A pregnant person who lives in Rapid City, South Dakota, has to drive 318 miles to reach Billings, Montana, home of the nearest facility that provides abortion care.

Martha Stahl, president and CEO of Planned Parenthood of Montana, told Rewire.News that having to travel the vast empty stretches of highway through the Dakotas, Wyoming, and Montana poses a tremendous barrier to accessing abortion care.

“It’s inconvenient at best, but when you’re talking about folks who are trying to access critical health-care services it can just be devastating to not get to where you need to get in a timely manner to seek that care,” Stahl said.

Rapid City, located in western South Dakota near the Black Hills National Forest, is one of America’s 27 “abortion deserts,” major cities where pregnant people have to travel more than 100 miles to reach a facility that provides abortion care, according to a new study.

Researchers at Advancing New Standards in Reproductive Health (ANSIRH), a research group at the University of California, San Francisco, analyzed cities with populations of 100,000 or more.

The study sought to understand the experience of people seeking abortion services in cities with no abortion provider, said Alice Cartwright, project director at ANSIRH and lead author of the study.

“Many large U.S. cities have no abortion clinic at all,” Cartwright said in a statement. “If women have to delay abortion care due to distance, it could result in their seeking abortions in later gestations, care that is even more limited in many parts of the United States.”

Each of the cities identified as “abortion deserts” are located in states with Republican-controlled legislatures, where lawmakers have passed dozens of laws to restrict abortion access over the past decade.

The study found that “abortion deserts” exist in every region in the United States except the Northeast. The Midwest has the fewest abortion providers per capita. Six states have only one facility providing abortion care: Kentucky, Mississippi, Missouri, North Dakota, South Dakota, and West Virginia. 

Ten of the 27 cities without an abortion facility within 100 miles are in Texas.

In Montana, Planned Parenthood has adapted to better serve people who have to travel long distances.

“We want all of our patients to only have to come in for one day of appointments,” Stahl said. “Even our surgical procedures later in pregnancy all happen in one day. That may mean someone has to arrive fairly early in the morning, but it also means they don’t have to stay overnight in a hotel.”

The organization has created a fund to provide financial assistance for both the cost of the procedure and travel costs.

Planned Parenthood Heights in Billings provides both medication abortion and surgical abortion, as well as comprehensive reproductive health-care services, including various kinds of birth control, STD testing and treatment, and other health care.

Ushma Upadhyay, associate professor at ANSIRH and senior author of the study, said the research shows that access to abortion varies significantly for pregnant people depending on where they live.

“New technologies like telemedicine provision of medication abortion can expand access, including in areas isolated from clinics,” Upadhyay said in a statement. “However, with state legislatures nationwide imposing abortion restrictions and ongoing efforts in several states to close clinics, the prospect of new ‘abortion deserts’ being created in the near future is very real.”

Stahl said the study shows that it is important for reproductive rights advocates to realize that when lawmakers pass laws to restrict or expand access to abortion services, the effect of those laws are not isolated.

“The work that happens to expand access in one state can actually benefit the surrounding states, and provide a model for expanding access,” Stahl said. “When we have bad things happen in states and we see restrictions, we have to think beyond just ‘this is happening to the women of South Dakota’ or ‘this is happening to the women of Texas.’”