Baltimore Sun

Abortion providers feeling strained

Survey: Interstate travel for procedure affecting patients

- By Margot Sanger-Katz, Claire Cain Miller and Josh Katz

The reversal of Roe v. Wade did not affect the legal status of abortion in New Mexico, where seven clinics are still operating. But that does not mean an abortion is easy to obtain there.

The wait times at five clinics have been at least three weeks because of an influx of women from nearby states that have banned or restricted abortion. Some clinics were so full they couldn’t book new appointmen­ts. Of the other two, one serves only patients seeking medication abortion before the 11th week of pregnancy, and the other is on the border with Texas, a drive of more than six hours from some parts of New Mexico.

New Mexico has been most affected by interstate abortion travel in making appointmen­ts, according to a nationwide survey of clinics by a research team led by Caitlin Myers, a professor of economics at Middlebury College who studies the effects of reproducti­ve policy. But the data suggest that as more bans go into effect, women who need to travel to another state for an abortion may have more difficulty getting appointmen­ts. It may even become hard for those living in some states where it remains legal.

In most of the country, the average wait time for abortions before the overturnin­g of Roe was around five days. That has increased slightly, according to the survey, conducted July 11-14. In cities near states with bans, though, wait times were already starting to get longer, the survey found. Twenty-two percent of such clinics were booking

appointmen­ts more than three weeks out. In cities farther from states with bans, 8% were. Thirteen percent of clinics still open were unreachabl­e or were so full they were not taking new appointmen­ts.

“Even assuming patients can overcome the navigation­al barriers to get to states where abortion is legal, it is going to be incredibly difficult to provide that care to everyone,” said Dr. Katherine Farris, medical director for a Planned Parenthood affiliate in the Southeast. On a recent day in Roanoke, Virginia, she saw patients from six states.

Overbooked clinics could mean patients must drive farther to find a clinic with an opening, and research has found that long driving distances decrease abortions, especially for poor women, who may struggle with the costs and complicati­ons of long journeys.

But long wait times also mean that more abortions

may be done later in pregnancy, a concern for people on both sides of the issue.

Before Roe was overturned, eight in 10 abortions in the United States were done in the first nine weeks of pregnancy — more than half of those in the first six weeks. That is likely to increase as wait times rise, providers and researcher­s said.

Many abortion opponents say abortions later in pregnancy are more problemati­c than early ones, one of the drivers behind bans that prohibit abortion after a certain number of weeks. Proponents say that forcing women who want abortions to delay having one can be harmful.

As pregnancie­s progress, there are fewer options. Medication abortion is approved in the United States only for use in the first 10 weeks of pregnancy. Abortions become costlier, more medically complicate­d and harder to obtain

in later pregnancy. Georgia, South Carolina, Tennessee and Ohio now ban abortion after six weeks. The earliest that women generally find out they’re pregnant is four weeks, so long wait times can mean an abortion is unavailabl­e.

Continuing an unwanted pregnancy for weeks can also take a physical and emotional toll on women, said Dr. Lisa Hofler, clinical vice chair for the department of obstetrics and gynecology at the University of New Mexico Center for Reproducti­ve Health, where patients now have to wait six weeks or can’t make appointmen­ts at all.

“The goal for patients and for the health care system, from a public health standpoint, is people should be able to access their abortion care as early as possible,” she said.

Mike Seibel, senior counsel at Abortion on Trial, a New Mexico anti-abortion litigation group, said he

worried the long waits could lead to later abortions.

But he said the stream of out-of-state women into his state may help his side persuade the public to consider abortion restrictio­ns in a state where the government has recently expanded abortion rights. He said New Mexicans are “not happy about this abortion deluge.”

The Middlebury researcher­s contacted every clinic in the country in March, June and July, asking for the soonest available abortion appointmen­t for a six-week-pregnant woman. In the latest round, they found availabili­ty at 650 of the 701 open clinics (some never answered the phone). Dates were obtained online or by phone. The researcher­s recorded the date but did not schedule appointmen­ts. A week later, The New York Times contacted several of the clinics with long wait times, finding similar trends.

In some states, the strain is concentrat­ed in clinics near states with bans. Most Illinois clinics have not yet seen increased wait times. But Dr. Erin King, executive director for Hope Clinic for Women near the Missouri border, said wait times there grew to around three weeks — from one or two days — immediatel­y after Roe was overturned. And the clinic has been forced to turn away patients.

The Planned Parenthood affiliate that operates abortion clinics in Nebraska, Iowa and Minnesota expects a 25% increase in patients once more bans go into effect, but so far wait times for abortions remain around three weeks.

In states such as these, wait times have always been longer than elsewhere in the country, because many doctors work part-time, and some fly in from other states. When the doctor at the Planned Parenthood in Lincoln, Nebraska, retired in June, the clinic had to pause while it found and credential­ed new providers.

“This is a problem that predates Dobbs,” said Emily Bisek, a Planned Parenthood spokespers­on for the region, referring to the Supreme Court case that resulted in the overturnin­g of Roe.

Adrienne Mansanares, CEO of the Planned Parenthood affiliate in New Mexico, Nevada and Colorado, said her organizati­on was struggling to meet demand in New Mexico.

“If we don’t expand care and we don’t protect care in the other states around us, it will become completely unbearable over time,” she said.

However, several providers have announced plans to relocate clinics or open new ones in New Mexico. Among those are Jackson Women’s Health Organizati­on, the clinic that brought the initial suit against Mississipp­i’s state health officer, Thomas Dobbs.

 ?? ROBYN BECK/GETTY-AFP ?? The check-in area at the Women’s Reproducti­ve Clinic on June 15 in Santa Teresa, N.M., near El Paso, Texas. Abortion clinics in New Mexico are seeing more women from nearby states that have banned or restricted abortion.
ROBYN BECK/GETTY-AFP The check-in area at the Women’s Reproducti­ve Clinic on June 15 in Santa Teresa, N.M., near El Paso, Texas. Abortion clinics in New Mexico are seeing more women from nearby states that have banned or restricted abortion.

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