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Patients Are Traveling for Abortions. How Does It Affect Care Access?

With one in five patients seeking abortion traveling out of state to get it, policymakers examine the longevity of abortion funds and the surge states absorbing these patients.

New data out of the Guttmacher Institute shows that nearly one in five patients seeking an abortion are traveling out of state to get it, calling into question the accessibility of the procedure.

The report, which looked at data from the first six months of 2023 and compared it to the same pre-Dobbs period of 2020, showed that people are going to states that border those with total abortion bans or early gestational bans.

“We knew that more people have been traveling across state lines for abortion since the end of Roe, but these findings are stunning nonetheless, and powerfully illustrate just how disruptive the overturning of Roe has been for tens of thousands of abortion patients,” Isaac Maddow-Zimet, data scientist at Guttmacher and project lead, said in a press release.

“Where people are traveling to get care is an important piece of the puzzle in untangling the post-Dobbs abortion landscape,” Maddow-Zimet added. “We hope that this data can prove useful to providers, advocates and policymakers who have been working tirelessly to improve access to abortion in the face of unprecedented challenges.”

The states with the highest number of patients traveling for abortion care included Florida, Illinois, Kansas, New Mexico, and North Carolina.

But the abortion access landscape is ever-changing, and patients now have fewer options for out-of-state abortion access than even during the study period. On July 1, North Carolina instituted a 12-week abortion ban, which resulted in a 31 percent reduction in abortion access the month after.

Those figures rebounded, although likely due to another state’s more extreme law. In South Carolina, a more restrictive, six-week abortion ban pushed around 600 more patients to travel to North Carolina to get the procedure, the Guttmacher analysis showed.

These figures call into question whether abortion care will remain accessible. The impact abortion bans have within the state are clear. Patients seeking the procedure have to travel out of state, which can be expensive and logistically difficult. Separate studies have found that long travel distances can be a key barrier to abortion care.

There is also the question of legal hurdles. Murky laws governing interstate travel for abortion care have made some healthcare providers hesitant to perform the procedure on patients from out-of-state. There is some headway in this area, as state shield laws work to protect patients and their providers from legal ramifications in these instances.

“Policies that protect and expand access, such as those that permit any qualified health care provider—not just physicians—to offer abortion care or shield laws that protect providers from criminal investigation from hostile states, have been critical in helping states meet patients’ needs,” Kelly Baden, vice president for public policy at Guttmacher, said in a statement. “We must also acknowledge the role that abortion funds and other support networks have played in helping people overcome the numerous financial and logistical barriers that traveling for abortion care entails. Their heroic efforts often make the difference in whether someone obtains an abortion or is forced to remain pregnant. However, nothing can substitute for sound public policy that recognizes abortion as a critical, necessary component of basic health care that everyone deserves, regardless of where they live.” 

Still, there is the overall question of how interstate travel for abortion access impacts states where the procedure is still legal. With increased patient volumes, abortion providers may be squeezed to provide treatment to everyone who comes to the clinic.

According to an October 2023 analysis from the Society for Family Planning, these states—often referred to as surge states—are absorbing a lot of the patients traveling from states with abortion restrictions.

In particular, states with six-week or near-total abortion bans saw abortion access plummet by 114,590 procedures between July 2022 and June 2023 compared to baseline data from April and May 2022. That shakes out to 94,930 fewer abortions in states with near-total bans and 19,660 fewer abortions in states with six-week bans.

The states with the biggest decreases in abortion access include Texas (36,970 procedures), Georgia (19,660 procedures), Tennessee (13,930 procedures), Louisiana (9,110 procedures), Alabama (7,620 procedures), and Wisconsin (7,260 procedures).

Conversely, in states where abortion remained legal after six weeks, abortion access increased by a cumulative 116,790 procedures. The largest increases happened in Illinois (21,500 procedures), Florida (20,460 procedures), North Carolina (11,830 procedures), California (8,810 procedures), and New Mexico (8,640 procedures).

The impact of higher patient volumes remains to be seen. Assessing patient care access in surge states could be a key research area moving forward.

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