Women living below the federal poverty level are being disproportionately affected by tightening antiabortion regulations, particularly as clinics across the country have been closing in recent years.
Poor women of childbearing age are more likely than other women to have to drive more than an hour to reach the closest abortion provider, according to drive-time analysis by The Washington Post.
Poor women of childbearing age who must drive
from the closest abortion clinic.
Areas within
1 hour of an
abortion clinic
200,000
50,000
15,000
5,000
Poor women of childbearing age who must drive
from the closest abortion clinic.
Areas within
1 hour of an
abortion clinic
200,000
50,000
15,000
5,000
Poor women of childbearing age who must drive
Areas within
1 hour of an
abortion clinic
from the closest abortion clinic.
200,000
50,000
15,000
5,000
La Crosse
Lexington
Greenville
Lubbock
College Station
Laredo
Poor women of childbearing age who must drive
Areas within
1 hour of an
abortion clinic
from the closest abortion clinic.
200,000
50,000
15,000
5,000
Seattle
Grand Forks
Portland
Billings
Boise
Minneapolis
State
College
Detroit
New York
Chicago
San Francisco
D.C.
Denver
Topeka
Columbia
St. Louis
Lexington
Las Vegas
Greenville
Santa Fe
Los Angeles
Memphis
Oklahoma City
Phoenix
Atlanta
Lubbock
Dallas
Jackson
El Paso
College Station
Austin
Fairbanks
San Antonio
Houston
Tampa
Anchorage
Honolulu
Laredo
Miami
Poor women of childbearing age who must drive
Areas within
1 hour of an
abortion clinic
from the closest abortion clinic.
200,000
50,000
15,000
5,000
Seattle
Portland
Billings
Boise
Minneapolis
Detroit
New York
South
Bend
Chicago
San Francisco
D.C.
Denver
Columbia
St. Louis
Lexington
Las Vegas
Greenville
Santa Fe
Los Angeles
Memphis
Oklahoma City
Phoenix
Atlanta
Lubbock
Dallas
Jackson
El Paso
College Station
Austin
Fairbanks
Houston
Lafayette
Tampa
Anchorage
Laredo
Honolulu
Miami
Research shows that women below the poverty level account for about half of the abortions in the United States.
What’s more, a majority of the 2.5 million women below the poverty limit who must drive farther are also subject to state laws that require at least two days to get a procedure, so two trips — or an overnight stay — are needed.
The cumulative effect of greater need, longer drives and extra days raises the question of whether the restrictions rise to the level of “undue burden” that the U.S. Supreme Court has said cannot be imposed on women exercising what the court has ruled a constitutional right to an abortion.
“Being low income comes with even greater challenges,” said Ushma Upadhyay, a researcher at Advancing New Standards in Reproductive Health located at the University of California at San Francisco.
[The widening gap in abortion laws in this country]
“Many poor women don’t have a car,” she said. “They don’t have money for gas. They don’t have money for buses or trains. That also means time off of work, which is an even greater burden for lower-income women.”
In upholding Roe v. Wade, the Supreme Court has allowed state restrictions on abortion as long as they do not constitute an “undue burden.” The question of burden, however, may be very different for women in poverty. Access is consistently more difficult for poor women, with the divide more pronounced in regions where access is already most restricted.
In nine states, a majority of poor women of reproductive age live more than an hour from the nearest facility, either in their state or a neighboring one.
In 14 states, the travel burden is greater because abortion regulations require multiple visits over more than one day, according to data from the Guttmacher Institute. A majority of the poor women who must drive more than an hour to a clinic live in those states.
Share of women in poverty more
than an hour away from a clinic
0%
10%
30%
50%
87%
Wyoming
(highest)
States that require
multiple clinic visits
NH
WA
VT
ME
MT
ND
MN
OR
MA
ID
NY
SD
WI
RI
WY
MI
CT
PA
IA
NE
NJ
NV
OH
IN
IL
UT
DE
CO
WV
CA
VA
KS
MO
MD
KY
NC
TN
OK
AZ
AR
NM
SC
AL
GA
MS
LA
TX
AK
FL
HI
Share of women in poverty
more than an hour away from a clinic
0%
10%
30%
50%
87%
Wyoming
(highest)
States that require
multiple clinic visits
NH
WA
VT
ME
MT
ND
MN
OR
MA
ID
WI
NY
SD
RI
WY
MI
CT
PA
IA
NE
NJ
NV
OH
IN
IL
UT
DE
CO
WV
CA
VA
KS
MO
MD
KY
NC
TN
OK
AZ
AR
NM
SC
AL
GA
MS
LA
TX
AK
FL
HI
Share of women in poverty more than an hour away from a clinic
87% Wyoming
(highest)
0%
10%
30%
50%
States that require multiple clinic visits
NH
WA
VT
ME
MT
ND
OR
MN
MA
ID
WI
NY
SD
RI
WY
MI
CT
PA
IA
NJ
NE
NV
OH
IN
IL
DE
UT
CO
WV
CA
VA
MD
KS
MO
KY
NC
TN
OK
AZ
AR
NM
SC
AL
GA
MS
LA
TX
AK
FL
HI
Share of women in poverty more than an hour away from a clinic
87% Wyoming (highest)
0%
10%
30%
50%
States that require multiple clinic visits
NH
WA
VT
ME
MT
ND
OR
MN
MA
ID
WI
NY
SD
RI
WY
MI
CT
PA
IA
NJ
NE
NV
OH
IN
IL
DE
UT
CO
WV
CA
VA
MD
KS
MO
KY
NC
TN
OK
AZ
AR
NM
SC
AL
GA
MS
LA
TX
AK
FL
HI
Missouri, which has some of the worst drive-times for poor women and also requires multiple visits, may soon lose it’s only open clinic if a dispute over licensing is not resolved. Even with that clinic operational, Missouri already has the greatest drive time disparity between poor and non-poor women. Fifty-five percent of women below the poverty level live more than an hour’s drive away, while 42 percent of non-poor women do.
The Post found that nationwide there were a total of 11 million women ages 15 to 44, or 18 percent, who had to drive more than an hour to get to a clinic, according to the latest data. That compares with 2.5 million, or 22 percent, of women in poverty who have to drive more than one hour.
Those differences among women in poverty and those who are not vary greatly across the country. Access is consistently better in the Northeast and Southwest, and more difficult in the Midwest and Plains states and in the South. In each region, women in poverty are more likely to have to drive farther.
Regional differences in percentage of poor and non-poor women who are more than an hour from a clinic
Less than
1 hour away
More than
1 hour away
Northeast
Poor: 8%
Non-poor: 6%
Southwest
9%
6%
Northwest
17%
14%
midwest & plains
28%
25%
South
31%
24%
Regional differences in drive times for poor and non-poor women
Northeast
Southwest
Northwest
midwest & plains
South
31%
28%
More than
1 hour away
25%
24%
17%
14%
8%
9%
6%
6%
Less than
1 hour away
Poor women
Non-poor women
Share of women in poverty more than an hour away from a clinic
Regional differences in drive times for poor and non-poor women
Northeast
Southwest
Northwest
Midwest & plains
South
31%
28%
25%
More than
1 hour away
24%
17%
14%
8%
9%
6%
6%
Less than
1 hour away
Poor women
Non-poor women
Regionally, the greatest disparity in access is in the South, where almost 1 in 3 poor women have to drive more than an hour, while less than 1 in 4 non-poor women have to drive that far. In the Midwest and Plains, a greater share of women overall have to drive farther because of greater open spaces. Outside the contiguous states, in Alaska, 45 percent of poor women have to drive an hour each way, and in Hawaii, 38 percent do.
Activists trying to eliminate abortion say poor women are being exploited by abortion providers and benefit when laws dissuade them.
“Life is life whether you’re rich or poor,” said Arkansas state Sen. Jason Rapert (R), who described meeting the adoptive parents of a boy who was born after extra counseling requirements stopped a woman from having an abortion. “This is not a rhetorical, theoretical discussion for me. It is truly life.”
[How often does the Supreme Court overturn precedents like Roe v. Wade?]
Advocates for access say that laws that make it harder to get to clinics and counseling requirements that delay procedures are not just a deterrent, they also affect patient safety for a woman seeking an abortion.
“Pushing out the time increases the complication rate,” said Upadhyay, the California researcher. “It’s in the woman’s interest to have the abortion sooner. Poor women should be able to have the children they want with the timing they want. All women should have access to abortion care, including low-income women.”
Methodology: Analysis used 2018 list of providers from researcher Ushma Upadhyay at Advancing New Standards in Reproductive Health at the University of California San Francisco. The analysis measured the time to the nearest facility, regardless of state boundaries. Drive time analysis done with ESRI ArcGIS Online. Age, gender and poverty demographics from Census Bureau American Community Survey tract-level table B17001 for 2013-2017. Drive time was calculated from Zip code of clinic to center of census tract. Map shows populations aggregated up from tract to contiguous portions of county that are closer or farther than an hour from a clinic. Information on women who receive abortions and laws requiring multiple visits from Guttmacher Institute. All figures cited are for women of reproductive age between 15 and 44.
Lauren Tierney contributed to this report.
