The heaviest burden will fall on low-income women whose poor access to health care makes unintended pregnancies more likely. Most are small businesses that lack the resources to up sticks and move across state lines. In America, by contrast, it happens mainly in standalone clinics that specialise. In most rich countries abortion is embedded within the hospital system. Even so, the sudden disappearance of abortion provision in more than a dozen states will cause great harm. Women in conservative states have for years had to make long journeys, at great financial and personal cost, to find health care that in most of the rich world is available free, close to home. A majority of abortions are thought to take place in states that will not ban abortion now Roe has been overturned. Six states had only one abortion clinic left. Across the South and the Midwest anti-abortion regulations had hollowed out Roe. The baleful consequences of ditching Roe are knowable, in part because they have been foreshadowed. About 36m women live in states in which the right to terminate a pregnancy has disappeared or is likely to do so soon. Another dozen or so states are expected to dust off pre- Roe bans or pass new ones. At a stroke, the court has in effect made abortion illegal in 13 states that have “trigger laws”, which automatically come into force or will imminently do so.
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