Black women are three times more likely to have an abortion than White women. 

Imagine having to travel 100 miles just to get birth control. Or, as one Texas woman experienced, needing an abortion and having to sleep overnight in an RV with your husband and three kids during a mandatory 24-hour waiting period because the closest clinic is 150 miles away.

These scenarios are becoming a reality for more and more American women as conservative politicians continue their assault on women’s health care access. While the right to choose may still technically be legal, a woman in need of health care will face widely different obstacles depending on the state she lives in. Since 2010, the attacks on abortion clinics have had the added impact of stripping away access to subsidized services—including contraception, annual exams and prenatal care—all of which are disproportionately sought out by Black women.

According to the Guttmacher Institute, 17 states have enacted some 51 laws restricting access to abortion services in the first half of 2015. These laws, including enforced waiting periods, bans on abortions after the first trimester and burdensome requirements called Targeted Regulation of Abortion Provider laws, have had the effect of closing clinic doors, leaving millions of American women without access, not only to abortion but also to care that would prevent unintended pregnancies. Waiting periods are required in 28 states; in 13 of them, women face a “two trip” hurdle—where they are required to go to the clinic first for counseling and a second time for the procedure.

“It’s almost as if we are beyond the worst states for abortion access; instead it is the worst regions for access. Just over half the states can be considered hostile or extremely hostile to abortion rights. The most hostile regions are the South and the middle of the country,” says Elizabeth Nash, senior state issues associate at the Guttmacher Institute.

In Texas, a state where 1.8 million women seek publicly funded reproductive care services, 26 clinics have shuttered their doors, leaving just 10 standing. Last year, as a result of a controversial law that required clinics to abide by strict regulations (such as acquiring the same admitting privileges as hospitals), the state saw the closing of Whole Women’s Health clinic in Beaumont. Consequently, there are no clinics left between New Orleans and Houston, two cities with huge populations of Black women. In four states, Mississippi, North Dakota, South Dakota and Wyoming, only one abortion clinic remains.

Louisiana, which is among the states with the highest rates of uninsured people in the country, has seen abortion opponents block the development of a new state-of-the-art Planned Parenthood facility in New Orleans. Pro-lifers, including Governor Bobby Jindal, cite the abortions Planned Parenthood provide as the reasoning behind their protest, even though abortions account for just 3 percent of its services. The project’s delay will result in thousands of women not having access to contraception, making the need for abortion care more likely and the service less accessible.

In June, the U.S. Supreme Court issued a stay blocking enforcement of the provisions in Texas’ House Bill 2. That law, which was famously filibustered by State Senator Wendy Davis, is now prime for a challenge that may put the future of abortion access in jeopardy. The legal standard of undue burden, which is defined as “a substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability,” could be reconsidered.

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“A low-income woman of color working a minimum wage job to make ends meet probably doesn’t have as much time to take off multiple days to have an abortion,” says Raegan McDonald-Mosley, chief medical officer at Planned Parenthood Federation of America. “And if the health center is several towns away, how will she afford the travel expenses on top of missing work? If she has children, child care becomes an obstacle. In states where they’ve cut funding to health centers that provide quality, affordable health care, if a woman doesn’t have a flexible job or child care, a simple checkup, cancer screening, pap smear or birth control consultation becomes a greater challenge. Without insurance or affordable providers in close proximity to where she lives, she is forced to put her health care on the back burner because it’s too costly and out of reach.”

Even though advocates and allies are fighting legislative battles on the state level to maintain reproductive access for all women, the unease around sex and abortion isn’t isolated to statehouses. Some African-American churches contribute to a climate of shame that can lead to a lack of resources for sex education and can put Black women in a precarious position. The effect of all these factors is that Black women have higher rates of unintended pregnancies than White women and are three times more likely to have an abortion, according to the Centers for Disease Control and Prevention.

Black communities are flooding the streets protesting the inhumane treatment of the children we choose to have, but some of us are failing to see the connection and understand abortion access as an issue of bodily autonomy. Religious rules around sex and abortion in Black communities can make talking about these issues, even with close family and friends, harder, and that allows for the rampant spread of misinformation about how to access contraception services.

Limiting access to health care services will not end abortion. A global study conducted by the World Health Organization found that less access to abortion services doesn’t actually lower the abortion rate, it just makes terminating a pregnancy more dangerous for poor women. But abortion opponents argue that they are concerned with protecting women’s health and thus conclude that many of these restrictive laws are necessary.

Another way anti-choice groups have tried to prevent abortion access is through the deluge of attacks on Planned Parenthood this past summer. In July, abortion opponents released secretly recorded videos allegedly showing representatives of Planned Parenthood negotiating costs for fetal tissue research. The controversy around these videos led Congress to vote again on defunding the women’s health care provider, but the measure failed. Despite these attacks, 45 percent of Americans still have a favorable view of Planned Parenthood, according to an NBC News/The Wall Street Journal poll.

The abortion rate is the lowest since 1973, yet opponents continue to work to increase restrictions to prevent even more women from accessing the procedure. “Our opposition has preyed upon the lack of access and the lack of resources. They are perpetuating this misinformation culture where people think that their legal rights don’t actually matter. It’s more dangerous for a woman to drive five hours than it is for her to get an abortion,” says Amy Hagstrom Miller, founder and CEO of Whole Woman’s Health.

With the recent targeting of Planned Parenthood, abortion opponents have forced the fight over abortion access to expand beyond the historical debate over choice and into the broader area of contraception. Without these preventive measures, Black women could face desperate situations. “The reality is that abortion access is one very important piece of a big puzzle,” says Eesha Pandit, copresident of the board of the National Network of Abortion Funds. “For low-income women of color, there are many challenges on a day-to-day basis: racism, sexism, poverty and an inadequate education. In this mix, being able to control your own body is not just an abstract right, it’s about dignity and humanity itself.”

This feature was originally published in the October issue of ESSENCE, on newsstands now.