A quarter of abortion clinics could close if Roe v. Wade is overturned, new study finds

After last month’s leak showing that Supreme Court justices are poised to overturn the landmark Roe v. Wade ruling, pro-choice advocates started weighing its implications for abortion access nationwide.

One of their findings: Over a quarter of abortion clinics in the U.S. could close after the court hands down its expected decision this summer, according to Advancing New Standards in Reproductive Health (ANSIRH), a research program based at the University of California at San Francisco.

Currently, 13 states have trigger laws that will go into effect with the decision, banning or significantly restricting abortion access, according to the research organization the Guttmacher Institute. As many as 26 states are expected to enact similar legislation following the decision.

As of 2021, there were 790 publicly advertised abortion clinics open in the U.S., according to the ANSIRH report. Of those, 758 are brick-and-mortar facilities and 32 are virtual telehealth facilities.

With the overturn of Roe, 202 facilities representing 26% of all abortion clinics in the U.S. would close, the report said. The decision will largely affect pregnant people in the South and Midwest, where most of those closures would occur.

Though the number of clinics nationwide has remained relatively stable in recent years, there are key regional nuances in openings and closings. Between 2017 and 2021, for example, twice as many facilities closed than opened in the South. Southern clinics now serve three times as many clients as clinics in the Northeast, according to the report.

“California alone had more abortion facilities than the 34 states with the fewest number of abortion facilities combined and nearly as many clinics as could be found in the entire U.S. South,” wrote ANSIRH in its report. California had 168 open facilities as of 2021, followed by New York with 89. 

Several states had only one facility: Mississippi, Missouri, North Dakota, South Dakota, West Virginia, and Wyoming.

The decision will not just have regional impact, according to the report, but economic as well. “Given that the majority of abortion patients are low-income,” wrote the ANSIRH in its report, “trends suggest that economic and logistical pressures on people seeking abortion will only be intensified as disparities between restricted and protected access states widen in the U.S.”