Oregon and Washington can support women who come here needing abortions and can lead the way on state-of-the-art reproductive healthcare and contraceptive options that have had abortion on the decline for decades anyway.

US federal protection of a woman’s right to abortion will effectively end in 2022. Even if the Supreme Court shocks close observers and does not kill Roe outright, it will surely remove the precedent’s teeth. What does this watershed change mean for Cascadians?

First off, it is a backward step that will cause real harms throughout the region, and disproportionately so for people of color and low-income people. Planned Parenthood clinics serving Spokane, Pullman, and rural Oregon are scrambling to build capacity and find funding for a flood of uninsured women traveling from Idaho, Montana, and even Texas for abortion care. Without additional funding, says Karl Eastlund, CEO of the eastern Washington and North Idaho affiliate, they may be forced to reduce preventive care, primary care, and mental health services in order to meet the urgent need for abortion. Staff also are bracing for an influx of roving, re-emboldened protesters who, as clinics in red states close, can now redouble their focus on those that remain.

Given these developments, Cascadia’s standing as a pro-choice stronghold is more important than ever for people wishing to choose whether, when, and how they have children. It is some comfort, then, that even as the area must gird itself to serve more patients, six key facts and trends will reduce the impact of the US Supreme Court’s whims with regard to Roe.

1. ABORTION RIGHTS AND COVERAGE WILL REMAIN INTACT FOR OR AND WA CASCADIANS

Much of Cascadia has robust legal protection for abortion as well as strong systems of care. In Cascadia’s most populous parts, essentially nothing will change legally post-Roe:

Washington’s longstanding and broad protections for abortion rights began entering state law even before Roe v. Wade. The state also now covers abortion services under the state’s Apple Care healthcare plans.

Oregon encoded Roe v. Wade into state law in 2017 and mandated insurance coverage.

Even red-state Alaska has a constitution that specifically spells out a right to privacy, and restricting abortion access would likely require a constitutional amendment. British Columbia is, of course, immune to SCOTUS action, but for the record: It places no gestational restrictions on abortion, and a 1995 law creates protected no-protest zones around clinics.

Further progress is afoot with regard to abortion medication that patients take in the comfort and convenience of their own homes. In 2017, Canada nationally removed restrictions on the abortion medication Mifepristone. Research at the University of British Columbia confirmed that the medication can be prescribed by any doctor or nurse practitioner and taken at home with no decrease in safety. On December 16, the US Food and Drug Administration, citing similar research, made permanent a set of rules that allow medication abortion to be dispensed via telemedicine, improving access for women in rural areas and “healthcare deserts”—critical for many across Cascadia.

2. ROE’S PROTECTIONS ARE ALREADY WEAK AT BEST FOR MANY WOMEN, INCLUDING IN ID AND MT

Legal rights are meaningless unless people have the means to act on them, and federal abortion rights have failed to create a uniform landscape of access. Idaho has abortion providers in only 3 out of 44 counties. This figure is about to get worse: the fall of Roe will trigger an Idaho law that bans all abortions save for rape and incest.

But even today, mandatory waiting periods, bogus “safety” regulations, and consent laws have driven up costs and created insurmountable barriers for some women while forcing others to seek care across state lines, if they can afford to do so. In Montana, abortion is already severely restricted, with parental notification requirements for teens and felony charges for some l...