Red-state Americans see abortion access slipping away

In states where abortion is no longer protected by law, nearly half of residents report that abortion access has narrowed since the Supreme Court struck down Roe v. Wade. 

A small but significant number of Americans know someone who has crossed state lines for an abortion, undergone a birth-control procedure or postponed getting pregnant in the months since the landmark ruling Dobbs v. Jackson Women’s Health Organization, which negated a constitutional right to abortion after nearly half a century. 

The findings, from a new NPR-Ipsos poll, reflect a divisive new reality. In roughly half of the states, a Republican majority doesn’t want abortion access to be easy. In the other half, a Democratic majority believes abortion should be available to all. 

Nearly 3 in 10 Americans told pollsters that access to abortion had eroded since the Dobbs decision. That share rose to 44 percent in states where abortion is not legal or otherwise protected.  

Abortion is now effectively outlawed in at least a dozen states, with exceptions only for medical emergencies. Some states allow abortions in cases of rape or incest. Others do not.  

Several red-state abortion bans remain stalled in the courts. The Guttmacher Institute, an abortion-rights research group, predicts abortion will be banned in 24 states once the post-Dobbs dust clears. The flurry of legislation and litigation would leave abortion mostly legal on the East and West coasts and in parts of the upper Midwest and lower Southwest, and mostly illegal everywhere else.  

That patchwork mirrors the sharp national divide in opinions about Roe and abortion.  

Seven Republicans in 10 agree with the Dobbs decision, according to the NPR-Ipsos poll. Two-thirds of Republicans believe abortion should be illegal in “most or all cases.” Only 9 percent think abortion laws in their states are too strict.  

Across the political aisle, the vast majority of Democrats agree with Roe and lament Dobbs. Eighty-four percent believe abortion should be entirely or mostly legal. Only 4 percent want more restrictive laws.  

As states implement the new bans, fresh debate is brewing on whether any meaningful access to abortion remains under the strictest laws.  

In theory, a pregnant person who shows up at a hospital in Texas or Louisiana or Mississippi with a dangerous complication should still qualify for an abortion.  

“If you walk into an emergency room, they have to treat you by law,” said David O’Steen, former executive director of the National Right to Life Committee. “The pro-life movement doesn’t want mothers to die.” 

Those exceptions defined the laws and helped anti-abortion lawmakers get them passed. Only 15 percent of Republicans believe abortion should be illegal in all cases, according to the new poll. 

Anti-abortion activists contend that the exceptions, taken together, “removed what were very much the talking points of the pro-abortion movement,” O’Steen said.  

Yet, a New York Times investigation found that very few of the promised exceptions have been granted. Doctors and hospitals “are turning away patients,” the Times reported, “saying that ambiguous laws and the threat of criminal penalties make them unwilling to test the rules.”  

Louisiana, which allows abortions in cases to protect the patient’s health and in cases involving deadly birth defects, has reported no abortions since its ban became law, the Times found. Mississippi, Alabama, Kentucky, Missouri and Texas all have reported tiny numbers of abortions under the new laws.  

“If the data are showing that abortions are not happening, then that proves the point that the exceptions are on paper, and not in practice,” said Dr. Tracey Wilkinson, an assistant professor of pediatrics at the Indiana University School of Medicine who studies abortion access.  

The Times report, tracking the fallout from Dobbs, found a Mississippi woman who said she could not find a doctor to provide an abortion after she was raped. An Ohio woman who faced dangerous pregnancy complications sought an abortion in her state but was turned away. 

“There is a lot of ambiguity and confusion and fear around the exceptions, what they are and how they can be interpreted,” said Rachel Jones, principal research scientist at Guttmacher Institute. 

Even before Dobbs, in an era when abortion remained legal across the land, entrenched opposition rendered it effectively unavailable in many places.  

As of 2020, six states had one abortion clinic each, and 89 percent of America’s counties had no clinic at all, the cumulative effect of decades of restrictions authored by anti-abortion lawmakers. 

“What does it mean if you have one clinic in your state, and it’s hundreds of miles away?” Jones said. “Do you have access to an abortion?” 

Despite the restrictions, the annual number of abortions was climbing. The Guttmacher Institute reported 930,160 abortions in 2020, compared with 862,320 in 2017. Preliminary data for 2021 suggested a further upward trend, Jones said. 

After Dobbs, “trigger” laws took effect in 13 states, banning abortion immediately or after state action. In most of those states, the number of abortions provided in the second half of 2022 “declined to basically none,” Jones said. 

The bans sparked a rise in interstate travel for legal abortions. A clinic in Granite City, Ill., reported that 86 percent of its post-Dobbs patients arrived from out of state.  

In the midterm elections, voters in several states considered ballot measures to protect or restrict abortion. Voters decided in favor of abortion rights in every case, affirming abortion-rights measures in California, Vermont and Michigan and rejecting abortion restrictions in Kentucky, Kansas and Montana.  

The outcome suggested a post-Dobbs, pro-abortion backlash. Abortion-rights activists marveled at “the people who voted for Rand Paul,” the conservative Kentucky senator, “and also voted for abortion access,” said Angela Vasquez-Giroux, vice president of communications and research at NARAL Pro-Choice America. 

Independent voters may have made the difference in the state contests. In the NPR-Ipsos poll, independents said they would in favor of abortion, rather than against it, by a 2-to-1 margin. 

Abortion-rights advocates, stunned by the Dobbs decision, drew fresh inspiration from the state victories.  

Anti-abortion activists, stung by the defeats, “are going to do everything in their power not to allow voters to make this decision moving forward,” Wilkinson said. “Because they will lose if they allow voters to make this decision.” 

That could be a hard sell. If the NPR-Ipsos poll proved anything, it is that Americans love ballot measures. Strong majorities of Democrats and Republicans said they would support using a ballot measure or voter referendum to decide abortion rights in their states.  

O’Steen, of the National Right to Life Committee, characterized the abortion-rights victories in the midterms as a singular event, fueled by Dobbs. Anti-abortion organizers will continue to pursue ballot initiatives, he predicted, “on a state-by-state basis.”