Abortion Travel Within the United States: An Analysis of Cross-State Movement to Obtain Abortion Care in 2018

Abstract

Background: In the United States, pregnant people seeking an abortion often travel in order to access care. Abortion access is often more limited for people who live in states with few abortion facilities and restrictive abortion legislation. Methods: We computed state-specific abortion rate (number of abortions per thousand women ages 15-44) with CDC 2018 Abortion Surveillance data and Census data. We calculated percentage of abortion patients leaving their state of residence for abortion care for each state using the CDC’s 2018 Abortion Surveillance data. We categorized percent leaving by policy restrictiveness using NARAL’s classification of restrictiveness of state abortion laws. We categorized percent leaving by “facility density” (number of abortion facilities per million women ages 15-44), calculated using Census data and ANSIRH’s Abortion Facility Database. We created a map of percent leaving by state and a scatterplot of percent leaving against facility density. Thirty-nine states with high quality data are included in our analysis. Findings: In 2018, an average of 8% of US patients left their state of residence for abortion care. Percent leaving varied widely by state: 59% left South Carolina, 53% South Dakota, 46% Mississippi, and 42% Kentucky, while 5% or fewer of patients left from 16 of the states we evaluated. States with more restrictive laws averaged 9% of patients leaving, while states with less restrictive or more protective laws averaged 4% of patients leaving. States in the bottom quartile for facility density averaged 32% leaving, while states in the top quartile averaged 2% leaving. Interpretation: Many patients travel across state lines for abortion care. Restrictive state-level abortion policy and facility scarcity may play a role in patients leaving their state of residence. Funding: This study was supported by a philanthropic foundation that makes grants anonymously. Funding: This study was supported by a philanthropic foundation that makes grants anonymously. The Declaration of Interest: The authors have no conflicts of interest to report.