A Post-Roe Retrospective

One Country Project
3 min readJun 24, 2023


For fifty years prior to June 24, 2022, women throughout the country who wanted — for whatever reason — to receive an abortion had the right to do so. Then the U.S. Supreme Court struck down Roe v. Wade’s (“Roe”) federal abortion protections in the landmark Dobbs v. Jackson Women’s Health Organization case.

June 24, 2022 was a dark day, with only darker days to come. While blue states swiftly passed laws protecting reproductive rights, red states — many of which are comprised of predominantly rural regions — had trigger laws descend or hurried to enact new abortion bans. In the year since this devastating decision, approximately one third of the country has lost nearly all abortion access.

Abortion is necessary and sometimes life-saving health care, but the near-total bans enacted by over 14 states are forcing women to travel hundreds of miles for abortion services. Even when Roe was intact, women in rural America had to travel greater distances because abortion clinics are usually located in urban centers. This became particularly apparent in the past decade, as states’ increasingly restrictive abortion laws resulted in the closure of dozens of clinics and forced 31 percent of women in rural areas to travel 100 miles or more to have an abortion.

Bans do not simply restrict abortion but are criminalizing physicians who are trying to provide basic, life-saving care to their patients. Physicians simply doing their job and acting to save women’s lives may face legal suits, the suspension of their medical licenses, felony charges, and even prison time. In fear of legal consequences, restricted in their decision-making autonomy, and unable to provide the best possible care, many doctors are closing their practices. Idaho’s incredibly restrictive law is pushing five of its nine remaining full-time maternal-fetal medicine physicians to leave the state by the end of the year. With staffing shortages and a hostile political climate, rural hospitals can no longer provide labor and delivery services — expanding maternity care deserts that affect all women seeking to raise a family.

More than 50 percent of rural women must travel over 30 minutes to reach the nearest hospital offering maternity services. Expecting mothers who experience pregnancy complications, from ectopic pregnancies to preeclampsia, must travel to receive critical care. Worsening access to hospital-based obstetric services has contributed to increases in maternal and infant mortality and morbidities among rural residents.

Politicians’ interference between doctors and their patients leads to devastating outcomes. The more physicians that leave a region, the more others will follow. Workers and families have little desire to stay in a community that has lost its health care services. This has long-term effects on rural economies, job forces, and entire communities across the country.

Caring about the well-being of women, children, and families means supporting paid family and medical leave policies, expanding childcare access, and funding women’s health research. If politicians care about women, they should not be criminalizing medical services, forcing doctors out of the state, deterring new doctors from practicing, and harming women’s health; they should protect women’s right to get an abortion — women’s right to make their own decisions to preserve their health and livelihoods.

Yet there is hope: the Dobbs decision changed not only the map of abortion access, but electoral maps across America. In Kansas, a record number of voters — around 910,000 compared to 473,438 in 2018 — turned out in a midterm primary to vote down a referendum that would have allowed the legislature to restrict or ban access to abortion. This win for women’s bodily autonomy even in such a deeply red state as Kansas was the first demonstration of the overwhelming support for women’s reproductive rights — but certainly not the last.

The 2022 elections saw voters prevail protecting access in five other abortion-related ballot measures and in electing lawmakers who supported abortion rights. Earlier this year, record youth turnout helped elect Justice Janet Protasiewicz to Wisconsin’s State Supreme Court and ensured women’s abortion health care access would be preserved.

With a majority of Americans in favor of protecting access to abortion, it’s no surprise that abortion has been a galvanizing force for action. Unfortunately, the gerrymandered districts of many states, particularly red states, are such that Legislatures do not reflect the makeup or the will of the people. Abortion is sure to be a key issue in the upcoming 2024 elections, from the local to the presidential level. It is more critical than ever that we fight for our voting rights to ensure that every single person’s voice is heard loud and clear as we continue the fight to protect a women’s right to choose.