A POST-DOBBS ANALYSIS OF IN- VS. OUT-OF-STATE ABORTION TRAVEL EXPERIENCE IN MASSACHUSETTS AND ILLINOIS

Abstract

Objectives

We aimed to describe differences in demographics and travel-related costs between in-state residents and out-of-state travelers who received abortion care after Dobbs v Jackson Women’s Health Organization.

Methods

We conducted a multi-site cross-sectional survey of patients who received abortion care at three clinics in Massachusetts and Illinois in 2023. Survey questions were derived from validated measures and included demographics, state of residence, and out-of-pocket expenses. Participants were recruited and surveyed on-site during their appointment. We compared characteristics between in-state and out-of-state participants using chi-squared tests.

Results

The overall enrollment rate in the study was 81%, with 148 in-state residents and 111 out-of-state travelers. A plurality of participants (35%) were between 18 and 24 years old, 32% identified as Black, 35% as White, and 75% as heterosexual or straight. There were no demographic differences between in-state residents and out-of-state travelers. However, out-of-state participants were more likely to lose at least one day of wages due to abortion-related travel (56.7% vs 40.6%, p<0.001). The average out-of-pocket travel cost for abortion care was $33.32 for in-state individuals compared to $294.50 for out-of-state travelers (p<0.001). For out-of-state travelers, airfare contributed to the largest share of expenses (41.3%), followed by accommodations (17.5%) and gas and parking (16.6%).

Conclusions

People traveling from out-of-state for abortion care missed more days of work and spent significantly more out-of-pocket on travel-related expenses compared to in-state individuals. Our findings highlight financial barriers to abortion access faced by people in abortion ban states. Abortion funds, clinics, and policymakers must urgently support initiatives to reduce prohibitive travel costs for abortion care.