You have to come in at least 24 hours into the clinic to receive your counseling, go home or to your hotel, and then come back into the clinic the next day for your procedure,” said Gavin.
The CDC estimated how many abortions occurred in each state in 2019, with Florida, Georgia, and Texas leading the south.
Alabama: 6,009 abortions reported
Florida: 71,914 abortions reported
Georgia: 36,907 abortions reported
Louisiana: 8,144 abortions reported
North Carolina: 28,450 abortions reported
South Carolina: 5,101 abortions reported
Tennessee: 9,719 abortions reported
Texas: 57,275 abortions reported
Having an abortion can be expensive, for the procedure itself and without considering the additional costs of hotels, gas, and taking off work when traveling for an abortion.
For Nelson, her procedure cost $500 total, a cost she split with her boyfriend. She had to work and save up before she could afford the procedure.
“By the time I was able to afford it I was, I think, 11 weeks,” said Nelson
Even though she had saved to afford her part of the procedure, Nelson couldn’t afford everything. She was told that for an additional cost, she could receive medical care that could help prevent infertility post-abortion.
Nelson said that at the time she didn’t know whether what the clinic was saying was accurate or not, but ended up not taking the additional care.
Limbo and preparation
The ban in Georgia will not take hold immediately, allowing some time for preparation in Georgia following the Supreme Court's decision. But in other states, at the end of the day, trigger laws will come into effect that will ban abortions as early as six weeks.
Bekele expects July to be a busy month.
Because Georgia’s “heartbeat” bill that would ban abortions after six weeks is currently being fought in the court system, abortions will not be banned overnight in the state.
In the meantime, there are advocacy groups that are working toward creating funds for abortion seekers, whether that be for traveling or otherwise.
Bekele said that their clinic works with the National Abortion Federation, which she called the biggest and main fund for those with hardships.
“They have really been just monumental,” said Bekele “Like helping women arrive, travel, accommodations, all that kind of stuff.”
This article originally appeared on Savannah Morning News: Georgia abortion seekers might need to travel to outside of state