One year ago, the Supreme Court struck down Roe v. Wade in a landmark decision that would fundamentally change abortion access in America.
Perhaps one of the most dramatic signs of that shift is in the patchwork legal landscape that has emerged as states have enacted laws banning or restricting abortions.
Currently, abortion is banned or unavailable in 14 states and is restricted to varying degrees in 11 others according to a dashboard of state laws maintained by the Kaiser Family Foundation.
An emerging area of legal dispute concerns the extent to which states can prohibit residents from seeking health care in other states. Seven states have passed an abortion “shield law,” in response to attempts by legislators in restrictive states to limit out-of-state travel.
These shield laws are intended to provide legal protection to abortion providers who treat residents of states where abortion has been restricted. Such laws are also intended to help protect patients seeking such care, as well as anyone assisting to facilitate access or travel.
Adding to uncertainty in the legal landscape, courts are reviewing challenges to new abortion restrictions, overturning or temporarily blocking some laws.
Seven states currently have some form of abortion restriction or ban that remains in limbo due to pending court decisions. In North Carolina, the legislature recently overrode their governor’s veto of a bill that bans abortion after 12 weeks. That law will now go into effect on July 1.
Laws banning or restricting abortion are having their intended effect. According to a comprehensive survey of abortion providers nationwide conducted by the Society for Family Planning, the average monthly number of abortions provided nationwide is down by about 3% compared to the period immediately before the Dobbs decision.
The largest declines are seen in the states with the most restrictive laws. Meanwhile, states where abortion remains legal have seen an increase in the number of abortions performed. This likely reflects people traveling from nearby states that have restricted or banned abortion.
North Carolina is one such state that has seen a significant uptick in abortions performed following the Dobbs decision, though the state’s near-total abortion ban takes effect on July 1.
Search interest in terms related to contraception spiked nationwide when a draft Supreme Court decision overturning Roe vs. Wade was leaked in May, and again two months later when the final decision was released. Several states had so-called “trigger laws,” abortion bans or restrictions that would take effect in the event that the Supreme Court overturned Roe v. Wade.
A few other states had laws banning or restricting abortion already on the books and which became enforceable when federal protections ended. Search interest on Google for contraceptives in these states was notably higher than in other states according to research published earlier this year, likely reflecting concerns among residents about future access to abortion or contraceptives.
The spread of abortion restrictions may also exacerbate shortages of obstetrics and gynecology specialists. Data from the 2022-2023 residency application process show that states with restrictive bans are seeing a greater decrease in residency applications for OB/GYN programs compared to states without bans.
Many of these states already have some of the fewest physicians per capita.