Ask an Expert: The U.S. Abortion Landscape and Policy with Sara Redd
By Shelby Crosier
On September 30, the Superior Court of Fulton County ruled that Georgia’s six-week ban on abortion was unconstitutional, pausing the ban and reinstating the prior 22-week gestational limit for abortion care in Georgia. Seven days later, the Supreme Court of Georgia reinstated the ban as an appeal from the state Attorney General proceeds through the courts, ending the brief window of expanded abortion access in the state.
Sara Redd, PhD, director of research translation with the Center for Reproductive Health Research in the Southeast, walks us through what happened and what this means in the context of the current abortion landscape in the U.S.
How has the abortion landscape changed in the U.S. and in the Southeast since Dobbs?
Nationally, we have seen an increase in abortions since the Dobbs decision in June 2022. However, it gets much more nuanced when we look at abortions at the state- or regional-level, and the Southeast is a region that has experienced a massive reduction in abortion access due to legal landscapes.
The Southeast consists of many states that have total bans, some with and some without exceptions, but we have a few points of access that have remained. That includes states with six-week bans like Georgia, Florida, and South Carolina; and North Carolina, which has a 12-week ban. Overall, we've seen a substantial reduction in abortions being provided within the region, and we have also seen an increase in people traveling outside of their state to get care.
One thing we know is that there is often region-specific out-of-state travel for abortion care. Here in the Southeast, that means people are traveling to those points of access that are within the region, and beyond. So, even in a state like Georgia with an early abortion ban, people are still traveling here to try to get care. And then for folks who need abortion care further into pregnancy, that's where we see people travelling further distances, probably outside of the South, to be able to access care.
As you mentioned, abortions have increased in the past two years at a nationwide level. Why is that happening?
That is a question that people in the field are still trying to answer. It may be that there is more awareness of and access to medication abortion, particularly via telehealth. People may be more aware of the different options for abortion care.
There is also a newer and growing abortion information ecosystem that has evolved. We have some incredible technology tools to help connect people to care, including websites and apps, that can help people understand what the landscape is in their state and what their options are for either receiving care in their state, traveling out of state to get care, or self-managing their care.
There are a lot of different factors in our social and political landscapes happening simultaneously, which are likely relevant to this national increase in abortions. But I think it is important to disaggregate national numbers and look at differences by state and by region to understand the many different environments and contexts that we have within the United States.
Georgia courts recently overturned the state’s six-week abortion ban, only to reinstate it a few days later. What happened?
There is often a lot of legal back and forth around enactment of restrictive abortion policies, one main reason being that these policies largely use vague, confusing, or even medically inaccurate language when establishing key policy provisions, often resulting in litigation to clarify the scope of these laws.
The case currently in question is called SisterSong v. State of Georgia, and a key piece to understanding this case is that it has multiple arguments that have played out legally on two different timelines. This case was filed in July 2022, and challenges H.B. 481 [the state law that bans abortion after approximately six weeks of pregnancy] by arguing that this law is unconstitutional according to Georgia's state constitution.
There are two main arguments that the plaintiffs are making in this case:
- The law is unconstitutional because, when it was enacted in 2019, it violated Roe v. Wade.
- The ban violates Georgia's constitutional protection of the fundamental right to privacy around medical decisions.
A similar situation to what we saw happen with this case in September happened two years ago. In November 2022, a Fulton County Superior Court judge ruled on the plaintiff’s first argument, blocking the ban, and stating that it was void because it violated Roe v. Wade when it was passed in 2019. Shortly after, the State of Georgia appealed that decision, and the Georgia Supreme Court reinstated the ban while the state's appeal progressed through the Court. In October 2023, the Georgia Supreme Court eventually reversed the lower court’s ruling, allowing the ban to stay in effect.
What we are in conversation about now has to do with the second argument from the plaintiffs. On September 30, the same Fulton County Superior Court judge ruled that Georgia's six-week ban is unconstitutional and that abortion is protected under the state constitution's fundamental right to privacy, permanently blocking the ban. Two days later, on October 2, the state of Georgia again appealed the decision and requested that the Georgia Supreme Court intervene to reinstate the ban. On October 7, the Georgia Supreme Court issued an order allowing the ban to go back into effect for now until they can hear the case and make a final decision.
How can people, both in Georgia and across the U.S., make sure that they have the most accurate and up-to-date information about abortion care in their state?
Individuals can always speak to a health care provider for specific information about their personal health situation possible options available in their state. For those wanting a general understanding of abortion laws in their state or in other places, The New York Times has a state-by-state guide to abortion laws that they update regularly.
People also can tap into their local reproductive health community and check out the different organizations serving their area. In my experience, community reproductive health organizations are the most plugged into local, county, and state policy landscapes, as their work is often directly affected by the legal landscapes they are navigating.
