[An increasing number of women are traveling out of state for
reproductive healthcare. This journey isn’t without very real
obstacles. The most tragic part is much of the associated trauma is
preventable if we just had access to local healthcare.]
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TRAVELING FOR ABORTIONS: THE UNTOLD STORY  
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Katelyn Jetelina
December 14, 2023
Your Local Epdemiologist
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_ An increasing number of women are traveling out of state for
reproductive healthcare. This journey isn’t without very real
obstacles. The most tragic part is much of the associated trauma is
preventable if we just had access to local healthcare. _

Kate Cox was forced to leave Texas to obtain an emergency procedure
forbidden by the state's strict abortion law, image: screen grab

 

This week, Kate Cox got an abortion. She joined more than 9.3 million
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who got a legal abortion in the past 10 years, of which 83,00
[[link removed]]0 (0.9%) got
one after 20 weeks of gestation.

I’ve seen many on social media wonder: _What’s the big deal? She
found the healthcare she needed after all, right? And this cross-state
journey is rare, right?_

Forced abortion travel has doubled
[[link removed].] following _Dobbs_.
And if you’re one of the lucky few who can travel, this journey
isn’t without very real challenges that may not be apparent to the
unseen eye.

The journey

The journey for an abortion looks very different depending on who you
are. In general, though, many challenges could be prevented if we, as
a society, accepted abortion as healthcare.

First, many people’s journeys stop before they begin:

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It takes a lot of cash—plane tickets, rental car, hotel rooms, food,
and procedure. This adds up to about $10,000-$30,000. As you can
imagine, many people can’t afford this, and often,
insurance doesn’t
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it.

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Half
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all abortion seekers live below the Federal Poverty Level—an income
of less than $13k/year.

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This is especially true for adolescents and teens (who make up a big
number of later abortion patients), undocumented people, and parents.

If they make the journey, it’s not without other hard realities
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Pain meds are available
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For those later in pregnancy, though, it doesn’t do much. You may
not have access to an epidural, depending on the state’s
regulations, because you’re at an outpatient clinic. This is
unimaginable pain—in all senses of the word.

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Your partner can’t be there to support you during labor, like hold
your hand, or coach you through pain. You can’t have a phone,
either. Tight security is required at abortion clinics. In the same
vein, you walk past protesters yelling at you every morning and every
night for a week. You wish, with all your heart, you could enjoy the
same level of ignorance.

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Recovering in a hotel room means a cold, unfamiliar place. Without
your slippers, without your bed, without your cat, and without access
to the comfort food you crave. All you want to be is at home.

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The journey means needing time off from work and getting your FMLA
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physician in another state. All you hope is that your employer won’t
ask questions because you don’t have any energy to explain.

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The journey may include carrying the baby’s ashes on an airplane.
This requires holding back a flood of emotions in public—exhaustion,
grief, anxiety, pain, a strong desire for privacy.

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People who have abortions are no more likely
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struggle with mental health than the people who do not—in
fact, _not_ getting a needed abortion has been found to increase
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and depression in the first 12 months. But there are emotional costs
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needing to travel, and much of that is driven
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stigma and ostracization of abortion care. Also, recognizing when you
need help (remember you don’t have a follow-up appointment with your
OB) and finding the right clinician or therapist, given the unique
circumstances and the trust required, is hard.

Two things help:

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The confidence in making the right decision: 95%
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people who have an abortion say it was the right decision for them.
The most common emotion
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afterward is relief.

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The healthcare workers—literally angels on earth—at the abortion
clinic ensure moments of human connection, empathy, and support.
You feel cared for
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which helps tremendously. And the rare souls you trust with your story
like family, friends, and clinicians thereafter also help
tremendously.

Travel for abortions is increasing

This journey is becoming more common. Before _Dobbs_, 1 in 10
[[link removed].] women
having abortions had to travel. Now it’s double— 1 in 5
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We see increased travel from many angles:

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While the number of abortions across states has greatly shifted 
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the national average hasn’t budged.

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Calls
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the National Abortion Hotline for travel services, like hotel rooms
and plane tickets, have tripled post-_Dobbs_ and remain high.

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National Abortion Federation. Source here
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Scientists who measured distance to abortion facilities found travel
time increased, on average, by three times
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In Texas, for example, the new travel time to the nearest abortion
facility increased by almost a full workday.

This speaks to why we see increases in self-managed abortion (i.e.,
medication abortion). It’s also why colleagues in Latin America, for
example, have been supporting people to self-manage with pills up to
24 weeks of pregnancy, which is safe and effective
[[link removed]].

Bottom line

An increasing number of women are traveling out of state for
reproductive healthcare. This journey isn’t without very real
obstacles. The most tragic part is much of the associated trauma is
preventable if we just had access to local healthcare.

It may be hard to understand, but it’s harder for people to live
through. Trust women. Listen to their stories. Trust their voices. It
is, after all, their lives and their livelihoods.

Love, YLE

If you want to support travel for abortions, here are some great
options.

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The Brigid Alliance [[link removed]] supports people who
are traveling for abortions at 15+ weeks.

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National Network of Abortion Funds [[link removed]] a
collective of over 100 abortion funds across the United States. 

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Jane’s Due Process [[link removed]] funds abortion
and practical support for Texas teens traveling for abortion care

_A big thank you to Dr. Heidi Moseson — a reproductive
epidemiologist— who helped immensely with much of the piece’s
research._

_“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn
Jetelina, MPH PhD—an epidemiologist, data scientist, wife, and mom
of two little girls. During the day, she works at a nonpartisan health
policy think tank and is a senior scientific consultant to a number of
organizations. At night she writes this newsletter. Her main goal is
to “translate” the ever-evolving public health science so that
people will be well-equipped to make evidence-based decisions. This
newsletter is free thanks to the generous support of fellow YLE
community members. To support this effort, subscribe to Your Local
Epidemiologist [[link removed]]._

* abortion
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* Reproductive rights
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* texas
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