Half of the US’s 100 biggest cities now have restrictive abortion laws, since the reversal of Roe v Wade last week.

On Friday, the US Supreme Court overturned the 1973 decision, which guaranteed a federal right to abortion. A number of states had “trigger bans” and restrictions ready to come into force if Roe was overturned, while others still have pre-Roe bans that could come back into effect.

Analysis by the Guttmacher Institute, a research and policy organisation committed to advancing sexual and reproductive health and rights worldwide, says there are now eight states that have the “most restrictive” abortion polices, where abortion is banned outright with very few exceptions. A further 17 have “restrictive” abortion policies, and may well see movements towards bans or harsher restrictions in the coming weeks and months.

Across the 100 largest cities in the US, which covers over 60 million people, a fifth (20 cities) are in states with “most restrictive” abortion policies, and a further 29 cities have restrictive policies.

When weighted for the population of the 100 largest cities, this percentage falls slightly, due to the huge populations in New York, Los Angeles and Chicago, which are all in what the Guttmacher Institute terms "protective" states, as their polices protect access to abortion.

A large proportion of these "most restrictive" cities are down to Texas, which has 13 cities among the US’s 100 largest. In fact, of the 15 largest cities in the country by population, five are in the 'Lone Star State'. The Texas Legislature passed a trigger law in 2021 that would make performing abortion a felony, the only exception being to save the life of the patient. Technically, the ban doesn’t come into effect until 30 days after the Supreme Court’s judgement, but clinics and abortion funds, which provide support to pregnant people seeking an abortion, are ceasing services now.

But these restrictive states didn’t only put in trigger bans, they also made huge efforts to restrict abortion while Roe was in place, forcing many clinics to shut down. In Missouri, the number of operating clinics has fallen in recent years to just one in St. Louis, meaning that only 170 abortions were administered within the state in 2020, with many residents crossing the state line into Kansas or Illinois for the service.

Texas is arguably where the ban will see the largest impact, where it will close down over a dozen clinics and force almost 60,000 people every year to seek alternative options for abortion care, or go ahead with their unwanted pregnancy.

Abortion networks have been preparing for this moment, and are ready to support people in crossing state lines to reach a clinic, or to access pills for a self-managed medication abortion.

Women in Corpus Christi, in southern Texas, will now need to travel over 700 miles to get to their nearest open abortion provider, in Las Cruces, New Mexico, while those from New Orleans, Louisiana, will have to travel 680 miles to the Illinois side of St. Louis for a clinic.

For those in Dallas or Houston in Texas, the nearest clinic is around 360 miles away in Wichita, Kansas. However, Kansas is still a restrictive abortion state, and is voting in August on whether to remove the constitutional right to abortion. If Kansas does further restrict or even ban abortion, then the nearest protective US state for Texans is New Mexico, adding hundreds more miles to the journey.