Abortion Access in the Midwest
Today and Tomorrow
This is a companion piece for some work I did with Line of Actual Control. If you would like additional analysis of what the maps I made mean and what they say about the future of abortion in the Midwest, take a look at their newsletter post. They focus on using open source information to answer questions about the world, oftentimes about warfare. Much of it is map related. If it interests you, check out their work!
Dobbs v. Jackson Women's Health Organization changed everything. A close to 50-year-long status quo for abortion was overturned, and it threw reproductive rights into chaos. The South, by and large, has had full bans or bans after 6 weeks come into effect due to existing trigger laws. Those restrictions have been stayed by the courts in Louisiana, Georgia, and Kentucky. North Carolina and Florida may be the only states south of Virginia and east of New Mexico with abortion after 7 weeks in the next month or two.
The Midwest, on the other hand, is much more varied. Three states have either banned abortion or restricted it to the first 6 weeks: Ohio (6 weeks), South Dakota (ban), and Missouri (ban). Wisconsin has no providers due to an 1800s law. Bans or 6 weeks restrictions have been blocked by the courts in Michigan (ban), Iowa (6 weeks), and North Dakota (6 weeks).
With voters in Kansas going to the polls next month to decide the fate of abortion in their state, Line of Actual Control approached me to map access to abortion in the Midwest. After some back and forth, I made a map series for them. They look good, and I think they show the state of abortion access particularly well.
Access
The GIF below shows access to abortion at up to 6, 11, 15, and 20 weeks as of 14 July 2022. The locations of providers and time frame that they offer abortions were scraped from Abortion Finder and other sources. They were then used to create 1 and 2-hour driving areas to show where there is and is not access to in-person abortion services. While telehealth exploded during the COVID-19 pandemic, in-person access continues to be important because medical abortions can only happen within the first 10 weeks of pregnancy.
At 6 weeks, women in large most of Wisconsin, Missouri, Kansas, Nebraska, North Dakota, and South Dakota are more than 2 hours from an in-person abortion.1 Other areas with coverage gaps include along the Ohio River in Ohio and Illinois as well as rural parts of Minnesota.
Abortions become less accessible the later in a pregnancy a woman is. At about 20 weeks, a woman desiring an abortion has to go to one of ten cities. These cities are oftentimes very far from home and require a large commitment of time and money to end a pregnancy.
Future
Forecasting the future is difficult. However, it seems that all of the states in the Midwest except for Illinois and Minnesota are poised to heavily restrict abortion.2 There is a chance that the courts will rule that Michigan’s pre-Roe law banning abortion is enforceable, but signatures have already been collected to add a right to an abortion to the state constitution. I think it is more possible than not that the ballot initiative will pass. That would lead to the Midwest looking something like this.
This is a world with large stretches of the Midwest without access to abortion. Women will need to travel long distances to seek out care. I think many places that will preserve access to abortion are major airline hubs: Chicago, Minneapolis-St Paul, Denver, and Detroit. That probably means that flights to one of these hubs would be a crucial way to access abortion care. The gray dots in the map below are the airports in states that may ban abortion with a 2-hour, or less, year-round flight to one of those hubs.
Yes, being able to drop $500 to fly to get an abortion with little to no notice is a very privileged position. But, something that strikes me looking at this map is the large areas where women would need to travel a large distance by car to get to one of these airports. Western Kansas, for example, is more than three hours by car to Denver and roughly 2 hours to the nearest airport. Central South Dakota is another area of extremely limited access.
While this may come to fruition, the story of abortion access in the Midwest is yet to be written. Now more than ever, state and local elections are important. The lawmakers who are elected this cycle will have the opportunity to shape access to healthcare for years to come. If you live in Kansas, vote on the constitutional amendment next month. Most states elect their state legislature in November. Do not sit this one out!
Behind the Curtain
As a geographer, when I say “Yeah, I can do that” when discussing a big project, it is a sign of storms to come. This map series was one of those cases. In March of 2021, I made a map exploring how long it takes to travel from the White House to locations within the core of the DC Metropolitan Area. I naïvely thought that this would be a straightforward scale-up of that work. Unfortunately, that was nowhere near the case.
A small number of counties in a compact area have a limited number of road segments. I used everything in the OpenStreetMap database for that work, so I tried that on this project. Bad move. I quickly crashed QGIS on my computer due to a lack of resources and moved to AWS. At my peak, I was using close to 200 GB of memory and overloading what the network analysis tools in QGIS could do. Thank you Jeff Bezos for creating a server company that fronts as a digital retailer!
So, I had a scale down. I tried removing the service, unknown, and undefined roads. That was still too big. In the end, I had to remove all of the residential streets and pair back to just the green lines shown on the map below.
In other ways, I was able to apply lessons learned from last year’s work. To combat the over-estimation of distance traveled, I set 1 hour to be 45 minutes within the algorithm. The assumptions that it makes — no stop signs/lights, no traffic, and always traveling exactly at the speed limit — were unrealistic. Based on my experience, 45 minutes of algorithm time produced distances comparable to 1 hour.
I understand that people who do not identify as women can get pregnant and may need an abortion. Forgive my use of simplified language to get a point across to a wider variety of people.
The clinic in Fargo, ND is moving to Moorhead, MN, so I included it as part of Minnesota