Reproductive Rights Under Siege: The Hidden Politics of Abortion Access

Tufts Public Opinion Lab
4 min readDec 13, 2023

by Caroline Soler (class of ‘25)

A critical yet overlooked battle is unfolding in a nation divided by politics and healthcare access. My earlier post reveals the stark contrast in accessibility between Crisis Pregnancy Centers (CPCs) and legitimate abortion clinics across America. In that, I showed that the presence of CPCs relative to legitimate abortion clinics is often only weakly correlated with demographic and socioeconomic factors. In this analysis, however, I explore the extent to which a county’s political leanings influence abortion access.

CPCs, often misleadingly presented as legitimate healthcare providers, strategically dissuade individuals from seeking abortion and contraception. Their tactics range from spreading misinformation to emotional manipulation, as well as preying on people of color, the young, and the economically disadvantaged. Despite lacking subjection to federal privacy laws or oversight, these centers receive significant financial support and exploit online search algorithms to enhance their visibility. In this post, I will show how the dominance of CPCs over abortion centers is directly related to partisanship, or more specifically, county-wide presidential vote in the 2020 election.

Refer to my preceding post for a detailed exposition of the ‘Inaccessibility Score,’ a metric quantifying the prevalence of Crisis Pregnancy Centers (CPCs) relative to abortion clinics across various regions in the United States. For this analysis, I added county-level electoral data from the 2020 US Presidential Election to incorporate an ideological dimension in this analysis. Each county was coded based on the candidate who received the majority of votes, allowing for a nuanced understanding of the political landscape concerning the availability of reproductive health services.

My analysis of CPCs and abortion centers across US counties reveals a stark contrast: 52% of counties lack CPCs, affecting 40 million citizens, while 83% are without abortion centers, impacting 120 million. The average county has more CPCs (.834) than abortion centers (.423), highlighting a significant gap in reproductive healthcare access and underscoring the need for policy interventions to address this critical public health issue. This disparity not only limits abortion access but also reflects the complex social and political landscape of reproductive rights in the US.

The plot visualizes the relationship between county-level accessibility to reproductive healthcare and political leanings for the most populated counties (counties with more than 300,000 citizens) colored by their 2020 presidential vote and sized by their population. The diagonal line divides counties by how many CPCs they have relative to abortion centers. Counties above the line have more abortion centers than CPCs, while the opposite is true for counties below the line. Of the 144 counties above the line (with more access to abortion centers than CPCs), 74% were won by Biden in 2020, whereas 26% voted for Trump in 2020. Among the 108 counties below the line (with more access to CPCs than abortion centers), 63% were won by Biden and 37% by Trump. However, when considering these as proportions of the total number of counties won by each candidate, it’s found that 46% of Biden’s counties and a significant 74% of Trump’s counties are below the line. This suggests that a larger proportion of counties won by Trump have more CPCs relative to abortion centers, indicating lower accessibility to abortion services.

Thus, there appears to be a strong relationship between a county’s partisan leanings and access to legitimate abortion centers in comparison to CPCs. People in counties that leaned Republican in the 2020 election are much more likely to live in areas with more CPCs than abortion centers. This follows trends in public opinion about abortion, as Pew Research found that Democrats are twice as likely as Republicans to support legal abortion in most cases. Much of this relationship may relate to a state’s policies when it comes to abortion access. States with Republican leadership may have more restrictive laws regarding reproductive healthcare, influencing the number of CPCs relative to abortion centers. Even more, some of these politicians may support the coercion and manipulation of CPCs, potentially supporting the funneling of philanthropic and government funds towards them. Conversely, Democratic-led counties are likely to adopt more liberal policies, facilitating more straightforward access to legitimate abortion services. In the post-Dobbs world, this disparity is likely to become even more pronounced as the implementation of restrictive abortion laws causes the closure of more and more legitimate abortion centers.

The alarming disparities in reproductive healthcare access in the United States demonstrated by these findings exist and should be concerning to all. We increasingly live in two Americas, with those in Democratic areas having much better access to abortion services than those in Republican areas. The deceptive practices of CPCs, their strategic targeting of vulnerable populations, and their robust financial support network have revealed a complex and deeply entrenched issue. The data presented here underscores the urgency of addressing this problem. As CPCs continue to outnumber abortion clinics, especially in regions with conservative political leanings, the threat to reproductive healthcare access grows. Abortion rights policymakers must be acutely aware of the harm caused by CPCs and actively engage in efforts to limit or regulate these organizations while crafting policies that ensure access to legitimate reproductive healthcare in the United States. In the words of the CEO of Heartbeat International, the second-largest global CPC affiliate company, this is “more of a political battle than ever before.” Further research must explore the relationship between funding sources and disparities in access, as well as the intricate connections between political ideologies and healthcare infrastructure. With the increasing restrictions on abortion access in various states, the proliferation of CPCs poses a growing problem that demands immediate attention and action. It is imperative to safeguard the reproductive rights and autonomy of all individuals, ensuring that all individuals have equitable access to comprehensive reproductive healthcare services.



Tufts Public Opinion Lab

The Tufts Public Opinion Lab (TPOL) is dedicated to studying contemporary controversies in American public opinion using quantitative data analysis.