Researchers say abortion care would become even further out of reach for Ohioans should the U.S. Supreme Court overturn or weaken Roe v. Wade, the 1973 landmark decision establishing a nationwide right to an abortion.

This summer, the court will rule on a Mississippi law banning most abortions after 15 weeks. If it is upheld, three proposed abortion bans in Ohio could go into effect.

Payal Chakraborty, a graduate student in the College of Public Health at Ohio State University, led a new study, which found in a worst-case scenario, Ohioans would travel 181 to 279 miles to access an abortion provider.

"Depending on which states ban abortion if Roe v. Wade is overturned, there would be either, like, a seven-times increase in average driving distance or a ten-times increase in average driving distance to get abortion care," Chakraborty reported.

She pointed out they also found Ohioans of color would be more affected by increased driving times than their white counterparts. According to data from February, centers of all Ohio counties were at most 99 miles away from an abortion provider.

A second study evaluated the reproductive-policy environment of states and the number of abortion providers and found an average of 8% of patients left their state for abortion care in 2017.

Mikaela Smith, a research scientist also at Ohio State, said in 12 states, more than 25% of patients crossed state lines, compared with fewer than 4% in 13 other states.

"States that have laws that are more restrictive of abortion tend to have a higher percent of patients leaving," Smith emphasized. "Those states that have more kind of protections around abortion have fewer percent of patients leaving."

Chakraborty added the logistical challenges of an abortion ban in Ohio go beyond extra miles on the road.

"The cost of getting an abortion is greatly increased," Chakraborty explained. "This would require missing work, finding child care, potential overnight stay, travel-related costs in terms of the amount of gas money or needing to access a car, etc."

Meanwhile, Smith noted in a survey last fall, a majority of Ohio women of reproductive age were supportive of legal abortion, which runs counter to restrictive policies being considered.

Reporting by Ohio News Connection in association with Media in the Public Interest and funded in part by the George Gund Foundation.

Connecticut is moving forward with efforts to create a certification program to help make doula care more accessible in the state.

Doulas support pregnant people throughout the birthing process. With state certification, doulas would be able to receive reimbursement from HUSKY, the state's Medicaid program, for their services.

In Connecticut, Black women are 2.6 times more likely than a white woman to die within six weeks of childbirth.

Tiffany Donelson, president and CEO of the Connecticut Health Foundation, said doulas are a key workforce to help reduce racial health disparities.

"No person should have a bad birthing experience, let alone face the possibility of mortality due to childbirth," Donelson asserted. "And that's what we want is a state where individuals are able to have the best birthing experience."

Research shows doulas can reduce the likelihood of birth complications and increase breastfeeding rates. The certification would establish a set of standards for the doula workforce.

Last month, the governor signed a bill into law to create the Doula Advisory Committee within the Department of Public Health.

The advisory committee will include doulas, midwives and other health care and birthing professionals to help come up with qualifications for the certification.

Cynthia Hayes, a certified interdisciplinary doula, said it is critical for the certification to be crafted with equity in mind.

"We have to get community input," Hayes urged. "We have to let them know we're here and why we're here because I think that it can only be successful if we have community buy-in, not only for those who will utilize the services but also for those who want to become certified doulas."

Connecticut's Department of Social Services also is working on adopting a "maternity bundle" supported through HUSKY which will pay for a wide variety of care from prenatal to postpartum, including doulas and breastfeeding services. It is expected to go into effect next January.

The latest U.S. Census data reveals abortions have been on the rise across the nation.

A new report from the Guttmacher Institute found 8% more procedures in 2020 than in 2017 - a total of more than 930,000 nationwide.

That's despite a jump in abortion restrictions, including in the Mountain State, where patients must receive counseling, wait 24 hours before having an abortion and are banned from using telemedicine.

Kaylen Barker - communications director with West Virginia Women's Health Center - explained that when people are forced to travel to other states to end a pregnancy, the restrictions hit lower-income and communities of color the hardest.

"And especially in areas like West Virginia," said Barker, "that have a disproportionate number of people living in poverty."

The Supreme Court could potentially overturn the federal right to an abortion in a ruling expected by the end of month in the case 'Dobbs v. Jackson Women's Health Organization.'

It involves a Mississippi state law that bans abortions after 15 weeks, which is well before many people realize they are pregnant.

Barker added those who can't get abortions are more likely to stay in contact with violent partners, prolonging cycles of abuse in families.

She noted that West Virginia already has one of the highest rates of kids living in foster care, and ranks 45th in the nation for teen births.

"They're more likely to raise children as single parents," said Barker, "and these factors combine to create worse childhood development and wellness outcomes for children."

Some experts are concerned an abortion ban could increase maternal deaths. Women in the U.S. already see a higher death rate in and post-pregnancy than their counterparts in other industrialized nations.

In the coming days, the U.S. Supreme Court is expected to issue a ruling that could remove longstanding federal abortion protections. In Minnesota, preparations are being made to accept patients from other states, but political races muddy the future here.

Should the nation's high court overturn the landmark Roe v. Wade decision, the procedure still would be legal in Minnesota, but it would automatically be banned in neighboring South Dakota - and soon after, in North Dakota.

Regional Planned Parenthood President Sarah Stoesz said they're adding Minnesota staff, and they've stopped new appointments in an at least one state and are assisting those individuals with care options elsewhere.

"It is on us to make sure that we are good neighbors to those around us," she said, "and that we are able to welcome women into our state so that they can be cared for."

DFL state Attorney General Keith Ellison also vowed to uphold Minnesota's current protections and not prosecute anyone who travels here for an abortion. However, some Republicans, including GOP gubernatorial candidate Scott Jensen, have said they want to add Minnesota to the list of states with bans. It comes as Republicans seek to gain more control of state government in the fall election.

It's not certain yet how far Jensen might go in trying to restrict abortion access should he become governor. But Emma Piorier, Alliance for a Better Minnesota communications director, said the comments he's offered so far have supporters of reproductive rights worried.

"This kind of extreme, anti-choice agenda that is being pushed by Minnesota Republicans," she said, "not only is out of touch with the needs and wants of Minnesotans, but is potentially extremely dangerous for the rights of our citizens."

In a recent statewide poll, 65% of Minnesotans said they oppose new, severe restrictions on abortion. Citing his Christian faith, Jensen has said the state should be governed with a pro-life approach.