Abortion clinics adjust to surge in demand in a post-roe world
Colorado’s abortion clinics have been adjusting to higher demand since the end of Roe vs. Wade more than a year-and-a-half ago, expanding their services to meet the needs of local and the increased numbers of out-of-state patients.
At the peak, shortly after the U.S. Supreme Court’s landmark decision in Dobbs vs. Jackson overturned the right to an abortion nationwide, about 40% of patients seeking abortions in Colorado were from out of state, said Fawn Bolak, regional director of communications at Planned Parenthood of the Rocky Mountains.
Last year, the average dropped to about 35% as patients learned more about their options for care in states closer to their homes, she said.
“This is our new normal,” Bolak said.
Most patients in the region who are seeking care from out of state come from Texas, which bans abortions except to save a mother’s life, so New Mexico is an easier drive, sometimes with shorter wait times now that some Texan providers have moved across the border, Bolak said.
Right after the Supreme Court ruling, patients seeking an abortion at Planned Parenthood’s 12 Colorado clinics had to wait about 28 days for an appointment, but now a more typical wait is five to eight days, she said.
Outside of Planned Parenthood, five other clinics offer abortion services in Colorado.
“If you’re a patient that’s seeking time-sensitive care, (a four-week wait) can be scary,” Bolak said.
The numbers started climbing even before the Dobbs decision, after Texas passed Senate Bill 8 banning abortions after five weeks of pregnancy in 2021, Bolak said. Since then, the number of patients receiving abortions at Planned Parenthood clinics in Colorado has gone up 26%, she said.
Planned Parenthood reduced the waiting time by training more providers to offer abortions, designating a team to help outof-state patients make arrangements and by moving some appointments, such as consultations with patients seeking birth control, to telehealth, Bolak said.
Bolak didn’t foresee another major spike in demand if the Supreme Court were to throw out the approval of mifepristone, one of two drugs used in most abortions, and said Planned Parenthood has enough of the other drug, misoprostol, to continue serving patients.
The medications are approved for abortions up to 10 weeks into pregnancy, and more than half of patients who received an abortion in 2020 used drugs, rather than surgery. Last year, a lower court in Texas ruled the U.S. Food and Drug Administration had improperly approved mifepristone, while a court in Washington state ruled the drug shouldn’t be subject to extra limits, setting up a judicial showdown.
Dr. Savita Ginde, CEO and chief medical officer at Boulder Valley Health Center, said that, post-dobbs, the clinic increased staff by about 25%, hiring providers, clinical support staff and more people to work in the call center and help patients coordinate travel logistics.
The center also plans to add weekend hours in the near future to help accommodate the two- to threefold increase in patients seeking abortions, she said.
Clinics also are working together in a way that they didn’t a few years ago, Ginde said. If they can’t see an abortion patient quickly, they’ll refer that person to another clinic with an opening, because the procedure is more complicated further into pregnancy, she said. She estimated people seeking both abortion and nonabortion care wait “several weeks” for an appointment at the Boulder Valley clinic, on average.
“We will talk to each other to see who can take care of that patient,” she said.
Clinics not only need to find more appointments for patients, but also will have to offer more financial assistance for the foreseeable future, Bolak said. She estimated Planned Parenthood of the Rocky Mountains gave about $1.2 million in patient assistance in the year before the Dobbs decision, but has handed out about $12 million to help with travel and related costs since the ruling came down in June 2022. While donations from the public allowed them to do that for now, it may not be sustainable in the long term, she said.
“It’s not reasonable for one state or a handful of states to provide reproductive health care for the entire country,” she said. “We should be very wary of getting comfortable in this environment.”
Not all abortion providers have been able to rapidly scale up operations, though.
Dr. Warren Hern, director of the Boulder Abortion Clinic, said that the number of women seeking help has gone up, but hiring staff and expanding the building to see more patients takes time. Hern said the clinic always had significant numbers of out-ofstate patients, because he — unlike most providers — sees women who are more than 22 weeks into pregnancy.
The number of women seeking care from the Boulder Abortion Clinic rose gradually as states passed restrictive abortion laws and doctors became afraid of prosecution or losing their medical licenses, Hern said. Previously, at least some women facing complications or who learned their fetuses wouldn’t survive could get abortions even if they lived in red states, he said.
“You went from having abortion in 50 states to having abortion in half of 50 states,” he said. “Women who have a desired pregnancy and have a complication can’t get help.”