DE FACTO ABORTION BAN….The reality that women seeking abortions in conservative states often have enormous practical hurdles to clear is not new, but this front-page Washington Post piece was nevertheless helpful in capturing the difficulties women who want to end their pregnancies face in South Dakota.

The waiting room at the Planned Parenthood clinic was packed by the time the doctor arrived — an hour late because of weather delays in Minneapolis.

It was clinic day, the one day a week when the only facility in South Dakota that provides abortions could take in patients. This time it was a Wednesday. The week before it was a Monday.

The day changes depending on the schedules of four doctors from Minnesota who fly here on a rotating basis to perform abortions, something no doctor in South Dakota will do. The last doctor in South Dakota to perform abortions stopped about eight years ago; the consensus in the medical community is that offering the procedure is not worth the stigma of being branded a baby killer.

South Dakota is one of only three states to have only one abortion provider — North Dakota and Mississippi are the other two — but at nearly 76,000 square miles, the Mount Rushmore State is the biggest of the three. What’s more, the state’s lone clinic offers abortions once a week, but which day each week depends on when out-of-state doctors will visit.

Of course, South Dakota is also home to some of the nation’s poorest counties, which makes it awfully difficult for women with meager resources to travel several hundred miles.

In this environment, the fight over Roe is secondary to a de facto ban on abortion that’s already in place.

Steve Benen

Follow Steve on Twitter @stevebenen. Steve Benen is a producer at MSNBC's The Rachel Maddow Show. He was the principal contributor to the Washington Monthly's Political Animal blog from August 2008 until January 2012.