Hundreds of bills aimed at restricting abortion access are introduced in state legislatures every year, and the ones that become law can have an immediate impact on providers across the country. States that currently have just one abortion clinic are proof of how strict, superfluous requirements force clinics to shutter, leaving women with fewer healthcare options.
Kentucky, Mississippi, Missouri, North Dakota, South Dakota, West Virginia, and Wyoming each have only one abortion clinic. One. For the whole state.
"Of course, states that have shut down all but a single clinic didn’t get there by accident, but as the result of deliberate steps to deny women access to constitutionally protected healthcare," James Owens, a NARAL Pro-Choice America spokesperson, told Refinery29. "Unfortunately, these states are not alone, as there has been a concerted, nationwide effort to undermine a woman’s access to abortion for more than a decade."
Mississippi was left with just one clinic providing abortion procedures 11 years ago — Jackson Women’s Health — and it's been fighting to stay open ever since. Most recently, a crisis pregnancy center moved in right across the street. These types of anti-abortion organizations advertise as clinics offering women advice on pregnancy options, but in reality, they distribute misleading or false information, exaggerate the risks of having an abortion, and pose "counselors" as medical professionals.
So far, Jackson Women's Health has managed to keep its door open, but now another one-abortion-clinic state is battling to not become the first state with zero clinics.
Kentucky's Republican governor, Matt Bevin, has effectively shut down abortion clinics and kept an existing Planned Parenthood from providing abortion procedures, leaving the E.M.W. Women’s Surgical Center as the only abortion provider in the state. The American Civil Liberties Union (ACLU) sued Kentucky on behalf of the E.M.W. Women’s Surgical Center in April after the state threatened to revoke the clinic's license because its agreements with a local hospital and ambulance service allegedly weren't sufficient. A federal judge allowed the E.M.W. Women’s Surgical Center to stay open until the case concludes.
State requirements forcing abortion clinics to have admitting privileges at nearby hospitals are known as TRAP laws — targeted regulation of abortion providers — because the American Medical Association and the American College of Obstetricians and Gynecologists consider them medically unnecessary and they force clinics that can't meet those strict standards to close.
In fact, the Supreme Court ruled last summer that similar laws in Texas were unconstitutional because they create an undue burden for women seeking to end a pregnancy, but other states (like Kentucky) still have these types of laws on the books.
Besides the fact that abortion is legal in the U.S., the main problem with having just one (or zero) abortion clinics in an entire state comes down to access. Do women really have the right to choose an abortion if there's no feasible way for them to get one?
A lack of clinics forces women to travel really far to get healthcare. When Texas abortion clinics closed after the state withheld their funding in 2011, women whose closest clinic shuttered drove an average of 85 miles for health services. This means an increase in travel costs, childcare expenses, and time off work, all of which make it more difficult for anyone — but especially low-income women — to get an abortion. And if a state is left without any abortion clinics, all of those factors would escalate even further.
The ACLU's case in Kentucky is set to go to trial in September and will determine whether or not the war against abortion will succeed in creating an abortion-free state in 2017.