Across the United States abortion numbers are dramatically shifting as patients from restrictive states turn to out-of-state providers. The #WeCount reporting effort is documenting these shifts in a year-long study to indicate the need for access to safe healthcare. Graphic by Society of Family Planning and #WeCount

On June 24, 2022, with the stroke of a pen, over 25 million Americans lost access to a critical healthcare service: abortion.

When the United States Supreme Court decided by a 6-3 vote, that abortion is not a constitutional right in the Dobbs v. Jackson Women’s Health Organization case, states were granted the authority to regulate abortion access. In the aftermath, 13 states enacted complete bans forcing residents to seek out-of-state providers, self-manage, or carry to term.

In an Oct. 28 report compiled by the #WeCount reporting effort, since Dobbs, Colorado providers have collectively reported a 33% increase in abortions, whereas providers in banned states like Texas saw a staggering 100% decrease in services.

“Each one of those data points represents a devastating loss to the people and families who couldn’t access abortion in the state where they live,” said Dr. Alison Norris, #WeCount co-chair and associate professor at the Ohio State University College of Public Health. “States like Colorado, which did not have restrictions against abortion care, saw these increases as people from other states drove where they could have an abortion.”

Supported by the Society for Family Planning, #WeCount analyzes abortion volume shifts by state based on the responses of 79% of all U.S. abortion providers. The year-long study began pre-Dobbs in April 2022, and Dr. Norris and #WeCount Co-Chair Dr. Ushma Upadhyay will continue gathering data through March 2023.

Thus far, the #WeCount analysis presents a sobering reality.

“The increases in some states were insufficient to account for the decreases in other states,” said Dr. Norris. “We came to this estimate that there were 10,000 fewer abortions in July and August than we would have expected compared to the numbers that we see in April.” She continued, “There are about 5,000 per month fewer abortions post-Dobbs as compared to pre-Dobbs.”

While Colorado providers have been supporting travelers for months because of restrictive laws like Texas’s September 2021 Senate Bill 8, that banned abortions after fetal heart activity detection, or about six weeks, the Dobbs decision significantly increased the need for services.

According to the Colorado Department of Public Health and Education, in 2021, travelers accounted for 13.6% of all Colorado abortions. As of Sept. 2022, that number skyrocketed to 40%, prompting providers to quickly adapt by extending hours and staffing for expanded care, said Dr. Norris.

At Planned Parenthood of the Rocky Mountains, Medical Director Dr. Kristina Tocce noted a significant increase in out-of-state patients, specifically those with life-threatening complications forced to travel because of wary providers.

“If you have restricted a medical service so much, it ends up clouding clinical judgment,” said Dr. Tocce. “There’s a whole population of providers who are uneasy … and that should never be involved when you are trying to make medical decisions with patients.”

Consequences of restricted access

Both Dr. Norris and Dr. Tocce agree that restricting abortion access will have detrimental effects on longterm public health.

For individuals who are able to travel, the burden of driving long distances and staying overnight causes financial set-backs and a delay in care; and individuals unable to travel might lose the ability entirely because of financial insecurity, age, caring for dependents, or other forms of systemic oppression that create barriers to travel.

As restrictions continue, Dr. Tocce said that favorable maternal health outcomes will decrease over time.

Already, a December 2021 study, published in Demography by Dr. Amanda Jean Stevenson, assistant professor at Colorado University at Boulder, estimated that after a one-year abortion ban, maternal deaths will increase 21%. Deaths for Black patients will increase 33%, the highest of any demographic.

“Overall, denying all wanted induced abortions in the United States would increase pregnancy-related mortality substantially, even if the rate of unsafe abortion did not increase,” the report noted.

Removing the debate

Regardless of one’s position on abortion, the choice to have a common medical procedure should only be decided by the pregnant individual.

In the Roaring Fork Valley, residents have the option to consider their decision with medical professionals and advocates who best fit their circumstances.

At Planned Parenthood in Glenwood Springs, comprehensive healthcare, including birth control, pregnancy tests and abortion services such as the pill and medical procedures are available for patients. The Pregnancy Resource Center, a faith-based nonprofit organization, also offers patients free healthcare such as pregnancy and STD testing in addition to counseling, and will connect patients to local agencies when necessary. Both organizations provide confidential and non-judgemental services.

“People agree they want to make the most informed choice they can, and desire an education that is pertinent to their situation,” said Marylu Sim, executive director of the Pregnancy Resource Center. “It really is that simple. Beyond education is support. Many of us don’t have extended family to come alongside us, and we have the opportunity to give spiritual, emotional and practical counsel as they desire.”

For medical professionals and advocates alike, keeping patients’ well-being at the core of care is most pertinent.

“We need to take [abortion] away from the debate and instead talk about the people at the heart of it,” said Dr. Norris. “So many people need abortions. Hundreds of thousands of people have an abortion in the United States every year, and it’s the stigma around it that makes it so much more stressful than other types of important care that you need in a timely way.”

She continued, “We need to put the humanity of the people at the center of the conversations.”

Please visit www.societyfp.org/wecount to learn more about the #WeCount report.