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Women from the remote U.S. territories of Guam and the Northern Mariana Islands will likely have to travel farther than other Americans to terminate a pregnancy if the Supreme Court overturns a precedent that established a national right to abortion in the United States.

Hawaii is the closest U.S. state where abortion is legal under local law. Even so, Honolulu is 3,800 miles (6,100 kilometers) away — about 50% farther than Boston is from Los Angeles.

“For a lot of people who are seeking abortion care, it might as well be on the moon,” said Vanessa L. Williams, an attorney who is active with the group Guam People for Choice.

It’s already difficult to get an abortion in Guam, a small, heavily Catholic island of about 170,000 people south of Japan.

The last physician who performed surgical abortions there retired in 2018. Two Guam-licensed doctors who live in Hawaii see patients virtually and mail them pills for medication abortions. But this alternative is available only until 11 weeks gestation.

Now there’s a possibility even this limited telehealth option will disappear.

A recently leaked draft opinion indicated the Supreme Court could overturn the landmark Roe v. Wade decision and allow individual states to ban abortion. About half of them would likely do so, abortion rights advocates say. Oklahoma got a head start Wednesday when its governor signed a measure prohibiting all abortions with few exceptions.

All three U.S. territories in the Pacific — Guam, the Northern Mariana Islands and American Samoa — also have the potential to adopt prohibitions, according to a 2019 report by the Center for Reproductive Rights. None have legal protections for abortion, and they could revive old abortion bans or enact new ones, the report said.

Traveling to the nearest states where abortion is allowed — Hawaii or the U.S. West Coast — would be prohibitive for many women.

A nonstop flight from Guam to Honolulu takes nearly eight hours. Only one commercial airline flies the route. A recent online search showed the cheapest tickets going for $1,500 roundtrip in late May.

Williams said many Guam residents need time off work, a hotel room and a rental car to travel for an abortion, adding more costs.

Hawaii legalized abortion in 1970, three years before Roe. The state today allows abortion until a fetus would be viable outside the womb. After that, it’s legal if a patient’s life or health is in danger.

Flying to a country in Asia that allows abortion would be quicker, but several reproductive rights advocates on Guam said they hadn’t heard of anyone doing that. For one, it would require a passport, which many don’t have, said Kiana Yabut of the group Famalao’an Rights.

Without Roe, Guam could revert to an abortion ban dating to 1990. The 9th U.S. Circuit Court of Appeals ruled the law unconstitutional in 1992, but it has never been repealed.

James Canto, Guam deputy attorney general, agreed under questioning by a Guam senator this month that existing abortion laws in various states and territories would “be the law of the land” if Roe was overturned.

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