11/05/2013 03:45 pm ET Updated Jan 23, 2014

Is Roe v. Wade in Danger?

Even though 87 percent of all U.S. counties lack an abortion provider according to 2008 data, actions to restrict the access of abortion services continue steadily. In 2013 so far, state legislatures have introduced 321 anti-choice measures and enacted 46 of them, according to internal research by NARAL Pro-Choice America. NARAL defines anti-choice broadly, including any measure that hinders a woman's ability to exercise her reproductive rights.

In a panel discussion at The Commonwealth Club of California that addressed reproductive rights, Lisa Lindelef, a pro-choice activist and board member of NARAL Pro-Choice America Foundation, noted that the abortion conversation has moved to the state level. Lindelef added that the landmark Roe v. Wade decision from 1973 that seemed to enshrine a woman's right to choose isn't being attacked directly. Instead, the restrictions being enacted are attacking the infrastructure around access to legal abortion services. "What they are doing is chipping away incrementally around it," she said. She noted that adding constraints like decreasing how early a woman can have a legal abortion, requiring ultrasounds, waiting periods, and counseling before gaining access to abortion services are all ways of undermining the right that Roe v. Wade outlined, without directly attacking that decision.

Last week, a federal judge ruled that the Texas law aimed at abortion clinics is unconstitutional. This is the same law that Texas Democratic state legislator Wendy Davis, who is now running for governor, filibustered against in June. The Texas attorney general filed an emergency appeal, and a federal appeals court reinstated most of the restrictions until the case is heard in January 2014.

Accessing abortion services has become restricted in some areas of the country. This interactive map from the The Daily Beast details how accessible clinics are and the restrictions imposed on women seeking abortions by geography.

Lindelef was joined by two other panelists: Fran Moreland Johns, author of Perilous Times: An Inside Look at Abortion Before - And After - Roe v. Wade, and Scotty McLennan, dean for religious life at Stanford University. Shanelle Matthews, communications strategist for ACLU Northern California, moderated the panel.

Fran Johns agreed with Lindelef about the possibility that current legislation could put Roe v. Wade in jeopardy. She added, "I would like never to see abortion happen again. But that's not going to happen." Johns' book examines back-alley abortions before Roe v. Wade and looks at the difficulty women face in accessing abortion services today. "What we want is for abortion to be safe, legal, and rare," added Lindelef.

Some areas of the country have been fairly progressive in their approach to ensuring that women have access to all reproductive services, including contraception and abortion. San Francisco even went a step further in 2011 by implementing an ordinance against crisis pregnancy centers (CPCs), to prevent false advertising. CPCs often advertise themselves as counseling centers that provide women with information on pregnancy and abortion services. However, according to pro-choice advocates, they tend to have an anti-abortion stance and generally counsel women against accessing abortion services.

While similar laws in New York and Baltimore were struck down, San Francisco's ordinance focused on false advertising and has been upheld. That has made San Francisco's ordinance the first successful one of its kind in the nation. The ordinance was enacted to ensure that CPCs advertise accurate information about the services they provide, making it a consumer protection issue, argued the authors of the ordinance, Supervisor Malia Cohen and City Attorney Dennis Herrera.

Geography plays a role in the restrictions that are enacted. The Daily Beast's analysis noted, "Often, the states with the fewest clinics also have more restrictions." In those cases, not only are women physically unable to access abortion, but there are added restrictions -- such as wait times and requirements of ultrasounds or in-person counseling -- that make it more burdensome for them to do so. That is all in addition to the social pressures that accompany the issue. "I've spoken with women, especially very young women, who felt so intimidated or frightened by the protestors that they were worried about, or felt they could not do it," said Fran Johns in an email. She's referring to protests held by activists outside abortion clinics to dissuade women from getting abortions, a tactic now being exported outside the U.S.

Johns added, "It's not so much an urban/rural issue as a state-by-state issue. But the saddest stories I heard were from women in rural or small-town areas who did not have the money, time, and resources to access a safe abortion." Again, state legislation plays a big role in allowing women access to safe services. The New York Times reported in September that in the last three years, 54 clinics in 27 states have closed. And an interactive map from The Washington Post shows which states have introduced and enacted restrictions on abortions this year. According to this article, restrictive abortion legislation has been introduced in 32 states and enacted in nine states.

Decisions on these laws differ from state to state: though a judge in Ohio upheld that state's law requiring doctors to follow FDA protocol in medical abortions, a similar regulation was deemed unconstitutional in Oklahoma and may be heard in front of the U.S. Supreme Court. As the article notes, "Supporters of the law say such procedures protect women. But the Oklahoma court concluded that it effectively bans medication abortions, which are used early in pregnancies, because doctors over the past decade have found the FDA protocol to be excessive or outdated."

The legislative wrangling at the state level leaves women behind who need abortion for any number of reasons. Cases such as those of the Davises from Oklahoma, profiled in an MSNBC report, will continue. According to the article,

Earlier that month, at home in Oklahoma City, the Davises were told that the boy she was carrying had a severe brain malformation known as holoprosencephaly. It is rare, though possible, for such a fetus to survive to birth, but doctors told them that he would not reach his first birthday. "He would never walk, lift his head," Jessica, 23, recalled in an interview...The lack of options sent them to Dallas, where protesters outside the clinic tried to hand Jessica a pair of baby socks. She told them to go to hell. She left the clinic with a death certificate, which she and Eric had asked for, and a footprint of the son they named Mark Gordon Scott Davis.

The funeral homes Jessica called for a "proper burial" laughed at her, or hung up "because I mentioned the word 'termination,'" she said. The funeral homes told her she had an abortion. "I don't look at it like that," Jessica said. "I'm showing my son mercy.'

For those who cannot afford to go elsewhere for the procedure, the outcomes are less well-known. One study conducted recently of women who wanted an abortion but were turned away shows increased negative consequences in their health and economic stability. However, this area can use more research, not only on the consequences of being turned away from an abortion for women, but also for the children who are subsequently born.

"It's never an easy decision," said Fran Johns, who herself had to obtain a secret and illegal abortion after being assaulted at her job, before Roe v. Wade made abortions legal.

And Lindelef cautioned, "Making this illegal is not going to make it go away. It will probably make it more frequent and less safe."