Abortion clinics across the country have had to either move across state lines or take on out-of-state clients since the Dobbs v. Jackson Women’s Health Organization decision from the Supreme Court overturned the right to reproductive care at the federal level. Eleven states have completely outlawed abortion—many without exceptions even for rape or incest—resulting in pregnant people across the country fleeing to other states for reproductive services.
Providers in states where abortion is still legal are facing backlogs—an issue that is resulting in procedures being performed later in pregnancy than necessary or ideal, Axios reported. Later-term abortions require more intensive care, and the associated costs are higher for both patients and providers.
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The issue isn’t limited to the financial costs and risks, but to the lack so resources, as well. Later-term procedures are also harder to obtain because "as pregnancy progresses, the number of people who are skilled to provide that care further goes down," Colleen McNicholas, chief medical officer at Planned Parenthood of the St. Louis Region and Southwest Missouri, told Axios.
According to the Centers for Disease Control and Prevention, about 93% of reported abortions in 2019 were performed at or before 13 weeks of pregnancy, 6% were conducted between 14 and 20 weeks, and 1% were performed at or after 21 weeks. As clinics continue to struggle with higher demand, experts believe such abortions performed after the 13th week of pregnancy are likely to increase.
According to Spectrum News, states like New Mexico—where abortion is still legal—have seen an increase related to individuals coming from Texas for care. After the Texas Heartbeat Act went into effect, the number of out-of-state women seeking care at the University of New Mexico’s Center for Reproductive Health surged. About 80% of the center’s patients are now from out of state, compared to the 20% of out-of-state patients the center saw before the law was passed.
“We have already reached capacity," said Dr. Amber Truehart, Medical Director at the Center for Reproductive Health at the University of New Mexico. "What's going to happen is any of those additional women from Texas who now can't get care there are going to have to look even further away."
But the clinics near Texas are not alone. Nationwide, many facilities are averaging about 500 calls a day—on top of the backlog of patients they are already trying to provide care for.
An Illinois clinic told Axios that patients from states other than Missouri and Illinois make up 40% of their cases, compared to 5% before the federal right to abortion was struck down.
Other clinics have expressed similar increases in out-of-state patients.
"You know, we can't answer that many calls, obviously, and that's far more appointments that are needed than we actually have available,” said Zack Gingrich-Gaylord, communications director for the Trust Women Foundation, which operates reproductive health care clinics in Wichita, Kansas, and Oklahoma City, Oklahoma. “We very much feel that presence of those people who we’re not able to talk to, who are not able to get an appointment in our clinic.”
The Trust Women clinic told NPR that the number of abortions performed increased from 800 in the first six months of 2021 to over 1,300 during the same period in 2022.
According to Axios, the average wait time for an out-of-state abortion appointment has increased from two to three days to two to three weeks. Due to abortion bans closing clinics in several states. Individuals are not only forced to wait for appointments due to limited resources and space available but bear the risk associated with traveling.
Doctors and abortion rights advocates told Spectrum News that traveling is taking an "emotional toll" on patients in their communities and "uprooting" the lives of women.
“The very beginning of my appointments with them is just trying to reassure them that I'm not judging them. Right? (That’s) not things that I believe. That I'm sorry that they had to go through this amount of trauma, just to get basic medical care,” Truehart told Spectrum News.
According to the Guttmacher Institute, a reproductive health research group, more than 20 states are “certain or likely” to ban or limit abortion due to the overturn of Roe v. Wade, while 16 states have laws that protect the right to abortion. This link shows how far patients in each state have to drive to access reproductive care.
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Read related: End of Roe era: Clinics forced to move across state lines, rape victims denied abortions