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On a commercial stretch of Queens, New York, across from a hair-braiding salon and next to a McDonald’s, two security guards mark the entrance to the Jamaica Sexual Health Clinic. For years this has been the neighbourhood’s go-to place for STI testing and HIV treatment. Joaquin Aracena, from the Bureau of Public Health Clinics, proudly shows its newest addition: the reproductive-health wing. With freshly painted white walls and pastel-green doors, it is distinctly less institutional-looking than the rest of the clinic.
“Once they did [away with] Roe v Wade I was able to get this space,” he says. The clinic now offers walk-in medication abortions free to all. Word is clearly spreading. Last year it provided just over 700 abortions; in January it was 100, and this morning the two nurse practitioners have already sent four women home with a non-transparent bag containing the pills they need to terminate their pregnancies.
This is one of the more unexpected results of the Supreme Court’s decision in 2022 to overturn Roe, a ruling that returned the issue of abortion to states and triggered bans. That gave the city’s government new energy to take a more active role in co-ordinating access to abortion, says the city’s health commissioner, Ashwin Vasan. This included putting up billboards in Arizona and Texas and opening clinics in underserved pockets of the city. Less than nine months after Dobbs v Jackson, the ruling that overturned Roe, the Jamaica clinic’s abortion service was up and running.
Many hurdles—practical, financial, social—can stand in a woman’s way, even where abortion is legal. One consequence of Dobbs is improved access in states with a supportive approach to abortion.
Map: The Economist
New data from the Guttmacher Institute, a pro-abortion-rights research group, estimate that over 1m abortions were performed in America in 2023—a rise of 10% compared with 2020 and the highest number in over a decade. This is astonishing, given that the procedure is now banned in 14 states and has become restricted in several more. States bordering those with bans had the steepest rises: up by 72% in Illinois since 2020, 76% in Virginia and 257% in New Mexico.
Last year more than 160,000 women—over 400 a day—crossed state borders to terminate pregnancies, versus 81,100 in 2020 (albeit a covid-19 year). More surprising is the growth among residents of abortion-supporting states. In California locals had an estimated 21,470 more abortions in 2023 than in 2020 (accounting for 88% of the state’s increase) and in New York they had 20,460 more (97%). Overall, in states without bans, over half of the rise was the result of locals having more abortions.
Efforts to improve access in such states may help explain this growth. Several states have reduced out-of-pocket spending for patients. Illinois, New Mexico and New York have increased their Medicaid reimbursement rates for first- and second-trimester abortion procedures by more than 200%, according to forthcoming analysis by KFF, a health-research group. In ten states health insurers are now required to cover abortion, up from six before Dobbs.
Map: The Economist
Nothing has helped expand access as much as abortion pills, which now account for 63% of abortions in America, up from 45% in 2019 (see chart). Medication abortions are cheaper than procedural ones, and easier for clinics to provide and (especially in rural areas) for patients to receive. They are effective in the first trimester, when 94% of abortions happen. Telehealth experiments during the pandemic helped fuel the expansion, as did a loosening of regulations on their use and distribution. Next week the Supreme Court will consider whether the rules should be tightened again.
Whereas in 2020 only 7% of providers offered abortions via telemedicine, by 2022 that had increased to 31%. Mai Fleming from Hey Jane, a virtual-only abortion provider, says she can offer medication abortions at “a fraction” of the cost of bricks-and-mortar clinics. She has seen particularly large increases in orders from states that border restrictive states, such as Colorado, Illinois and New Mexico.
Abortion havens have also solidified legal protections, both for patients (eg, data privacy) and providers (eg, malpractice insurance). Some have amended state constitutions to include a right to abortion. Six states now have telemedicine shield laws that protect licensed practitioners from prosecution if they prescribe and send pills to patients in states that ban abortion.
Alternative explanations for the nationwide rise in abortions, beyond the spread of pills and efforts to lower barriers, do not seem to hold water. It does not, for example, appear to stem from a spike in unplanned pregnancies, which—a short bump during the covid pandemic excepted—show little sign of change since Dobbs.
It would be wrong to conclude that all is fine in post-Roe America. Abortion pills may be a godsend for early unplanned pregnancies, but for women in states with bans who need an abortion later—often due to fetal abnormalities detected at the 20-week scan—getting an abortion is harder than it has been for decades.■
Correction (March 19th 2024): An earlier version of this article misstated the number of women who crossed state borders to terminate pregnancies in 2020. Sorry.
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Bank of England Governor Andrew Bailey attends the central bank’s Monetary Policy Report press conference at the Bank of England, in the City of London, on May 8, 2025.
Carlos Jasso | Afp | Getty Images
Bank of England Governor Andrew Bailey told CNBC on Thursday that the U.K. was heading for more economic uncertainty, despite the country being the first to strike a trade agreement with the U.S. under President Donald Trump’s controversial tariff regime.
“The tariff and trade situation has injected more uncertainty into the situation… There’s more uncertainty now than there was in the past,” Bailey told CNBC in an interview.
“A U.K.-U.S. trade agreement is very welcome in that sense, very welcome. But the U.K. is a very open economy,” he continued.
That means that the impact from tariffs on the U.K. economy comes not just from its own trade relationship with Washington, but also from those of the U.S. and the rest of the world, he said.
“I hope that what we’re seeing on the U.K.-U.S. trade side will be the first of many, and it will be repeated by a whole series of trade agreements, but we have to see that happen of course, and where it actually ends up.”
“Because, of course, we are looking at tariff levels that are probably higher than they were beforehand.”
In Bank of England’s Monetary Policy Report released Thursday, the word “uncertainty” was used 41 times across its 97 pages, up from 36 times in February, according to a CNBC tally.
The U.K. central bank cut interest rates by a quarter percentage point on Thursday, taking its key rate to 4.25%. The decision was highly divided among the seven members of its Monetary Policy Committee, with five voting for the 25 basis point cut, two voting to hold rates and two voting to reduce by a larger 50 basis points.
Bailey said that while some analysts had perceived the rate decision as more hawkish than expected — in other words, leaning toward holding rates elevated than slashing them rapidly — he was not surprised by the close vote.
“What it reflects is that there are two sides, there are risks on both sides here,” he told CNBC.
“We could get a much more severe weakness of demand than we were expecting, that could then pass through to a weaker outlook for inflation than we were expecting.”
“There’s a risk on the other side that we could get some combination of more persistence in the inflation effects that are gradually working their way through the system,” such as in wages and energy, while “supply capacity in the economy is weaker,” he said.
IN THE DELUGE of 145 executive orders issued by President Donald Trump (on subjects as disparate as “Restoring American Seafood Competitiveness” and “Maintaining Acceptable Water Pressure in Showerheads”) it can be difficult to discern which are truly consequential. But one of them, signed on April 23rd under the bland headline “Restoring Equality of Opportunity and Meritocracy”, aims to remake civil-rights law. Those primed to distrust Mr Trump on such matters may be surprised to learn that the president’s target is not just important but also well-chosen.
A Programme at Harvard Divinity School aspired to “deZionize Jewish consciousness”. During “privilege trainings”, working-class Harvard students were instructed that, by being Jewish, they were oppressing wealthier, better prepared classmates. A course in Harvard’s graduate school of public health, “The Settler Colonial Determinants of Health”, sought to “interrogate the relationships between settler colonialism, Zionism, antisemitism, and other forms of racism”: Will these findings by Harvard’s task-force on antisemitism and anti-Israel bias, released on April 29th, shock anyone? Maybe not. Americans may be numb by now to bulletins about the excesses, not to say inanities, of some leftist academics.