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  • Dobbs’s Confounding Effect on Abortion Rates

    Dobbs’s Confounding Effect on Abortion Rates

    When the Supreme Court overturned Roe v. Wade, Diana Greene Foster made a painful prediction: She estimated that one in four women who wanted an abortion wouldn’t be able to get one. Foster, a demographer at UC San Francisco, told me that she’d based her expectation on her knowledge of how abortion rates decline when women lose insurance coverage or have to travel long distances after clinics close.

    And she was well aware of what this statistic meant. She’d spent 10 years following 1,000 women recruited from clinic waiting rooms. Some got an abortion, but others were turned away. The “turnaways” were more likely to suffer serious health consequences, live in poverty, and stay in contact with violent partners. With nearly 1 million abortions performed in America each year, Foster worried that hundreds of thousands of women would be forced to continue unwanted pregnancies. “Having a baby before they’re ready kind of knocks people off their life course,” she told me.

    But now, more than a year removed from the Dobbs v. Jackson Women’s Health Organization decision, Foster has revised her estimate. After seeing early reports of women traveling across state lines and ordering pills online, she now estimates that about 5 percent of women who want an abortion cannot get one. Indeed, two recent reports show that although Dobbs upended abortion access in America, many women have nevertheless found ways to end their pregnancy. A study by the Guttmacher Institute, a research group that supports abortion rights, signals that national abortion rates have not meaningfully fallen since 2020. Instead, they seem to have gone up a bit. A report released this week by the Society of Family Planning, another pro-abortion-rights group, shows that an increase in abortions in states that allow the procedure more than offset the post-Dobbs drop-off in states that closed down clinics.

    Read: The abortion backup plan that no one is talking about

    Some of this increase may be a result of trends that predate Dobbs: Abortion rates in the U.S. have been going up since 2017. But the reports suggest that the increase may also be due to travel by women who live in red states and the expanded access to abortion that many blue states enacted after the ruling. Still, it is not yet clear exactly how much each of these factors is contributing to the observed increase—and how many women who want an abortion are still unable to get one.

    Alison Norris, a co-chair of the Society of Family Planning study, told me that she fears that the public will “become complacent” if they see the likely increase in abortion rates and believe that everyone has access. “Feeling like the problem isn’t really that big of a deal because the numbers seem to have returned to what they were pre-Dobbs is a misunderstanding of the data,” she said.

    It seems illogical that more than a dozen states would ban abortion and national rates would hardly change. But even as red states have choked off access, blue states have widened it. And the data show that women have flooded the remaining clinics and ordered abortion pills from pharmacies that ship across the country. More than half of all abortions are done using medication, a pattern that began even before the Dobbs decision.

    “It just doesn’t work to make abortion illegal,” Linda Prine, a doctor at Mount Sinai Hospital, told me. “There may be some people who are having babies that they didn’t want to have, but when you shift resources all over the place, and all kinds of other avenues open up, there’s also people who are getting abortions that might not have gotten them otherwise.”

    With mail-order abortion pills, “it’s this weird moment where abortion might, ironically, be more available than it’s ever been,” Rachel Rebouché, an expert in abortion law and the dean of the Temple University Beasley School of Law, told me.

    The Guttmacher Institute sampled abortion clinics to estimate the change in abortion counts between the first halves of 2020 and 2023. Areas surrounding states with post-Roe bans saw their abortion numbers surge over that period of time. In Colorado, which is near South Dakota, a state with a ban, abortions increased by about 89 percent, compared with an 8 percent rise in the prior three-year period. New Mexico saw abortions climb by 220 percent. (For comparison, before Dobbs, the state recorded a 27 percent hike from 2017 to 2020.) Even states in solidly blue regions saw their abortion rates grow over the three-year interval from 2020 to 2023: Guttmacher estimates that California’s abortion clinics provided 16 percent more abortions, and New York’s about 18 percent more.

    Some shifts predated the court’s intervention. After a decades-long decline, abortions began ticking upward around 2017. In 2020, they increased by 8 percent compared with 2017. The researchers I spoke with for this story told me that they couldn’t point to a decisive cause for the shift that started six years ago; they suggested rising child-care costs and Trump-era cuts to Medicaid coverage as possible factors. But the rise in abortion rates reflects a broader change: Women seem to want fewer children than they used to. Caitlin Myers, a professor at Middlebury College, told me that abortion rates might have increased even more if the Court hadn’t reversed Roe. “It looks like more people just want abortions than did a few years ago,” she said. “What we don’t know is, would they have gone up even more if there weren’t people trapped in Texas or Louisiana?”

    One of the most significant factors in maintaining post-Roe abortion access dates from the latter half of 2021. As the coronavirus pandemic clobbered the health-care system, the FDA suspended its requirement that women pick up abortion medications in person. A few months later, it made the switch permanent. The timing was opportune: People became accustomed to receiving all of their medical care through virtual appointments at the same time that they could get abortion pills delivered to their doorstep, Rebouché told me. People no longer have to travel to a clinic and cross anti-abortion picket lines. But access to mifepristone, one of the most commonly used drugs for medication abortions, is under threat. After an anti-abortion group challenged the FDA’s approval of the drug, a federal court instated regulations that would require women to visit a doctor three times to get the pills, making access much more difficult. The Supreme Court is weighing whether to hear an appeal, and has frozen the 2021 rules in place while it decides.

    But paradoxically, several of the factors that may have contributed to the rise in abortion rates seem to have sprung directly from the Dobbs decision. In the year since the ruling, six blue states have enacted laws that allow practitioners to ship abortion pills anywhere, even to deep-red Texas. Although these laws haven’t yet been litigated to test whether they’re truly impenetrable, doctors have relied on them to mail medication across the country. Aid Access, an online service that operates outside the formal health-care system, receives requests for about 6,500 abortion pills a month. (The pills cost $150, but Aid Access sends them for free to people who can’t pay.) Demand for Aid Access pills in states that ban or restrict medication abortion has mushroomed since the Dobbs decision, rising from an average of about 82 requests per day before Dobbs to 214 after. The Guttmacher report doesn’t count abortions that take place in this legally fuzzy space, suggesting that actual abortion figures could be higher.

    As the Supreme Court revoked the constitutional right to an abortion and turned the issue back to the states, it also hardened the resolve of abortion-rights supporters. In the five months after Roe fell, the National Network of Abortion Funds received four times the money from donations than it got in all of 2020. People often donate as states encroach on abortion rights. In many cases, they bankrolled people’s travel out of ban states. Community networks also gained experience in shuttling people out of state to get abortions. “There’s definitely been innovation in the face of abortion bans,” Abigail Aiken, who documents abortions that occur outside of the formal health-care system, told me.

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    Some researchers believe that the Dobbs decision has actually convinced more women to get abortions. Abortion-rights advocacy groups have erected highway billboards that promise Abortion is ok. Public opinion has tilted in favor of abortion rights. Ushma Upadhyay, a professor at UC San Francisco, told me that California’s rising abortion rates cannot all be due to people traveling from states that ban abortion. “It’s also got to be an increase among Californians,” she said. “It’s just a lot of attention, destigmatization, and funding that has been made available. Even before Dobbs, there was a lot of unmet need for abortion in this country.”

    Abortion used to be a topic that was “talked about in the shadows,” Greer Donley, an expert in abortion law and a professor at the University of Pittsburgh, told me. “Dobbs kind of blew that up.” Still, she believes that it’s unlikely that people are getting significantly more abortions simply because of changes within blue states. Just as obstacles don’t seem to have stopped people from seeking abortions, efforts that moderately expand access are unlikely to lead people to get an abortion, she said.

    The people I spoke with emphasized that even though overall abortion rates might be going up, not everyone who wants the procedure can get it. People who don’t speak English or Spanish, who don’t have internet access, or who are in jail still have trouble getting abortions. “What I foresee is a bunch of Black women being stuck pregnant who didn’t want to be pregnant, in a state where it’s incredibly dangerous to be Black and pregnant,” Laurie Bertram Roberts, a founder of the Mississippi Reproductive Freedom Fund, told me.

    Bertram Roberts’s fund used to provide travel stipends of up to $250. Now women need three times that. Most people travel from Mississippi to a clinic in Carbondale, Illinois. The trip takes two days—48 hours that women must take off work and find child care for. “If you are in the middle of Texas, and you have to travel to Illinois, even if funds covered all the costs, to say that abortion is more accessible for that person seems callous and wrong,” Donley told me.

    Many women spend weeks waiting for an abortion. “It is excruciating to be carrying a pregnancy that one knows they’re planning to end,” Upadhyay said. And although studies show that abortion pills are safe, women who take them can bleed for up to three weeks, and they may worry that they’ll be prosecuted if they seek help at a hospital. Only two states—Nevada and South Carolina—explicitly criminalize women who give themselves an abortion (and few women have been charged under the laws), but the legislation contributes to a climate of fear.

    More than a year out from the Dobbs decision, the grainy picture of abortion access is coming into focus. With the benefit of distance, the story seems not to be solely one of diminished access, widespread surveillance, and forced births, as the ruling’s opponents had warned. For most Americans, abortion might be more accessible than it’s ever been. But for another, more vulnerable group, abortion is a far-off privilege. “If I lived in my birth state—I was born in Minnesota—my work would be one hundred times easier,” Bertram Roberts told me, later adding, “I think about that a lot, about how the two states that bookend my life are so different.”

    Rose Horowitch

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  • American Families Have a Massive Food-Waste Problem

    American Families Have a Massive Food-Waste Problem

    If you have children, you probably already understand them to be very adorable food-waste machines. If you do not have children, I have five, so let me paint you a picture. On a recent Tuesday night, the post-dinner wreckage in my house was devastating. Peas were welded to the floor; my 5-year-old had decided that he was allergic to chicken and left a pile of it untouched on his plate. After working all day, making the meal in the first place, and then spending dinnertime convincing five irrational, tiny people to try their vegetables, I didn’t even have the energy to convince them to take their plates into the kitchen, let alone box up their leftovers for tomorrow. So I did exactly what I’m not supposed to do, according to the planet’s future: I threw it all out, washed the dishes, and flopped into bed, exhausted.

    Tens of millions of tons of food that leaves farms in the United States is wasted. Much of that waste happens at the industrial level, during harvesting, handling, storage, and processing, but a staggering amount of food gets wasted at home, scraped into the garbage can at the end of a meal or tossed after too long in the crisper drawer. According to a 2020 Penn State University study, almost a third of the food that American households buy is wasted.

    On the individual level, all of this waste is expensive, annoying, and gross. In the aggregate, it’s unfortunate, given that about a fifth of American families reported not having enough to eat last year. But it’s also bad for the planet. Every step of the modern food-production process generates greenhouse gases. Before they ended up in the trash, all of those slimy vegetables and uneaten hunks of chicken were grown using water and farmland and pesticides and fertilizer. They were most likely packed in plastic and paper, and then stored and transported using fossil fuels and electricity. Throwing away food means throwing away all of the resources it requires, but the problems don’t end there: As food rots in landfills and open dumps, it emits methane, a greenhouse gas much more potent than carbon dioxide. According to the United Nations, food loss and waste accounts for about 8 to 10 percent of global greenhouse-gas emissions.

    Read: Your diet is cooking the planet

    Some amount of food waste is probably inevitable, especially with young kids. “The very youngest children … are still kind of understanding what they like, with novel foods and healthy foods. We want to give them that opportunity,” Brian Roe, a farm-management professor and the director of the Food Waste Collaborative at Ohio State University, told me. “You need to waste a little bit of food while they develop palates.”

    More saliently, Roe’s research indicates that food waste is often inversely proportional to spare time: We get busy, we eat out, and our well-intended groceries head to the trash. His data show a 280 percent increase in food waste from February 2021 to February 2022, right as pandemic restrictions were loosening and people with the income to do so started eating out more. In other words, as soon as people had the option to eat without cooking, they did. “When you’ve got more kids and more craziness and a time crunch, all of a sudden, what you thought was going to be 40 minutes to prep dinners is out the window,” he told me. Thus, “those ingredients are more likely to go to waste.”

    Wasting less food starts at the grocery store: Most financially secure families simply need less food than they buy. The sustainability consultant Ashlee Piper told me that she likes to take a picture of her fridge and pantry before heading to the store, in order to avoid buying duplicates. She also recommends shopping not for your “aspirational life” but for the one you are actually living: If, realistically, you’re never going to make your own pasta or pack gourmet lunches for your kids, don’t shop for those meals. “There’s no lunchbox sheriff,” she told me. (Comforting!)

    Once you unpack the groceries, experts say to be strategic about making perishable foods highly visible, accessible, and appetizing. Julia Rockwell, a San Francisco mom and sustainability expert, recommends an “Eat Me” station, whether it’s a basket, a bowl, a tray, or a section of the refrigerator, which she says is especially helpful for teenagers, inclined as they are to “go full claws into the fridge.” A designated place for high-urgency snacks reminds them, “Here’s a yogurt that you missed, or here’s a half of a banana, or here’s the things let’s go to first,” she told me. Leftovers and soon-to-spoil foods also make great dinners or lunches for younger kids, who will be happy to snack on items that don’t necessarily go together in a traditional meal.

    If you’re cleaning out your fridge and pantry strictly according to expiration dates, stop: If a food is past its expiration date but looks and smells fine, it probably is; most of the time, expiration dates are an indicator of quality, not safety. (Deli meats and unpasteurized cheeses are notable exceptions.) Brush up on the language of food packaging—“best by” is just a suggestion, while “expiration” is the date the manufacturer has decided when quality will begin to decline. Frozen food is pretty much always safe, and packaged foods and canned goods without swelling, dents, or rust can last for years, though they may not taste as good. (You can conceal your less-than-fresh nonperishables in another meal, such as adding older ground beef from the freezer to a chili. When in doubt about, say, an older vegetable, Roe says, “coat it in panko and fry it up.”)

    Read: Expiration dates are meaningless

    And whatever you’re feeding your kids, experts repeatedly told me, you should probably be feeding them less. How many blueberries does your pickiest kid really eat at the breakfast table? And how many do you put on their plate that you wish they’d eat? The difference in this pint-size math equation is an essential factor in food-waste management for families. Jennifer Anderson, a mom and registered dietician, discourages “wishful portions.” “You know the amount you want your child to eat, so you put that much on their plate … Take that amount, cut it in half, then cut it in half again,” she told me. “A practical portion is a quarter of what you wish they would eat.”

    Since talking to Anderson, I’ve kept her advice in mind. I still spend more time than I’d like trying to convince my kids to eat yellow peppers when they’ve decided the red ones are the only acceptable type. But the math is simple: Smaller portions on their plate means fewer leftovers in the trash later, and I’ve noticed a real difference.

    And I still find myself dumping plates of picked-over food into the trash or compost. But I move on to the next meal with more grace and less guilt for having helped my kids become little stewards of a healthier planet. I want them to understand that our food comes from somewhere, and that not eating it has consequences. That doesn’t mean guilting them for not liking dragon fruit, or demanding that they clean their plate at every meal, or scaring them about climate change. It’s more like bringing them along, helping them participate in a family project with planetary implications. Wish me luck with the peppers.

    This story is part of the Atlantic Planet series supported by HHMI’s Science and Educational Media Group.

    Alexandra Frost

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