At least 43 abortion clinics have shut their doors in the 30 days since the US Supreme Court overturned Roe v. Wade in June, according to new research.
The research was published Thursday by the Guttmacher Institute, a research and policy organization focused on sexual and reproductive health that supports abortion rights.
The closures are concentrated in the South and Midwest, regions that have banned or significantly restricted access to abortion. Guttmacher predicts that the state of abortion access, already “dire,” will get even worse as more states ban abortion in the coming weeks and months.
“We knew that bad things were going to come off the decision when it came out on Friday, the 24th, and unfortunately, we’re not particularly surprised,” said Rachel K. Jones, a principal research scientist with Guttmacher who worked on the report.
There was one element of the closures that was a surprise, said Elizabeth Nash, a state policy analyst with the organization who worked on the report.
“Even before Dobbs fell, we knew this would happen, but I think the speed of the closings is a little bit surprising to everybody,” Nash said. “It’s happening lightning quick.”
The landscape for abortion access has changed dramatically since the Supreme Court issued its opinion in Dobbs v. Jackson Women’s Health late last month. The opinion ended a US constitutional right to an abortion, giving states the green light to implement bans or extreme limits on the procedure.
Since then, several states have sought to enforce abortion restrictions that were previously on the books but blocked by federal court orders or that were designed to go into effect if the Supreme Court reversed its abortion rights precedent.
Abortion providers have had some success getting those bans blocked in state court in a handful of places, but in at least 11 states, laws restricting abortion at about six weeks into pregnancy or banning it outright have been allowed to go into effect.
As of July 24, according to Guttmacher, seven states have been able to enact complete bans on abortion: Alabama, Arkansas, Mississippi, Missouri, Oklahoma, South Dakota and Texas. Four states have implemented restrictions on abortion after about six weeks of pregnancy: Georgia, Ohio, South Carolina and Tennessee.
Prior to the bans, these 11 states had 71 clinics. Now there are only 28 left.
Researchers believe that it will be difficult for people to get access to the procedure even in the states with six-week bans, since there will potentially be long wait times for appointments. At six weeks, experts say, most people don’t even know they are pregnant.
“Obtaining an abortion was already difficult in many states even before the Supreme Court overturned Roe,” the report says. “The clinic closures resulting from state-level bans and restrictions in the wake of the June 24 decision will further deepen inequities in access to care as the addition of long travel distances to reach and abortion clinic in another state will be a barrier for many people.”
And it could be a barrier for people who are already vulnerable to poor birth outcomes.
“It will be particularly difficult for those who feel the greatest impact from these bans, which are low-income individuals, Black and brown patients, young people and LGBTQ individuals,” Nash said.
Studies show that young lesbian and bisexual young women are at a greater risk of an unwanted pregnancy than their heterosexual peers. Childhood neglect, family rejection and bullying are significant teen pregnancy risk factors. Lesbian and bisexual women may be up to three times as likely as heterosexual women to report having been sexually assaulted in their lifetime, studies show.
Black women are three times more likely to die from pregnancy-related causes than White women, according to the US Centers for Disease Control and Prevention.
According to the CDC, Black women also had the highest rate of abortions, followed by Hispanic women.
Nationally, half of all people who seek an abortion live below the poverty level, studies show.
“Wealthier and whiter people have more resources, greater connections to the health care system. So they can leave the state to access abortion,” Nash said.
The researchers created a list of clinics that were known to provide abortions as of 2020 in the 11 states that quickly moved to restrict abortion access. They used news reports, information from other abortion access organizations and social media to determine which clinics closed. Guttmacher plans to keep a running list of closures as the legal landscape shifts.
Get CNN Health's weekly newsletter
Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.
The legal status of abortion remains in flux in several states, creating a fluid situation around access in states beyond the 11 that Guttmacher highlighted in its report. In Wisconsin, for instance, providers stopped offering abortion care because of a pre-Roe trigger ban, but that 1849 law faces a legal challenge.
Jones said that if all 26 states that Guttmacher expects to ban abortion do so, more than 200 clinics would ultimately close because of the Supreme Court decision.
“Unfortunately, this is probably just the tip of the iceberg,” Jones said. “The situation is only going to get worse for people, particularly in the Midwest and South.”