More women seek out-of-state abortions

ATLANTA - At a routine ultrasound when she was five months pregnant, Hevan Lunsford began to panic when the technician took longer than normal, then told her she would need to see a specialist.

Lunsford, a nurse in Alabama, knew it was serious and begged for an appointment the next day.

That’s when the doctor gave her and her husband the news: The baby boy they decided to name Sebastian was severely underdeveloped and had only half a heart. If he survived, he would need care to ease his pain and several surgeries. He might not live long.

Lunsford, devastated, asked the doctor about ending the pregnancy.

“I felt the only way to guarantee that he would not have any suffering was to go through with the abortion,” she said of that painful decision nearly three years ago.

But the doctor said Alabama law prohibits abortions after five months. He handed Lunsford a piece of paper with information for a clinic in Atlanta, a roughly 180-mile drive east.

Lunsford is one of thousands of women in the U.S. who have crossed state lines for an abortion in recent years as states have passed ever stricter laws and as the number of clinics has declined.

Although abortion opponents say the laws are intended to reduce abortions and not send people to other states, at least 276,000 women terminated their pregnancies outside their home state between 2012 and 2017, according to an analysis of data collected from state reports and the U.S. Centers for Disease Control and Prevention.

In New Mexico, the number of women from out of state who had abortions more than doubled in that period, while Missouri women represented nearly half the abortions performed in neighboring Kansas.

“The procedure itself was probably the least traumatic part of it,” Lunsford said. “If it would have been at my hospital, there would have been a feeling like what I was doing was OK and a reasonable choice.”

While abortions across the U.S. are down, the share of women who had abortions out of state rose by half a percentage point, and certain states had notable increases over the six-year period.

In pockets of the Midwest, South and Mountain West, the number of women terminating a pregnancy in another state rose considerably, particularly where a lack of clinics means the closest provider is in another state or where less restrictive policies in a neighboring state make it easier and quicker to terminate a pregnancy there.

“In many places, the right to abortion exists on paper, but the ability to access it is almost impossible,” said Amy Hagstrom Miller, CEO of Whole Women’s Health, which operates seven abortion clinics in Maryland, Indiana, Texas, Virginia and Minnesota. “We see people’s access to care depend on their ZIP code.”

Thirteen states saw a rise in the number of out-of-state women having abortions between 2012 and 2017.

In Illinois, the percentage of abortions performed on non-residents more than doubled to 16.5% of all reported state abortions in 2017. That is being driven in large part by women from Missouri, one of six states with only a single abortion provider.

Even that provider, in St. Louis, has been under threat of closing after the state health department refused to renew its license. Missouri lawmakers also passed a law this year that would ban almost all abortions past eight weeks of a pregnancy, but it faces a legal challenge.

About 10 miles from St. Louis, across the Mississippi River, is the Hope Clinic in Granite City, Illinois, which has seen a 30% increase in patients this year and has added two doctors, deputy director Alison Dreith said.

About 55 percent of its patients come from Missouri, and it also sees women from Indiana, Kentucky and Ohio. All those states have mandatory waiting periods to receive an abortion, a requirement Illinois does not have.

Dreith called it a scary time for women in states with highly restrictive laws and few clinics.

“The landscape that we’re seeing today did not happen overnight, and it was not by accident,” she said.

Between 2011 and May 31 of this year, 33 states passed 480 laws restricting abortion, according to ?the Guttmacher Institute, a research organization that supports ?abortion rights.

The most high-profile restrictive laws, which face legal challenges that could eventually test the U.S. Supreme Court’s Roe v. Wade decision, would ban abortion after a fetal heartbeat can be detected - as early as six weeks.

Advocates say that if the Supreme Court upholds the latest restrictions, it will become more common for women to seek an abortion in another state.

“The intent of these lawmakers is to completely outlaw abortion and force people not to have abortions. But in reality, it pushes people farther and wider to access the care they want and need,” said Quita Tinsley, deputy director of Access Reproductive Care Southeast.

Abortion opponents say the intent of laws limiting the procedure is not to push women to another state but to build more time for them to consider their options and reduce the overall number of abortions.

“I have been insistent in telling my pro-life colleagues that’s all well and good if the last abortion clinic shuts down, but it’s no victory if women end up driving 10 minutes across the river to Granite City, Illinois, or to Fairview Heights,” said Sam Lee, director of Campaign Life Missouri and a longtime anti-abortion lobbyist.