2 years late how the Dobbs Supreme Court decision changed abortion access

STEVE INSKEEP, HOST:

We have an update now on the fight over abortion two years to the day after the Supreme Court ended a constitutional right to it.

A MARTÍNEZ, HOST:

States have debated the issue ever since. Some already had laws that instantly banned the procedure, Republican-dominated legislatures soon added to them. Many women have described dramatic changes in access, among them, Lauren Miller of Texas, who testified before Congress.

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LAUREN MILLER: A 15-minute procedure that could've been done three miles from my house took several thousand dollars and three days.

MARTÍNEZ: Also, since the court ruling, voters have turned aside some efforts to restrict abortion, including in more conservative states such as Ohio and Kansas.

INSKEEP: The overall effect on abortion in this country is surprising. NPR's Elissa Nadworny covers reproductive rights and is on the line. Good morning.

ELISSA NADWORNY, BYLINE: Good morning.

INSKEEP: OK, what's the surprise?

NADWORNY: Well, the number of abortions is actually up across the U.S. It is true that access is a lot harder. Fourteen states have near total abortion bans, and many others have restrictions on time limits. It's actually been a time of chaos and confusion because there are a lot of new laws and then legal challenges, so it's hard to know what the law is where you live. And yet abortions are up.

INSKEEP: Well, why, given all that you just said, would the number of abortions grow over the past two years?

NADWORNY: Yeah, so it really has to do with how people access abortions. More than half are with medication. And there's been a major rise in telehealth, so you don't have to go in person to get treated. You could get pills in the mail. Even people in banned states can access pills from providers in places like Massachusetts and New York, where they have laws that allow them to send pills to places like Texas or Mississippi.

INSKEEP: And give them some legal protections, at least in their own states. OK, so it sounds like people in the banned states still get abortions. What else is happening in those states?

NADWORNY: Well, in states with bans, most clinics have closed, and in their place, crisis pregnancy centers, often with an anti-abortion agenda, have sprung up. Jenice Fountain runs a reproductive justice organization in Alabama, where there is a total abortion ban.

JENICE FOUNTAIN: So in Alabama, some things that I have noticed, there's a lot of folks that are birthing now that are like, I would have rather terminated and, like, birthed later on in life or not at all again.

NADWORNY: So more women are having children.

INSKEEP: OK, so that is also happening. Many different trends here. What about people who are traveling out of state for an abortion?

NADWORNY: That's definitely happening and makes up about a fifth of all abortions. Last year, 171,000 patients traveled out of state. That's according to data out this month from the Guttmacher Institute, which supports abortion. Lauren Miller, that mom from Dallas you heard earlier, she was pregnant with twins. Her doctors told her that one twin wasn't viable and was threatening the life of the other twin and making Lauren really sick. But her doctors were unable to do what's called a single fetal reduction because the state has multiple laws banning abortion. Miller testified on Capitol Hill earlier this month about having to go to Colorado to get the procedure.

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MILLER: The bounty laws in Texas had us worrying about who could turn against us. Was it safer to attempt 12 hours in a car through rural Texas while I was violently ill? What if I got worse? We knew flying was faster, but what if I was pulled out of the security line and questioned or not allowed on the flight because I was too sick? Should we leave our cellphones at home and rely only on cash to prevent being tracked?

INSKEEP: OK, so that's the testimony. What are you watching for in the months to come?

NADWORNY: Well, the big thing I'm watching is that abortion could be on the ballot this fall in as many as 10 states. And we've got one more Supreme Court case coming, so hopefully that'll come out this week.

INSKEEP: Elissa, thanks for the update. Really appreciate it.

NADWORNY: You bet, Steve.

INSKEEP: That's NPR's Elissa Nadworny, who covers reproductive rights.

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