Abortion by ZIP Code

The decision to get an abortion is increasingly being governed by geography.

When you consider the question of abortion, your ZIP code isn't exactly the first thing that comes to mind. But it's a factor that matters more to abortion access than you would guess.

More than ever, whether a woman can choose to have an abortion is a question of where in the U.S. she lives. A recent analysis of state abortion laws by the Guttmacher Institute, a reproductive-rights think tank, categorized states with four to five abortion restrictions as "hostile" to abortion, and placed states with more than five restrictions into the "extremely hostile" camp.

If you were an American woman considering an abortion in 2000, there was a 31 percent chance you lived in a state considered "hostile" to abortion, with no states considered "extremely hostile" to the procedure. In 2014, that "hostile" number surged to 57 percent, with 18 states considered "extremely hostile."

The authors of the study found that the entire South is "hostile" to abortion, and that much of the South, as well as much of the Midwest, is "extremely hostile."

States have enacted 231 abortion restrictions since Republicans flooded state legislatures in 2010, and the number of states considered "extremely hostile" to abortion has more than tripled.

Such statistics have Gretchen Borchelt, the director of state reproductive health policy at the National Women's Law Center, concerned.

"We don't think a woman's right to choose should depend on her ZIP code," Borchelt said. "It seems like we're heading that way, though, and I think Guttmacher's map really paints a picture of a country where geography determines a woman's access to abortion."

In the 2014 state legislative session, lawmakers introduced 335 provisions aimed at restricting access to abortion, 26 of which were enacted by the year's end in 15 states. That number represents a significant decrease from the 70 provisions enacted in 2013 and the 92 enacted in 2011, but analysts say such drop-offs are to be expected in even-numbered years.

It is typical for election-year legislative sessions to be shorter and less productive than non-election year sessions, the report's authors explain. And even beyond the election cycle, it makes sense that growth would slow after a big spike. "You can't just talk about the 26 restrictions enacted in 2014 in isolation," said Elizabeth Nash, who spearheaded the Guttmacher Institute's analysis. "These restrictions are cumulative. What we've seen over the past four years are a mountain of restrictions that women have to navigate to access services."

It's not just a matter of outright abortion bans. The restrictive measures include a variety of measures making abortions more difficult to obtain, from expanding mandatory waiting periods to making it more difficult for minors to access those services.

Often, the provisions are tucked into larger pieces of legislation that are unrelated to abortion. A recent measure in Arizona, which opens abortion clinics up to surprise state inspections without a warrant, was inserted into a larger bill on child therapy. In North Carolina, a bill on motorcycle safety carried multiple abortion-restricting provisions.

But there is a silver lining for abortion advocates. Over the past year, some lawmakers have pushed back against the rising tide of restrictions, introducing 95 measures designed to expand access to abortion in 17 states. While the win is dubious—only four of those measures have actually been signed into law—that still accounts for more pro-abortion measures than have been introduced in any year since 1990.

"It was a mixed bag," Borchelt said of how women's reproductive rights fared in 2014. "I think there was some bad and a lot of good." The Affordable Care Act is under attack again, she noted. But gender rating, which has long allowed insurers to charge women more for health care coverage than men, is prohibited under the ACA. Overall voter turnout in the midterm elections was dismal, and the electoral results for pro-choice women running for office weren't particularly strong. But several "personhood" measures that would have outlawed abortion (as well as many forms of birth control) were easily defeated.

One pattern Borchelt noted at the state level this year was lawmakers moving away from introducing outright abortion bans in favor of what she termed "hide the ball" tactics, such as regulating abortion clinics or extending abortion wait periods. With Republicans enjoying an unprecedented sweep of power at the state level, lawmakers are expected to press for even more restrictions in 2015.

Planned Parenthood's Cecile Richards said the picture in Congress doesn't look much rosier for advocates. "The Senate has frankly been the body to push back on some of the real excesses of the House of Representatives and was repeatedly the more levelheaded, less partisan body," Richards told National Journal in a recent interview. "It's definitely going to be a big change to see the Senate change hands."