Abstract
ObjectivesTo determine trends for Georgia and contiguous state residents seeking abortions in Georgia between 1994 and 2016.MethodsWe analyzed aggregate vital statistics data, collected in Georgia, on Georgia residents (n = 675,995) and contiguous state residents (Alabama, Florida, North Carolina, South Carolina, Tennessee) (n = 76,232) obtaining abortion and delivery services in Georgia between 1994 and 2016. We examined demographic, pregnancy, and abortion characteristics using counts, ratios, and χ2 tests of proportion.ResultsOf the data analyzed, 10.1% of all abortions were for contiguous state residents. The number of abortions in Georgia for contiguous state residents increased 35.3% from 1994 to 2016 (from n = 3115 to n = 4216) while it decreased for Georgia residents by 11.1% (from n = 32,934 to n = 29,264). Contiguous state residents exhibited a higher abortion ratio (1115) compared to Georgia women (224). These populations exhibited statistically significant differences across all variables and time points. Both populations demonstrated similar trends in ethnicity, race, education, marital status, and age. However, contiguous state residents were more likely to obtain an abortion at ≥ 20 weeks gestational age (13.8%) and obtained a lower proportion of suction curettage abortions (60.0%) and a higher proportion of dilation and evacuation procedures (31.9%). They were also less likely to be primigravid.Conclusions for PracticeWomen from neighboring states seek abortions in Georgia later in gestation and may therefore lack affordable, safe, early abortion care in their home states. Understanding trends in travel for abortion can allow providers and policymakers to better respond to the needs of patients.
Highlights
Patients seek a variety of health care services outside of their state of residency, whether due to proximity, quality of care, service availability, anonymity, or related factors—abortion is one of these services (Jatlaoui et al 2018)
We examined surveillance data in Induced Termination of Pregnancy (ITOP) and Birth files from the Georgia Depart‐ ment of Public Health (GDPH) between 1994 and 2016; all data included in this study refer to events that occurred in Georgia
We analyzed 752,227 abortions in Georgia between 1994 and 2016, 675,995 (89.9%) for Georgia residents and 76,232 (10.1%) for contiguous state residents. 35.3% more women from contiguous states received abortion services in Georgia in 2016 than in 1994 (3115 to 4216), trends in individual states varied
Summary
Patients seek a variety of health care services outside of their state of residency, whether due to proximity, quality of care, service availability, anonymity, or related factors—abortion is one of these services (Jatlaoui et al 2018). In the first quarter of 2019, 28 states introduced abortion ban legislation, seven of these bills passed at least one state legislative chamber, and in three states they became law (Nash et al 2019). These bills included trigger bans to outlaw abortion if Roe v. Gestational age bans, reason bans (based on fetal characteristics), and bans on certain abortion proce‐ dures (Ibid 2019). Such differences in policies may lead to unequal access to abortion services based on a woman’s state of residency
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