Abortions in Alabama fell from more than 500 terminations in June to fewer than 10 each month following the U.S. Supreme Court’s decision to overturn Roe vs. Wade on June 24, according to a new report.

The number of abortions was in decline in the state before the court removed national protections for the procedure, according to researchers with the Society of Family Planning, which advocates for contraception and abortion. The same day of the federal court’s ruling, a federal judge lifted an injunction on Alabama’s 2019 abortion ban, which makes abortion illegal unless the pregnancy poses a serious risk to the patient’s health without exception for rape or incest.

It is not clear whether the estimated 10 abortions performed monthly in July and August reflect cases that would or would not be considered illegal under the new law.

Across the United States, 10,670 fewer people had abortions in July and August.

The report cited a 6% decrease in abortions nationally from April to August.

The south central region of the U.S., which includes Alabama, saw a 96% decrease in abortions overall from April to August, according to the report.

In 2020, Alabama’s five clinics provided 5,713 abortions, many of which were medication abortions. In 2021, Alabama’s clinics provided 6,489 abortions. Overall, 8,294 abortions were administered to Alabamians, including in-state procedures, in 2021.

Some people who did receive abortions this summer and fall likely had to travel across state lines, researchers noted.

Alabama Attorney General Steve Marshall’s office said in June that officials were considering whether aiding an Alabamian in traveling to receive an abortion was legal. To date, no decisions have been publicly revealed. The attorney general’s office did not immediately respond to a request for comment Tuesday.

The report also claimed that some patients may have a harder time accessing out-of-state abortions.

“The burdens of travel, cost and time are experienced inequitably: people who have low incomes, who must travel further and who experience other intersecting forms of structural oppression will experience more difficulties in obtaining care both in- and out-of-state,” researchers wrote.

The same states that experienced declines in abortions had the “greatest structural and social inequities in terms of maternal morbidity and mortality and poverty,” the report read.

Alabama’s most recently reported maternal mortality rate was 36.4 per 100,000 live births, ranking third worst in the U.S. The state’s most recent maternal mortality report revealed that two-thirds of mothers who died within a year of giving birth used Medicaid.

The state’s infant mortality rate is 6.99 deaths per 1,000 live births, totaling 403 deaths in 2020 and ranking sixth worst in the nation. Fayette, Greene, Tallapoosa, Lowndes, Conecuh, Clarke and Washington counties all have at least 15 infant deaths per 1,000 live births, according to data from the Alabama Department of Public Health. The department also reported that, in 2020, Black babies died at twice the rate of white babies.

Alabama has had an infant mortality reduction plan in place since 2018.

Sarah Swetlik is a gender and politics reporter at AL.com. Her staff position is supported through a partnership with Report for America. Contribute to support her work here.