Last year, more than 14,000 Texas patients crossed the border into New Mexico for abortions. Another 16,000 left the southern states bound for Illinois. And nearly 12,000 more traveled north from South Carolina and Georgia to North Carolina.
These were among the more than 171,000 patients who traveled for abortions in 2023, according to the new estimates, demonstrating both the upheaval in access since the overturning of Roe v. Wade and the limits of state bans to stop the procedure. The data also highlights the unstable nature of an issue that will test politicians at the polls in November.
Out-of-state trips for abortions – whether to undergo a procedure or obtain abortion pills – more than doubled in 2023 compared to 2019, and accounted for nearly a fifth of recorded abortions. On Thursday, the Supreme Court rejected a case that would have sharply restricted access to medication abortion, allowing the pills to remain available to patients traveling from states with bans.
Most patients who traveled went to the next closest state that allowed abortions. But those in the south, where 13 states banned or restricted the procedure, had to go further.
One of the travelers was a 24-year-old woman from Columbus, Georgia, who asked to be identified only by her first initial, A. She flew to New York last summer after discovering she was past six weeks pregnant, when Georgia was no longer pregnant. allows abortion.
She decided to travel for a weekend instead of self-managing with pills at home. “I had to go back to work on Monday,” she explains. “I just didn’t have that much time.”
Texas, the largest state to ban abortion, had the most residents cross state lines to undergo the procedure, the data shows.
As for recipients, nowhere were more out-of-state patients seen – and from more states – than in Illinois.
People from states where the procedure was still legal also traveled for abortions, sometimes because the nearest clinic was across state lines or because the influx of out-of-state patients made appointments scarce. The data shows that abortions increased in almost every state where they remained legal.
Many patients faced multi-day travel, loss of income and childcare expenses. Some patients were unable to travel. Previous research found that in the first half of 2023, nearly a quarter of women living in states with near-total bans — who might otherwise have sought an abortion — did not get one.
“Abortion is one of the most common procedures in medicine,” said Amy Hagstrom Miller, founder of Whole Woman’s Health, which runs clinics in Maryland, Minnesota, New Mexico and Virginia.
“We make people travel hundreds or thousands of miles for a procedure that usually takes less than 10 minutes and can be done in a doctor’s office,” he explained. “No one does that for any other medical procedure.”
The new estimates of in-state and out-of-state abortions come from the Guttmacher Institute, a research organization that supports abortion rights, and offer the first detailed picture of the interstate travelers who helped push the number of abortions nationwide to a maximum in 2023. The researchers surveyed a sample of clinics in each state where abortion remained legal to estimate the number of abortions.
For some anti-abortion groups, the sense of victory after the overturning of Roe has been clouded by the number of people circumventing abortion bans, and by the lack of political will to address the issue in an election year.
“We’re stirring up some of the Republicans who would be very comfortable kicking the can down the road, patting themselves on the back, running for re-election and then focusing on other issues that matter more to them,” said John Seago, president of Texas Right to Life.
“We have never had a sense of finality. We have only seen the other side intensify their efforts to promote abortion,” he added.
The availability of abortion pills has considerably blunted the impact of many state bans. But some patients still have to travel to see a professional due to their health or the advanced stage of their pregnancy. Others simply prefer it.
“I didn’t want them to hand me the pills at school,” said Mia, a 20-year-old college student from Houston who asked to be identified only by her first name. Instead, last August she drove 12 hours to an Albuquerque clinic. “In case something went wrong, I didn’t know if I could go to a hospital,” she said. “I thought it would be best to go in person and then I would know it was solved.”
The clinic covered the cost of the procedure, but Mia paid about $500 for gas, two nights in an Airbnb, and Uber rides to and from her appointment.
The explosion of out-of-state travel has been met with support from abortion clinics and abortion funds, which expanded access to services and financial support for patients.
“We now have places where people who have been driving all night can nap in our clinics,” Ms. Hagstrom Miller said. “We have couches. We have specific waiting rooms for kids, with toys. We bring snacks and food.”
States with liberal abortion laws have also played an important role.
“It appears that the protective policies that states enact do matter,” said Kelly Baden, vice president of public policy at the Guttmacher Institute. “But we shouldn’t normalize reliance on networks of volunteers and donations.”
Illinois has invested more than $23 million to expand access to abortion and reproductive health care since 2022. State providers have expanded clinic hours and increased staffing and availability of abortion services in hospitals.
“Things are going very well,” said Dr. Allison Cowett, medical director at Family Planning Associates, a Chicago clinic whose patient volume has doubled since 2018. “We’ve caught up with the speed of things. “This is our new normal.”
The Chicago Abortion Fund provides, on average, about $880 to each patient seeking an abortion in Illinois, up from about $545 in 2022, thanks to donations and grants from the city and state.
“It still feels precarious: You don’t know when the priority of a single institution or a single foundation will change,” said Megan Jeyifo, the fund’s executive director.
In Florida, the fight over abortion restrictions is far from over, with consequences for women across the South. Last year, the number of abortions in the state increased 18%, including nearly 10,000 out-of-state patients.
The six-week ban that went into effect in May has already altered these patterns, and abortion advocates are asking voters to preserve abortion rights in the state Constitution in November.
For now, the closest state that offers abortions after six weeks of pregnancy is North Carolina, which requires counseling and a 72-hour waiting period.
“It’s a logistical nightmare,” says Kelly Flynn, CEO of A Woman’s Choice, which has clinics in Florida, North Carolina and Virginia. To save patients two trips out of Florida, the doctors at their Florida clinic are licensed in North Carolina, so they can perform the required counseling before the patient travels north.
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