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The Midwest and South could see larger abortion deserts if Roe v. Wade is overturned


A Supreme Court decision on abortion rights is expected any day now. A leaked draft opinion from the court has foreshadowed that the decision could overturn Roe v. Wade. And a new report finds that if that happens, a quarter of all clinics in the U.S. that provide abortions could be forced to shut down. NPR's Pien Huang has more.

PIEN HUANG, BYLINE: In the past five years, the total number of clinics that openly offer abortions has stayed pretty constant. There's around 790 across the country. But Ushma Upadhyay, a researcher at UCSF, says there have been huge shifts in where they are. As clinics that provide abortions in the South and Midwest have closed, others have opened in states like California, which already had the most clinics of any state.

USHMA UPADHYAY: Really, when you break it down, it becomes a tale of two states. Access is becoming more diametrically opposed.

HUANG: Laws limiting abortions have essentially created abortion care deserts in large parts of the country. In Missouri, for instance, it can be really hard to get an abortion. Patients are required to get counseling and wait three days beforehand. And there are big out-of-pocket costs since insurance can't cover it. Plus, there's one clinic in the whole state, and it's in Saint Louis. Dr. Amy Addante says that means people in Missouri often end up driving just across the river to her state, Illinois.

AMY ADDANTE: You call a clinic. They schedule you an appointment. You walk in that day. You have your abortion that day. That 15-minute drive was, I mean, night and day in terms of how a patient obtains access to abortion care.

HUANG: Addante is an OB-GYN and with the advocacy group Physicians for Reproductive Health. She expects a huge surge in patients seeking abortions if the Supreme Court overturns Roe v. Wade. Abortions could be banned in half of all states. As many as 200 clinics could be forced to close.

ADDANTE: We only have so many hours in a day we can provide abortion care. We only have so many nurses, so many doctors.

HUANG: One way to meet some of that demand is telehealth. Half of the clinics that opened in the past five years are online only. Dr. Jamie Phifer started Abortion on Demand, a telehealth provider in more than 20 states. She's staffing up in case Roe v. Wade gets overturned.

JAMIE PHIFER: So patients will likely be traveling more from restrictive states into haven states. And we anticipate serving patients who are already in these haven states experiencing longer wait times for in-person care.

HUANG: Online clinics provide abortion pills by mail, but they can only end pregnancies in the first trimester. Phifer says telehealth is a supplement. It can't replace the brick-and-mortar clinic.

Pien Huang, NPR News. Transcript provided by NPR, Copyright NPR.

Pien Huang is a health reporter on the Science desk. She was NPR's first Reflect America Fellow, working with shows, desks and podcasts to bring more diverse voices to air and online.