The term “internally-displaced people” is often used to describe people from Ukraine, Syria, and countless other conflict zones around the globe. They are refugees within their own borders, forced to flee home to find safety. We usually think of this happening a world away from America, but the alarming truth is that the term may soon become a part of life here, and the unlikely cause is the repeal of Roe v. Wade.
Since 1973, many states have outlawed abortion, but far more are poised to today. Between existing and proposed abortion bans, this vital form of medical care will suddenly be out of reach to pregnant people in 26 states. But the situation is far worse than even those numbers sound.
Prior to Roe, abortion bans ended at the state line. No matter how draconian the punishments might be, those with the money, time, and resources to leave could find care elsewhere. But the Dobbs decision portends a far darker future, one where states have the tools to track and punish their residents for abortions out of state.
About 50 years ago, it was impossible for Texas or Mississippi to send state troopers to watch every abortion provider in New York and Connecticut. It’s still impossible today, but they don’t need to send in the Texas Rangers when they have Google. Law enforcement will use the tools of modern policing—location data from all of our devices, harvesting our search queries and social media content—to enforce backwards abortion bans, and pregnant people will find themselves stuck.
These patients—seeking care in an unfamiliar state, and facing an arrest warrant at home—will meet the international criteria for being internally displaced. According to the United Nations’ Guiding Principles on Internal Displacement, internally displaced people include those forced to flee their home to avoid “violations of human rights.” While America may soon be a country where our Constitution omits any protection for reproductive health, international law clearly disagrees, holding that pregnant people have a fundamental right to access abortion care.
Of course, Americans have faced temporary displacement in recent years from natural disasters like Hurricane Katrina, but this sort of human rights-based displacement will be one of the largest in modern American history. We must prepare for displacement on a truly epic scale, investing now in the resources to support those displaced by the flight to find care.
To look for analogous examples of mass displacement—Americans forced from their homes by law and not nature—we look back to some of the darkest chapters in this nation’s history: the Indian Removal Act, the Underground Railroad, and the mass exodus of Black Southerners in the face of the racial terrorism of Jim Crow.
According to the Centers for Disease Control, more than 600,000 abortions were performed every year for the last decade, a level of medical need that won’t simply disappear, despite the Supreme Court ruling. And hundreds of thousands of procedures were performed in states that will soon outlaw or radically restrict care. Of course, not every abortion seeker will have the financial means or physical ability to leave their state, especially minor survivors of incest living under the guardianship of the state, but tens of thousands or more likely will.
Abortion funds have been supporting out-of-state travel for abortion seekers for years, helping pregnant people get to the states where they can get care, but such travel has largely been short-term in the past. Now, pregnant people will need help with long-term relocation and resettlement on a massive scale.
This requires planning and investment from rights-protective states, building the infrastructure to provide safe housing, medical care, assistance with job placement and education, and financial support to those seeking safety within our borders. New York, Connecticut, and other pro-choice states have already started to acknowledge the reality, passing bans on extradition to anti-choice states for those accused of obtaining an unlawful abortion. But while those extradition bans are vital to let abortion seekers avoid arrest, they don’t go all the way in supporting those who suddenly find their lives upended, stranded far from the only home they know.
Albert Fox Cahn is the founder and executive director of the Surveillance Technology Oversight Project (S.T.O.P.), a New York-based civil rights and privacy group, a TED fellow, and a visiting fellow at Yale Law School’s Information Society Project.
Sam Van Doran is development director at S.T.O.P. and a 2021 Fellow with Coro New York’s Immigrant Civic Leadership Program.