In 2017, the nearest abortion clinic was functionally next door at 8 weeks of pregnancy and a day's drive away at 20 — and the closure of a single clinic moved the country from the first picture toward the second.
At 8 weeks of pregnancy — when 9 in 10 US abortions take place — 151 of the 749 large cities in this dataset record a round-trip drive of an hour or more to the nearest abortion clinic. By 20 weeks, that figure is 339 cities — nearly half.
The population-weighted round-trip drive grows from 15 minutes at 8 weeks to over an hour at 20. The share of urban Americans facing a 4-hour-plus round-trip rises from 1.4% to 10.8%. The geography of access does not stand still as a pregnancy progresses; it collapses.
In September 2017 The Pudding published a map. This is what was on it.
At 8 weeks of gestation, 598 of 749 cities — 79.8% — record a round-trip drive of zero hours. The closest clinic sits in or immediately next to the city. Only 14 cities (1.9%) face a round-trip drive of four hours or more. Population-weighted, 88.8% of the urban Americans in this dataset live in a 0-hour-drive city.
This is the friendliest snapshot the data can produce: the earliest gestation, the largest universe of clinics, before any closure. About 89-91% of US abortions happen in this first-trimester window, so it is also the picture that fits the median experience.
In Boise, Idaho, the round-trip drive to the nearest clinic is 0 hours at 8 weeks. At 16 weeks it becomes 8 hours. Three other Idaho cities — Nampa, Meridian, Caldwell — show the identical pattern. So does El Paso, Texas (0 → 7) and Bend, Oregon (0 → 6). For these cities the gestational ladder is binary: a first-trimester patient never leaves town; a second-trimester patient drives across or out of the state.
The same collapse shows up at the population level. The share of urban Americans facing a 4-hour-plus round-trip more than triples between 8 and 20 weeks (1.4% → 10.8%). The clinic universe for a 20-week patient is a small fraction of the universe for an 8-week one — and the geography does the rest.
Population-weighted across each state's qualifying cities, Idaho records a 20-week round-trip drive of 9.0 hours — the longest in the dataset. North Dakota follows at 8.6, Louisiana at 6.6, South Dakota at 6.5, Mississippi at 5.3.
Idaho also posts the largest 8-to-20-week growth in any state — a population-weighted 8.4-hour increase. North Dakota grows 6.7, Louisiana 6.2, Mississippi 4.8, Virginia 4.3. These are not all remote states: Virginia is the 12th most populous in the country.
By contrast, 18 states record a population-weighted 20-week drive under one hour. The 27 "abortion deserts" identified by ANSIRH researchers in 2017 — large cities more than 100 miles from a clinic — sit, almost without exception, inside the same state cluster.
Some cities never had a near-by option. Rapid City, South Dakota records a 9-hour round-trip drive even at 8 weeks. Lubbock, Midland, Odessa, Amarillo and San Angelo — all in West Texas — register 6 to 8 hours round-trip at the earliest gestation. Their first-trimester patients are already on what is functionally a road trip.
At 20 weeks, the longest round-trip in the dataset is Bismarck, North Dakota, at 11 hours — the equivalent of a working day plus a meal. Lubbock, Boise, Nampa, Meridian, Caldwell, Rapid City and Missoula each record 10-hour round-trips.
Driving time is the floor of the burden, not the ceiling. 27 US states required a mandatory waiting period between counseling and procedure in 2017, and 14 of those required the counseling in person — meaning two trips. A 10-hour round-trip in that legal context is not "a long drive"; it is two days off work, a hotel, gas, and whatever child care a person has to arrange to disappear for 48 hours.
The dataset's "closed" columns simulate the closure of the city's closest clinic — a controlled stress test on the system. The result: the share of cities lacking a 1-hour round-trip jumps from 20.2% to 37.8% at 8 weeks, and from 45.3% to 67.4% at 20 weeks. Population-weighted, the share of urban Americans living in a 0-hour-drive city collapses from 66.9% to 42.7% at 20 weeks.
At 8 weeks, five cities in the Texas Rio Grande Valley — McAllen, Mission, Edinburg, Pharr, Harlingen — go from a 0-1 hour drive to a 6-7 hour drive when their nearest clinic is removed. Three North Dakota cities jump 6-7 hours. Mississippi's Jackson goes from 0 to 5; Louisiana's Shreveport from 0 to 5. These are one-clinic regions.
At 20 weeks the picture is stranger and starker. Salt Lake City, Albuquerque, Billings — all population centers — sit at zero hours in the open scenario and at 11 to 15 hours when a single clinic closes. Eight Utah cities move 10-12 hours each. The closure of a single second-trimester provider is enough to push hundreds of thousands of urban Americans into a 10-plus-hour round-trip.
None of this was hypothetical in 2017. HB2 in Texas had closed more than half the state's clinics between 2013 and 2015 before being struck down in Whole Woman's Health v. Hellerstedt. Wyoming's only abortion-providing clinic closed in July 2017 — two months before The Pudding published this dataset.
This dataset documents the access network in a specific window: HB2 had been overturned but its closed clinics had not reopened, and Roe v. Wade was still standing. The Pudding's headline ("How far is too far?") was an open question.
Five years after this snapshot, in June 2022, Dobbs v. Jackson Women's Health overturned Roe and triggered a cascade of total bans and 6-week, 12-week, and 15-week limits across roughly half the country. The closed columns of this 2017 dataset turned out to be a dress rehearsal: the cities where a single closure pushed the round-trip into double digits are now the cities whose patients drive to Illinois, New Mexico, Colorado, or Kansas — not because their nearest clinic closed, but because every clinic in their state did.
The map below is the 2017 baseline. Read it as a yardstick. The worst drives in this dataset are now the typical drives for whole regions of the country.
