After Roe v Wade was overturned in June 2022, Daphne did not want to leave anything to chance.
Abortion is currently legal until 18 weeks in Utah, where the 38-year-old lives – but the state has a 2020 trigger law banning almost all abortion care that is currently under appeal.
Daphne knew she didn’t want children so she decided to undergo surgical sterilization in October 2022, to have “peace of mind that [she] physically cannot become pregnant”.
“My husband could have gotten a vasectomy for less money and an easier recovery time. However, that doesn’t change the outcome if I were to be assaulted. Living in Utah, I could not and would not risk having to seek an abortion, likely having to leave the state to do so, after an already traumatic event,” Daphne said.
The procedure, which was not fully covered by her health insurance, left her around $1,000 out of pocket.
“I’m lucky I was able to take these measures, and most cannot,” she added.
Almost two years after the supreme court decided there is no constitutional right to abortion in the Dobbs v Jackson Women’s Health Organization case, patients have increasingly been forced to travel out of their state in order to access abortion care, while others have carried unwanted pregnancies to term. A study earlier published in January estimated there have been nearly 65,000 pregnancies from rape in states with abortion bans.
Interstate travel for abortion care in the US doubled between 2020 and 2023, from one in 10 to almost one in five people leaving their state to access treatment, data from the Guttmacher Institute shows.
In states where it is possible, many go to neighboring states. Hanz, a 30-year-old who works as a clinical social worker in an abortion clinic in Illinois, but lives in Missouri, found out they were pregnant in late July 2022, they recalled: “As soon as I saw the two lines on the test, I knew I had more rights standing in Illinois than I would when I got home that night. Abortion rights had already got so much worse in recent years – and then Roe was overturned.” (Missouri passed a trigger law in 2019 that banned abortions except in medical emergencies.)
Hanz wanted a child, but felt it wasn’t the right time. “I was really weighing what I wanted and what felt like the right decision. It was very hard for me to terminate the pregnancy, but I had a difficult time growing up and didn’t feel I could bring a child into the world and not be able to give them the quality of life I wanted to,” they said.
After spending a month carefully weighing their options, they crossed into Illinois to terminate the pregnancy at the beginning of September at nine weeks.
“Making the decision was much harder than having the actual abortion,” Hanz said, adding that fears remain about crossing the border to receive care.
“I’ve talked to people who thought they may be arrested when they returned to their home state – you’re not breaking the law by crossing the state,” Hanz said.
For others, the introduction of abortion restrictions has meant they are not having children they may have had. Over the last few years, Brie, 41, had been considering having another child – but after Dobbs, she felt she could not undergo the risk of a pregnancy at her age in the state of Texas.
“My husband and I had dreamt of a third child. Now, I know it’s definitely not going to happen,” Brie said, adding that she felt she could not risk a pregnancy in Texas, which has a near-total abortion ban.
Her medical history adds to her fears: she had a complicated first pregnancy, including experiencing pre-eclampsia, and needed an emergency C-section.
“It was scary and dangerous,” she said. “With my history, there’s no way I’d trust having this pregnancy in Texas or the south. I’d have to move.”
The loss of the constitutional right to abortion has taken the choice out of her hands, she feels. “Our seven-year-old son is asking for a younger sibling,” Brie said. “I know I’m in a privileged position – we have two wonderful, healthy kids – but I don’t appreciate the state making my family planning decisions.”
Abortion is an issue that divides her family. “The last two years have been a very volatile time, even having these discussions within my extended family,” she said. The issue is at odds with other values prized in Texas, she believes: “People here are very concerned with freedom. But there’s this huge conflict here between concern with personal freedom, and the approach to women and fertility. The only acceptable carveout is women that are pregnant.”
Every month, she feels anxious about the chance of pregnancy. “It’s constantly on my mind and has been since Dobbs: am I going to be thrown under the bus by my state this month?
“You play scenarios out, what if, where would I go, who would I tell. It’s a big wall of separation between who could you trust. I think that’s the goal: to isolate and put women in a position of insecurity.”
For some, the fall of Roe was a call to action. Paul, in his mid-50s and living in North Carolina, knew little about abortion rights when he heard the news two years ago.
“Up until then, it was not something I cared about – it was obvious that women should have the right to choose,” he said. He had thought abortion was a “settled issue”.
When he heard the news, he remembers that he and his wife “stared at each other in silence, and thought, what the hell happens next? It doesn’t affect us personally, but it does affect millions of women. I went in completely blind.”
Compelled by a need to take action, by November 2022, Paul had begun volunteering with a group that offered logistical assistance to people requiring abortions, often picking up patients who had travelled from states with more restrictive laws and driving them to clinics.
“I’ve driven young teens with their parents who are absolutely petrified; women in their 20s who accept it’s something they have to do, and others to whom it’s no big deal. Everyone has a different set of circumstances – you don’t have to explain your reason to me,” he said.
After North Carolina reduced the limit from 20 to 12 weeks in May 2023, the number of patients traveling to the state dwindled until the service disbanded. Now, Paul volunteers most weeks as a clinic escort.
“More Saturdays than not, I can be found wearing a rainbow-striped vest, shielding women behind umbrellas as I walk them into the clinic. I have been called a murderer, a baby killer … And I’ll happily do it again next weekend as well,” he said. “A lot of men don’t want to acknowledge that men have a role to play in fixing this – it’s not up to just women.”
For Jane*, a woman from Texas in her 60s, the writing was on the wall before Dobbs as she watched restrictions chip away at abortion rights year after year. Between 1973 and May 2022, 1,380 abortion restrictions were enacted in states, according to the Guttmacher Institute, with more than 630 of these enacted since 2011.
Jane became involved in direct action in 2018, driving people in need of abortion to appointments: “I became involved because I realised pro-choice is just that – it doesn’t address access. It’s a limited way at looking at reproductive justice. Seeing the impact of restrictions on abortion, I felt that to do nothing is to be complicit.”
After Texas passed a bill outlawing abortion following the detection of cardiac activity – usually around six weeks – in 2021, Jane was galvanized to take further action. Toward the end of that year, she reached out to Las Libres, a Mexican network that mails pills for self-managed medical abortion.
“The inhumanity of restrictions just raised my temperature and made me increasingly angry and willing to stick my neck out and do something to help,” she said. “Dobbs was the logical next step after increasing regulations permitted under Roe. [Access] was very effectively overturned before Dobbs.”
Jane has been packaging and posting pills to states with abortion bans for the last two years.
“It is empowering and effective to fight back,” Jane said. “Perhaps I am in denial about my own risk, but I have had a good life, I enjoy relative financial stability in my retirement, and who better than me to be in a position to fight back? Small actions matter, and allow me to maintain hope.”
*Name has been changed
