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Anna swivels from side to side in her plush black desk chair. The afternoon sunlight streams into the room from a big window beside her. It’s spring in Charlotte, North Carolina, and track practice has just let out. There are only a few short weeks left of high school, then she’s finished with childhood forever.
“I started the college process kind of late,” Anna says, dark hair framing her face, big headphones over her ears. She started her college application list last summer, right around the time the Supreme Court overturned the 1973 landmark Roe v. Wade decision, which had made abortion legal across the U.S. for five decades.
Anna always dreamed of the “classic college experience”—going to a big school with a football team and an abundance of school spirit. Her main sources of college information came from her dad, her friends, and what she saw online. “Should I apply to Auburn?” Anna asked her dad one day. “A lot of my friends are.”
Instead of answering directly, he asked if she wanted to spend her college years in a red state. “He was like, ‘You’re a woman; they don’t like you.’ And I was like, ‘Okay. Hyperbolic, but fair enough.’”
The college decision process has always been complex and emotional. High school seniors ask themselves, ‘Can I afford tuition? Will I fit in and be happy? How far from home is it? What does my college say about me?’ And now, for the first time in two generations, young women are making these decisions in a world where access to reproductive health care is not guaranteed.
It’s been one year since the U.S. Supreme Court ruled that the Constitution does not protect a woman’s right to have an abortion. In June 2022, the court’s ruling in Dobbs v. Jackson Women’s Health Organization—a case that dealt with Mississippi’s 15-week abortion ban and ultimately challenged the Roe decision—unraveled 50 years of precedence. Since then, 14 states have enacted total abortion bans, and Georgia has put in place a 6-week abortion ban, Nebraska a 12-week ban, and four other states 15- to 20-week bans, according to The New York Times. Ten of those states with total bans make no exception for rape or incest. The battles rage on in state legislatures: Judges in at least six states have temporarily blocked restrictive abortion bans from taking effect, but the legal challenges might not hold for long.
This spring, in a case that might have potentially made the abortion pill mifepristone illegal, the Supreme Court instead issued a stay on a lower-court ruling, allowing the drug to remain legal and available. The SCOTUS ruling also kicked the case back to a lower appeals court.
Pregnant people in red states aren’t the only ones affected. Roe’s overturning has had far-reaching effects across the country, influencing national politics, life, love, art, career, and education decisions.
While a college’s prestige, tuition, and acceptance rates remain the dominant factors in applicants’ decision-making process, abortion access is now a consideration as well. Young women must imagine what their lives might look like in a state where they may not have total bodily autonomy. For many, choosing a college is their first big, life-altering decision. And for some, that decision is now more complicated.
Women’s Health talked to three young women from different backgrounds who are considering their college choices, and to experts, college admissions officers, and activists as well to find out how Roe’s overturning has changed the higher education application process.
Students care about abortion access when choosing their college, research shows.
“Students are not only deciding, ‘Can I afford to go to this college?’” says Leslie Rios, a policy associate at Temple University’s Hope Center for College, Community, and Justice. “They also have to think about which basic health services will be available, what right to privacy they might have when choosing what’s best for their body, as well as if they feel safe at the college.”
It’s still too soon to know how heavily abortion access weighs on students’ college decisions, Rios says, but some studies provide insights.
Nearly 75 percent of currently enrolled college students said reproductive health laws in their college’s state are at least somewhat important in their decision to stay enrolled, and 60 percent of people without a degree yet say these laws are at least somewhat important in their enrollment decisions, according to an April 2023 Gallup Poll. More than 80 percent of college students and college hopefuls say they would prefer going to school in a state with greater access to reproductive health services.
Last summer, just after Roe was overturned, an Intelligent poll found that 45 percent of students were considering or planning to transfer to an abortion-friendly state, and 20 percent of students in states where abortion was now illegal, or at risk of becoming so, “definitely” planned to transfer.
The survey questions’ framing is important. “I don’t know the extent to which [the responses will] actually, practically have meaningful shifts,” says Kristen Jozkowski, professor in sexual health and principal investigator for the Indiana Abortion Attitudes Study. Just because someone says abortion is important to their decision doesn’t mean they’ll act on it. But attitude does influence behavior, Jozkowski says.
“Never underestimate the sophistication of an 18-year-old,” says Nanci Tessier, principal at Art & Science Group, a consulting firm for higher educational institutions, nonprofits, and independent schools. “They think about big questions and big issues that relate to not only themselves as an individual, but also to their world at large.”
States’ constantly changing and complicated rulings on abortion over the past 12 months have been hard to keep track of and confusing. But young people are paying attention, and they’re talking about it. They’re also aware that how a state deals with abortion can be a bellwether for other hot-topic issues: gun control, transgender rights, the status of queer people, and more.
Nearly 75 percent of currently enrolled college students said reproductive health laws in their college’s state are at least somewhat important in their decision to stay enrolled, according to an April 2023 Gallup Poll.
On Reddit, a forum on “college admissions questions, advice and discussions,” r/ApplyingToCollege, is 1 million members strong, and questions around abortion access’s impact on college choice are common. In the “important links” section threads, a link for “The End of Roe v. Wade and What it Means for Your Application Process” sits near “Decision Calendar” and “Questions About AP Scores.” It includes resources for updated state restrictions, a color-coded map, and a deep comments thread.
“I’m in Kansas but I had fully intended on changing my university if they voted to ban abortions,” one user wrote. “I live in the South and it’s too late unless I transfer. But for grad school I’m out of here :>,” wrote another. “Indiana off the list,” a third commented, to which users responded, “Yeah, even I ditched Purdue,” while another commenter wrote, “I refuse to go below Maryland.”
These surveys and Reddit comments play out in real time too. Alex McNeil, one of the Reddit forum’s moderators, runs a private college consulting company in the Bay Area and has been helping families across the country research schools. These days, that might include having a frank conversation about a state’s legislative environment.
“We are having discussions with students who have shifted their admissions plans based around these issues that we’ve never had before,” he says. McNeil estimates about a quarter of clients who identified as women “changed their process” based on legislation, deciding, for example, not to apply to schools in Ohio, such as Kenyon and Oberlin.
Lina, an 18-year-old senior living in Austria, dreamed of going to school in America since she was a little girl. “It’s all I ever wanted,” she says. “But you grow up a little bit and you realize that’s not the way it is. There’s so much more to it than Pop-Tarts and American Girl dolls.”
Since ninth grade, she’s been envisioning herself at Savannah College of Art and Design, where she hoped to study film. But Lina, who is gay, ultimately decided against going to school in Georgia because of the regressive attitudes toward the LGBTQ+ community and abortion laws. She needed to be in a state that would protect her and other people’s right to an abortion, “no matter the reason,” she says. Instead, she’ll start her American adventure in Chicago this fall.
Advocates for Youth, a group that helps young people promote sexual health and equity, saw membership in its newly created Youth Abortion Support Collective boom since launching in 2020. The group is a network of young people who are experts on abortion resources and options. The roughly 100 to 150 original members now number over 1,000, according to Tamara Marzouk, the director of Abortion Access at Advocates for Youth. “This is a moment where we’re seeing that young people are angry,’’ she said. “And they’re also catalyzed to act.’’
Geography has always played a role in college choice.
But that criteria was usually discussed in relation to travel distance and costs. Today, “geography” often doubles as shorthand for political and social climate.
“We’ve had conversations like, ‘Okay, you’re interested in Northwestern and Boston College. What do you think about Tulane or Duke, or what about Vanderbilt or Rice University?’” McNeil says. “Those schools have been ruled out because they’re in states that have very regressive legislative climates for reproductive rights and for abortion specifically.”
In Austria, Lina realized her college decision couldn’t be based solely on education. “You’re going to be there for at least the next four years, if not the rest of your life,” she says. “And even though you may be accepted and supported and acknowledged in your educational environment, that may not always be the case outside [of it].”
Last October, Ava, an 18-year-old from New Jersey, sat down to answer a college essay question for the University of Texas at Austin, her “dream school.” She decided to write about abortion. “I didn’t really want to steer away from [the topic],’’ she says. “So I just wrote about it.’’
The Dobbs decision came down only a few weeks after junior year wrapped at Ava’s public high school. That spring, she had taken a government class in which students learned about Roe v. Wade. And as friends finalized college lists, reproductive health care became part of the conversation. Ava would hear friends say, “My mom wouldn’t let me go there,” or “My parents don’t want me to apply.”
The UT essay made Ava pause to reflect on state policies. Currently, Texas bans abortions with no exceptions for rape or incest, and abortion providers can be sued for assisting in abortions after week six. Her list of 12 to 14 schools (she wanted to go to a big school with a strong political science department) were mostly in the North, but she included schools in Texas, North Carolina, Virginia, and Georgia too. She later toured Cornell University, an Ivy League college in Ithaca, New York, fell in love with it, and applied early. But she kept schools like UT on her list.
In December of 2022, Ava received her acceptance to Cornell and quickly withdrew her other applications.
“I feel pretty sad for everyone,” Ava reflects, noting that the men in her class didn’t seem to bear the same burden. “[It’s] very unfortunate. We really have to take into consideration basic health care.… A choice was kind of made for us.”
In Charlotte, Anna says Roe and abortion bans were a big topic of conversation among her friends. Several got into schools in states like Georgia, but if they were accepted to another school, some opted out, concerned about their status as a woman, she says. (Georgia has a six-week abortion ban, and in March, the state banned most gender-affirming procedures and hormone-replacement therapies for transgender people under 18.) While abortion access wasn’t the main factor in their final college decision, Anna explains, it definitely played a role.
“Up until last year, we had landmark legislation saying ‘privacy is a right and a woman has that right,’” she explains. “And it was the fundamental betrayal of those kinds of ideals—that I held, and I thought other people held—that made me realize, if they’re willing to cross that line, I don’t want to be in that state for the next four years to see which other ones [they cross].”
The week after Anna spoke to Women’s Health, North Carolina, which previously allowed abortion up to 20 weeks, passed a 12-week abortion ban. Anna had been tracking the bill and wasn’t surprised by the outcome. “I just feel a bit helpless,” she wrote in an email. The ban goes into effect in July.
Forty-five percent of students were considering or planning to transfer to an abortion-friendly state, according to a 2022 Intelligent poll.
It’s still too early to see hard data on how college enrollment patterns have changed.
It’s difficult to get an accurate numerical snapshot of how Roe’s overturning affects young women’s final decisions, because many factors affect enrollment numbers, including the pandemic, population growth in some states, and declining birth rates in others.
While overall college enrollment has declined across the U.S. since the pandemic, the toll on women seems to be heaviest.
Community colleges have seen an almost 5 percent enrollment decline for women, with public four-year institutions clocking a post-pandemic decline of almost 2 percent, according to the National Student Clearinghouse Research Center (NSCRC), a nonprofit that provides educational reporting, verification, and research services to colleges and universities.
“Women enroll at higher rates in higher education, and so when you see these losses, it’s kind of stark,” says Shannon Lee, one of the center’s research associates. NSCRC does not collect data on how reproductive health laws play a role in college decisions. To explain this shift, Lee points to the economic burden of college, a higher demand for jobs that don’t necessarily require a college degree, and caregiving responsibilities as the main reasons women’s enrollment may have been affected.
As for Anna, her college decision came down to tuition. Despite careful consideration of how restricted access to reproductive health care might affect her, college cost was the deciding factor, and she picked the more affordable option. Anna proudly points to her Tar Heel T-shirt over Zoom.
“If I had the money to afford it, I would be going out of state,” she says. Instead, this fall, she will be going to the University of North Carolina in Chapel Hill. “As excited as I am, and I am very excited, I did not want to stay in North Carolina for the next four years.’
State leaders and reproductive rights advocates are worried about the impact abortion bans will have on communities.
It’s no secret that restrictive abortion legislation disproportionately affects marginalized groups, including Black, brown, Indigenous, LGBTQ+, and low-income communities who already face hurdles with health care access, Rios says.
And while students from middle-class families might be able to fly home or organize transportation for an abortion, it’s students who are attending community colleges for cost reasons who will suffer most, adds Mary Banks, a former Columbia University admissions officer and a consultant at Quad Education Group, a college admissions consulting company.
Add that to the statistic that roughly 61 percent of women who have children after enrolling in community college drop out, according to the National Campaign to Prevent Teen and Unplanned Pregnancy, and you’ve got a perfect storm. “That’s an astonishing figure for kids who are trying to get through school,” Banks says.
And it’s not just education that’s lost. A state’s business, culture, art, and industry sectors can suffer too. If students do, in fact, start to reject college offers in places with restrictive health laws, it could affect those states in big ways. Half of recent grads stick around to work near their college campus after graduation, and over two-thirds stay in state, according to the National Bureau of Economic Research. One of the study’s authors, Johnathan G. Conzelmann, a graduate research consultant at UNC Chapel Hill, speculates that “areas less likely to protect reproductive rights could become more insular over time.”
Tennessee State Senator Heidi Campbell (D) is “very concerned” about brain drain in her state. Currently, Tennessee has a no-exception, total abortion ban. The governor signed a new bill in April that provides exemptions for ectopic and other nonviable pregnancies and allows abortions if a woman’s life is at risk.
“We’re losing ob-gyns and we’re losing academics,” Campbell says. In fact, states banning abortions saw a “steep” 10.5 percent drop in obstetrics and gynecology residency applications in 2023, according to an April study from the Association of American Medical Colleges. That has potential long-term effects on doctor availability in the South and Midwest, since many stay to work where they’re trained.
And this is also where the story hits home for me.
Just before the Republican-majority legislature voted to override Gov. Roy Cooper’s abortion ban veto in North Carolina, my best friend, Carson, a current student at NYU Grossman School of Medicine, a top medical school in the country, sat in her apartment and desperately began calling legislators from our home state. “I’m actually panicking,” she texted me.
Ever since she was an 18-year-old college freshman, Carson has talked about working as a doctor in North Carolina, serving the communities that raised and nurtured her. And she wants to eventually live closer to family. Carson plans to apply to ob-gyn residency programs next year—UNC and Duke University are at the top of her list. She says that both schools have fantastic programs, and has heard glowing reports from attendings and residents at NYU about the two Carolina institutions.
But Carson says she can’t train with restrictions—she can’t risk losing essential high-risk pregnancy counseling and care training. Right now, many residency programs in states banning abortion face a tough paradox: If they continue providing abortion training, they might face prosecution, but if they don’t offer proper abortion training, they could lose their accreditation status, per The New York Times. (Losing accreditation would make it hard to recruit staff and would block residents from obtaining specialty board certification.)
“Applying and matching to a residency program is hard enough. I wish this wasn’t even a factor I had to consider,” she texted as soon as the news came down. Carson hasn’t officially crossed the schools off her list yet, but the news made her heart sink. The new law makes her “exponentially less excited” about her options in North Carolina, she says.
Sen. Campbell’s own daughter is a high school senior, but the lawmaker wants her out of Tennessee for college.
“I don’t want her to be in a state where she doesn’t have reproductive rights,” Sen. Campbell says. “I don’t want my daughter to be in school in a state where she feels diminished, and she was in agreement with that.”
But despite the chaos and confusion, life must go on for these young women. Lina dreams of directing a SuperBowl commercial. Ava is ready to dive into public policy. And come August, Anna will pack up her life and make a two-hour drive to set up her new dorm room in Chapel Hill. They will persist in getting an education and making their mark on the world, carrying their concerns with them.
“We’re all teenage girls, so this affects us,” Anna explains. “You hear of things that happen at colleges, happen at frats, and there’s fear.”
Currie Engel is the associate news editor at Women’s Health. She previously worked as an award-winning local reporter specializing in health investigations and features, and as a researcher at Time magazine.
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