How the Dobbs abortion decision is playing out in Massachusetts, one year later

Massachusetts has not experienced much of the political turmoil triggered by the U.S. Supreme Court's Dobbs decision, which ended the constitutional right to an abortion. The state's lawmakers have moved to secure that right, boost protections for providers and stockpile abortion pills.

But Massachusetts is feeling the effects of a deepening political divide on abortion access playing out across the country.

A map of the U.S., hanging on the wall of the Women's Health Services clinic in Brookline, is one illustration.

Red, green and blue flag-shaped pins mark the home states of 90 patients who’ve traveled to this Brookline facility for an abortion over the past year.

Before last spring, Dr. Lolly Delli-Bovi rarely saw patients from beyond New England. “But then the minute the leaked opinion came out and then the Dobbs decision,” she said, “we started seeing people from basically everywhere in the South.” Essentially, from states where abortion limits or bans have taken effect in the year since the Dobbs decision.

Overall, Massachusetts clinics are not reporting an influx of patients from distant states in the past year. One database based on voluntary reporting shows fewer total abortions statewide since the Supreme Court overturned Roe v. Wade. (Updated data from the state on out-of-state residents receiving abortions is expected later this summer.)

However, Delli-Bovi is seeing an increase in both in-state and out-of-state patients. That may be because her clinic is one of the more affordable options. Still, she says, it’s the patients with resources who come, especially from out-of-state. Delli-Bovi worries that maternal mortality rates could rise in states with strict abortion limits or bans.

“That's what makes me eternally sad,” she said, “who's not coming.”

To ease legal concerns about traveling to Massachusetts for an abortion, advocates are focused on legislation that would ban the sale of cell phone data created within the state. The bill will have its first hearing on Monday. It was crafted in response to efforts in places like Texas, which allows civil lawsuits against people who help a patient get an abortion.

Abortion rights advocates in Massachusetts are also concerned about model legislation some groups that oppose abortion rights are drafting. It would restrict crossing state lines for an abortion.

“What we’re worried about is that someone travels to Massachusetts for care and their cell phone is tracked,” said Rebecca Hart Holder, president of Reproductive Equity Now. The concern, she said, is that “an anti-choice actor in their state buys the data and uses it to prove that they had an abortion and tries to go after them for that abortion care.”

Hart Holder sees the proposed sales ban as an extension of a law passed last summer that provides protections for clinicians who perform abortions in Massachusetts. Carol Rose, director of the American Civil Liberties Union of Massachusetts, says she isn’t aware of any efforts to sue Massachusetts clinicians for abortions performed on patients from out-of-state yet.

The main worries Rose hears these days, from clinicians who call a hotline staffed by attorneys who support abortion access, are about the changing legal landscape.

“What can they say, who can they help and then a lot of people are concerned about mifepristone and upcoming regulations,” said Rose.

An appeals court in New Orleans is expected to rule soon on a lawsuit that aims to undo FDA approval for mifepristone, one of two pills commonly used in non-surgical abortions. In Massachusetts, the state and individual providers have stockpiled about a two-year supply.

While abortion rights leaders have spent the year lobbying for continued access, groups opposed to abortion in Massachusetts have felt increasingly under attack.

“It’s been so divisive and, in many ways, nasty,” said Teresa Larkin, the executive director of Your Options Medical, a small network of clinics that provide free pregnancy testing and ultrasounds, but not abortions.

“We were not prepared for that,” she said.

The website for Your Options Medical states that its clinics do not offer abortions or refer to abortion providers, and only mentions negative effects of the procedure. The clinics will provide information, including how far along a pregnancy is, and parenting classes.

Pregnancy centers across the country have become a target for critics who say they mislead or undermine people seeking guidance during a pregnancy. Last summer, someone sprayed a threat on Larkin’s clinic in Revere.

“It’s not fair to centers that are doing things right, that are being honorable, to paint everyone with the same brush,” Larkin said.

Larkin has installed security cameras and auto lock doors, precautions common facilities that provide abortions since 1994. (That’s the year John Salvi shot and killed receptionists at two Brookline abortion clinics. Protests and threats against clinics and providers who perform abortions in Massachusetts are still regular occurrences.)

There's fear that malice directed at pregnancy resource centers like Larkin’s will increase after the state launches a $1 million public awareness campaign with warnings about these facilities. This week a woman filed suit against a center in Worcester, claiming clinicians failed to detect an ectopic pregnancy. When it ruptured, the complaint says, she needed emergency surgery.

Massachusetts Citizens for Life defends the care delivered at pregnancy resource centers. The group, working with Larkin and others, has created an alliance to promote their work.

“The thing we’ve always done as a movement, and done very well, is to take care of women in crisis pregnancies,” said David Franks, who chairs the board at Massachusetts Citizens for Life. “Expanding that is essential to what we think needs to happen in a post-Dobbs world.”

Frank and Larkin say they hope to find common ground with abortion rights supporters on this point: providing pregnancy care. But abortion rights supporters say that must include abortion care.

"From our perspective, abortion is health care. Period," said Ellen Frank, interim CEO at Planned Parenthood League of Massachusetts. "I don’t see a conversation where that would be any different for us."