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171,000 Traveled for Abortions Last Year. See Where They Went.

By Molly Cook Escobar, Amy Schoenfeld Walker, Allison McCann, Scott Reinhard and Helmuth Rosales

Source: The Guttmacher Institute

Orange states had a total or six-week ban in 2023.

More than 14,000 Texas patients crossed the border into New Mexico for an abortion last year. An additional 16,000 left 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 an abortion in 2023, new estimates show, demonstrating both the upheaval in access since the overturn of Roe v. Wade and the limits of state bans to stop the procedure. The data also highlights the unsettled nature of an issue that will test politicians up and down the ballot in November.

Out-of-state travel for abortions — either to have a procedure or obtain abortion pills — more than doubled in 2023 compared with 2019, and made up nearly a fifth of recorded abortions. On Thursday, the Supreme Court rejected a case that would have sharply curtailed access to medication abortion, allowing the pills to remain available to patients traveling from states with bans.

Where patients traveled for abortions

Source: Guttmacher Institute

Note: Map reflects abortion laws as of Dec. 31, except in Wisconsin, where a ban was in place for a majority of the year. Routes with fewer than 100 patients are not shown.

Most traveling patients 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 farther.

One traveler was a 24-year-old woman from Columbus, Ga., who asked to be identified by only her first initial, A. She flew to New York City last summer after discovering she was past six weeks of pregnancy, when Georgia no longer allows abortion.

She decided to travel over a weekend instead of self-managing with pills at home. “I had to go back to work on Monday,” she said. “I just didn’t have that kind of time.”

Texas, the largest state to ban abortion, had the most residents travel across state lines for the procedure, the data shows.

An exodus from Texas

Source: Guttmacher Institute

Note: Routes with fewer than 100 patients are not shown.

On the receiving end, nowhere saw more out-of-state patients — and from more states — than Illinois.

An island of access in the Midwest

Source: Guttmacher Institute

Note: Routes with fewer than 100 patients are not shown.

People in states where the procedure remained legal also traveled for abortions, sometimes because the closest clinic was across state lines or the influx of out-of-state patients made appointments scarce. The data shows that abortions rose in nearly every state where they remained legal.

Many traveling patients faced multiday trips, lost income and child care costs. Some patients were unable to travel. Earlier research found that in the first half of 2023, almost a quarter of women living in states with near-total bans — who may have otherwise sought an abortion — did not get one.

“Abortion is one of the most common procedures in medicine,” said Amy Hagstrom Miller, the founder of Whole Woman’s Health, which runs clinics in Maryland, Minnesota, New Mexico and Virginia.

“We’re having people travel hundreds or thousands of miles for a procedure that typically takes less than 10 minutes and can be done in a doctor’s office setting,” she said. “Nobody does that for any other medical procedure.”

The new estimates of resident and out-of-state abortions come from the Guttmacher Institute, a research organization that supports abortion rights, and they offer the first detailed picture of the interstate travelers who helped push the number of abortions nationwide to a high 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 feeling of victory after the overturn of Roe has been dimmed by the number of people circumventing abortion bans — and the lack of political will to address the issue in an election year.

“We’re agitating some of the Republicans who would be very comfortable spiking the football, patting themselves on the back, running for re-election, and then focusing on other issues that they’re more interested in,” said John Seago, the president of Texas Right to Life.

“We’ve never had a sense of finality. We’ve only seen the other side escalate their efforts to promote abortion,” he added.

Change in abortions by state

State

Abortions 2023

Change from 2019

Nonresident share
Wyo.420385%18%
N.M.20,960369%71%
Kan.20,640206%69%
Va.34,610110%17%
Colo.25,210103%28%
S.C.9,04081%40%
Ill.90,54073%41%
Del.3,52072%8%
Nev.15,98061%16%
N.C.45,80056%35%
Mont.2,22038%10%
Utah4,11035%7%
Minn.14,62031%21%
Ore.11,93031%11%
Wash.24,22030%8%
Mich.37,51029%7%
Md.38,60029%21%
Alaska1,65025%3%
Vt.1,49025%26%
Hawaii3,91024%6%
Conn.14,79023%6%
Pa.37,85021%7%
N.J.58,38021%7%
Iowa4,15020%10%
Calif.179,61019%4%
Fla.85,22018%11%
Neb.2,54018%15%
N.H.2,45017%12%
Ohio23,75016%13%
Maine2,40014%6%
Mass.21,57013%6%
N.Y.130,80012%5%
R.I.2,9604%10%
Ariz.13,2202%3%
D.C.9,100-8%53%
Ga.33,500-16%24%
Ind.4,530-41%21%
Wis.870-88%1%
No results

Source: Guttmacher Institute

Note: No data was collected from 13 states that had near-total abortion bans for all of 2023. A ban was in place in Wisconsin for a majority of the year.

The availability of abortion pills has significantly blunted the impact of many state bans. But some patients still must travel to see a provider because of a medical condition or how far along they are in pregnancy. Others simply prefer it.

“I didn’t want the pills to get delivered to my school,” said Mia, 20, a college student in Houston who asked to be identified by only her first name. Instead, last August, she drove 12 hours to an Albuquerque clinic. “In case anything went wrong, I didn’t know if I could go to a hospital,” she said. “I figured it would be best to go in person and that way I’d know that it was taken care of.”

The clinic covered the procedure’s cost, but Mia paid around $500 for gas, two nights at an Airbnb and Uber rides to get 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.

“Now we have places where people who’ve been driving all night can nap in our clinics,” said Ms. Hagstrom Miller. “We have couches. We have waiting rooms specifically for children, with toys. We bring in sandwiches and food.”

States with liberal abortion laws have also played a significant role.

“It looks like the protective policies that the states are enacting do matter,” said Kelly Baden, the vice president for public policy at the Guttmacher Institute. “But we should not be normalizing the reliance on networks of volunteers and donations.”

Illinois has invested upwards of $23 million into expanding abortion access and reproductive health care since 2022. Providers in the state have extended clinic hours and increased staffing and the availability of hospital-based abortion care.

“Things are running along very smoothly,” said Dr. Allison Cowett, the medical director at Family Planning Associates, a Chicago clinic whose patient volume has doubled since 2018. “We’ve caught up to 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 around $545 in 2022, thanks to donations and city and state grants.

“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.

Despite restrictions, patients traveled across the Southeast

Source: Guttmacher Institute

Note: Routes shown are for patients traveling into and out of Florida, Georgia, North Carolina and South Carolina. Routes with fewer than 100 patients are not shown.

In Florida, the fight over abortion restrictions is far from over, with consequences for women across the South. The state had an 18 percent rise in abortions last year, including nearly 10,000 out-of-state patients.

A six-week ban that took effect in May has already upended those patterns, and advocates are asking voters to preserve abortion rights in the state’s Constitution in November.

For now, the closest state offering abortions later than six weeks in pregnancy is North Carolina, which requires counseling and a 72-hour waiting period.

“It’s a logistical nightmare,” said Kelly Flynn, the chief executive of A Woman’s Choice, which has clinics in Florida, North Carolina and Virginia. To save patients two trips out of Florida, physicians at her Florida clinic are licensed in North Carolina so that they can perform the mandatory counseling before the patient travels north.