“We don’t want a country where abortion is simply outlawed. We want a country where it isn’t even considered,” said Representative Paul Ryan in a speech a few weeks ago.

It’s not as far off as you think. In just the past several weeks, the Kansas legislature passed a sweeping new bill that says life begins at conception. This follows on the heels of North Dakota’s ban on abortions after a fetal heartbeat is found (typically about week six, before many women know they are pregnant), Arkansas’s prohibition of abortions after week 12, and Alabama’s tightened regulations on abortion providers. On the other side of the issue, a federal court in New York ordered that the so-called “morning-after pill” be made available to women and girls of all ages, instead of requiring a prescription for girls under a certain age. (This is currently being appealed by the Justice Department.)

The word “choice” presumes that women actually have options. While the right to have an abortion is still protected by Roe v. Wade, in practical terms, it has become a privilege that is reserved for the residents of relatively affluent states. In more than half of all states, 90 percent of counties lack any abortion providers. Women in almost nine in 10 (87 percent) of U.S. counties (a third of U.S. women of reproductive age) lack access to any abortion services at all, according to a 2011 study in Perspectives on Sexual and Reproductive Health.

The upshot is that more and more women who are determined to obtain an abortion must travel great distances and out-of-state to do so. A 2005 study in the Annual Review of Public Health found that “nearly one-quarter (24 percent) of women seeking an abortion travel 50 miles or more to find a capable physician.”

Not coincidentally, two of the states imposing the harshest new restrictions are the very states that women travel to. Roughly half of the abortions in Kansas were performed on non-residents and approximately one third in North Dakota, according to statistics compiled by the Centers for Disease Control and Prevention. The new laws in these states will have consequences for women far beyond their own borders, cutting off access to abortion services not just for their residents but for women in surrounding states.

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