Abortion is a Spatial Issue
How geography determines who can - and who can't - get an abortion in the Midwest
Highlights from today’s post:
The spatial constraints of abortion access in the US Midwest
Cartography from an actual cartographer
Before we get into today’s post, do you need to convert geo coordinates into useful location information?
Also! This piece was written in collaboration with Tom Fish of FishEye. I highly recommend checking out his newsletter if you like regular updates on maps, geography, Wikipedia, and other fun bits. Check out the companion piece he wrote here.
Recently, like many Americans, I’ve been thinking about abortion access. I also just got back from the Midwest (Kansas, specifically), where the roads are long, straight, and cardinally-oriented.
If you want to get somewhere located diagonal from you in the Midwest, it’s not a simple matter of driving, say, northwest until you reach your destination. You’ll have to drive exactly north until you reach your destination’s latitude and then exactly west until you reach your destination’s longitude1. Places located due north, south, east, or west from you are therefore far more accessible than those located between any of the cardinal directions.
Compare the primary road networks within 100 miles of Des Moines, Iowa and Hartford, Connecticut. Can you guess which is which?
When it comes to abortion access in the Midwest, these geographic realities collide with the region’s lack of abortion providers. Tom and I2 built a series of maps to illustrate these gaps.
Say you’re a woman living in northwest Illinois who learns you are six weeks pregnant and wishes to terminate your pregnancy. Since you work a retail job, you can’t take time off without losing wages. That limits you to abortion providers within an hour or two of your home - a radius that you can drive to after work or on a day off.
Though Illinois is a state with nominally good abortion access - after all, it has dozens of clinics and borders Iowa, which also has somewhat strong access - you’d still have to drive well over two hours one-way to access an abortion in either state. That likely means, in the best case scenario, you’d have to take unpaid time off work, to say nothing about potentially having to stay somewhere overnight if you have complications from the procedure.
Consider another quirk of geography. If you were six weeks pregnant and lived in the relatively large city of Fort Wayne, Indiana3, you’d also have to drive over two hours to get an abortion in either Indiana or Ohio.
This bizarre situation is squarely due to the constraints of the Midwest’s road networks. The outer edges of the driving networks of clinics to the southwest, southeast, northwest, and northeast form a near-perfect diamond around that chunk of Indiana. Of course, that doesn’t mean there are no roads there - in fact, there are many! - it’s just that the roads that do exist are dozens and dozens of right angles away from the nearest abortion clinic.
We see these diamond shapes and diagonal edges appear again and again in the maps. For clinics that offer abortions later in pregnancies, the effect is even more pronounced.
As access to abortion services later in pregnancy dwindles to islands here and there, the road networks around these islands become important determinants of proximity to abortion services.
Chicago and Minneapolis, with their many clinics, form massive diamonds of access in and around Illinois and Minnesota, respectively. Conversely, the spotty access to abortion at 20 weeks of pregnancy in Iowa leaves behind a jagged W-shaped area in the northern part of the state. Ohio’s ban on abortions after six weeks of pregnancy puts women in the state at the mercy of providers in southern Michigan and Pittsburgh.
Finally, as you may be able to tell from the maps, Missouri already bans abortions in most circumstances. (There are clinics just across the border in Kansas, Iowa, and Illinois that provide services for Missourians). Neighboring Kansas, though, has decent access, with four clinics spread throughout the state. If you live in western Missouri, chances are good that you’d go to Kansas for an abortion.
However, abortion’s future in Kansas will be put to the ballot in a confusing, duplicitous, and overall ghoulish4 referendum on August 2nd. If the outcome of that referendum lays the groundwork for further restrictions in Kansas, a massive swath of the southwestern Midwest could be left without abortion access of any kind.
As Tom points out in his piece, predicting the future of abortion access is difficult, particularly given the unique geography of the Midwest. But if greater restrictions are enacted in Kansas, Michigan, or other states, access in the region could end up looking something like the map above, with even more pronounced islands in Illinois and Minnesota surrounded by seas of restrictions, crackdowns, and long travel times.
(PS: If you live in Kansas, vote No on August 2nd)
While “if you enjoyed this…” might not be the right thing after a piece like this, I’ll instead say that if you want to support writing like the kind Tom and I do, drop your email below and we’ll keep it coming.
This is, of course, an oversimplification. Not every driving route in the Midwest adheres to these rules. But many do! Plus, there aren’t zero roads outside of these networks - it’s just that non-highway roads rapidly become tiny byways with low speed limits and/or where you might get stuck behind a tractor.
But actually pretty much exclusively Tom.
Population: 268,000; metro population: 419,000