Texas and some other states have explicitly restricted medication abortion.

Without Roe, clinics would close in wide swaths of the South and Midwest. The closures would increase average driving distances to the nearest clinic to about 280 miles, up from 35 miles, for women in states without one, found research by Caitlin Knowles Myers, an economist at Middlebury College, and colleagues.

Research on past abortion laws has shown that longer distances tend to reduce abortions, as the challenges of travel mount. Groups offering financial and logistical support to Texas women said donations had decreased after a bump when the law went into effect.

The groups added they would not have enough resources to help women in so many states. Remaining clinics would most likely be overwhelmed with patients. Trust Women, which has an abortion clinic in Oklahoma, is seeing 10 times as many Texans there as it used to. That causes a ripple effect. Many Oklahomans can’t get local care and have to seek it elsewhere, said Rebecca Tong, an executive director of the clinics.

The clinics have tried to expand to meet demand, but especially in Oklahoma, where abortion would be outlawed if Roe were overturned, it’s hard to recruit doctors, she said: “Some would be leaving a full-time job with benefits, and for what?”

At Hope Medical in Shreveport, La., two-thirds of patients are now from Texas, up from one-fifth before the Texas law went into effect. The clinic used to do the majority of abortions before nine weeks, but now most patients are in their late first or early second trimester, because of the longer wait times for appointments.

“What ultimately is happening is because we are so busy and we can’t work any faster, we’re seeing women whose pregnancies were further along,” said Kathaleen Pittman, the clinic’s administrator. “It’s happening not just to Texas women but to Louisiana women because they’re having to wait too.”

Still, clinics are preparing for an even bigger surge if Roe is overturned, planning to expand capacity if abortion remains legal in their state — or, if not, to open over state lines where it is legal; offer more guidance through telemedicine; or offer pre-abortion care.

Kristina Tocce, the medical director of Planned Parenthood of the Rocky Mountains, said the influx of Texas patients had provided a preview of a possible future, in which Colorado, which is expected to keep abortion fully legal, could become a post-Roe abortion hub.

“What is going to happen when this happens to more and more states?” she said. “I don’t know, but we can’t absorb 26 states going dark.”

Note: Our calculated decline in overall abortions compares the recent numbers to a baseline of abortion numbers from before the legal change. For legal in-state abortions and requests for abortion pills, we compared the period from March to July in 2021 with the period from September to December in 2021.

For out-of-state abortions, we compared the period from March to July in 2021 with a 2019 monthly average. (Figures from early 2021 were not available.)

Because the number of abortions in Texas increased in August 2021, in anticipation of the new restrictions, we did not include that figure when establishing the historical numbers.

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