New figures shed light on US abortion travel as Trump cuts tracking research

The Guardian

20-04-2025

For the second year in a row, abortion providers performed more than 1m abortions in the United States in 2024. About 155,000 people crossed state lines for abortions – roughly double the number of patients who did so in 2020, before the US supreme court overturned Roe v Wade and paved the way for more than a dozen state-level abortion bans to take effect.
These numbers, released earlier this week by the abortion rights-supporting Guttmacher Institute, have not changed much since 2023, when the US also performed more than 1m abortions and 169,000 people traveled for the procedure.
This lack of change masks a deep geographical divide in the US, as a handful of states have now become major hubs for people seeking abortions.
In 2024, Illinois provided roughly 35,000 abortions to out-of-state patients, while North Carolina provided 16,700. Kansas and New Mexico, which neighbor anti-abortion Texas, provided 16,100 and 12,800 abortions – the vast majority of which were to out-of-state patients.
'Travel is so incredibly costly, both for patients and for the broader support network of funds, practical support organizations and providers,' said Isaac Maddow-Zimet, a Guttmacher data scientist. The sheer magnitude of the travel, he said, is 'testament to the great efforts that a lot of people are taking in order to make sure that people could access care that really they should be able to access within their own community – without necessarily expending this enormous financial and logistical cost'.
As the Guttmacher report focuses on abortions provided through the formal healthcare system, it does not count self-managed abortions, which appear to be on the rise post-Roe. (Medical experts widely agree that individuals can safely end their own first-trimester pregnancies using abortion pills.) The report also does not track abortions provided to people living in states with total abortion bans, even though providers living in blue states sometimes mail abortion pills across state lines – a practice that, in recent months, has sparked heated litigation.
This does not mean, researchers warned, that everybody who wants a post-Roe abortion is still able to get one. Caitlin Myers, a Middlebury College economics professor who has researched the impact of abortion bans, estimated that about 20-25% of people who want abortions are blocked from getting them by bans.
The Guttmacher report arrived days after the Trump administration effectively demolished the CDC team responsible for government reports on abortion provision in the United States, which are known as 'abortion surveillance' reports. These cuts have alarmed researchers.
'If we can't measure outcomes, we can't do science,' Myers said. 'My concern is that this work fundamentally relies on the ability to track public health outcomes, and if we aren't tracking them, we don't know what's happening to people. We don't know what's happening in their lives. We don't know the effect of policies and interventions.'
In addition to the CDC and Guttmacher, just one other group – #WeCount, a research project by the Society of Family Planning – regularly collects nationwide data on abortion incidence. The groups use different methods to collect data, so the CDC's annual report on the topic has long been less comprehensive than the post-Roe reports issued by Guttmacher and #WeCount.
A number of states – including California, a haven for abortion rights – do not provide information to the federal government about the abortions performed within their borders. The CDC report also lags behind the Guttmacher and #WeCount reports; its most recent report, issued in November, counted abortions performed in 2022.
The CDC report does include information about abortion patients' demographic backgrounds and the gestational age of their pregnancies, which can serve as a critical fact-check in heated debates around abortion. Anti-abortion activists, for example, often condemn abortions that take place later on in pregnancy, but the 2022 CDC report found that only about 1.1% of all abortions take place at or after 21 weeks' gestation.
'Abortion surveillance can be used to asses changes in clinical practice patterns over time,' a former employee from the CDC's Division of Reproductive Health said in a text. 'Without this report, we are losing the ability to track these changes.'
Notably, the move to ax the researchers behind the CDC report appears to run counter to Project 2025, a famous playbook of conservative policies. Project 2025 urged the federal government to dramatically expand the CDC's 'abortion surveillance' by cutting funds to states that did not provide the CDC with information about 'exactly how many abortions take place within its borders, at what gestational age of the child, for what reason, the mother's state of residence, and by what method'. It also suggested that the CDC collect statistics on miscarriages, stillbirths and 'treatments that incidentally result in the death of a child (such as chemotherapy)'.
These proposals alarmed researchers and raised concerns about patients' data privacy, especially given the fact that abortion remains a deeply controversial procedure. But given the turbulence of the Trump administration, experts are not sure whether another agency will ultimately take up Project 2025's recommendations.
Maddow-Zimet said he doesn't 'think that we're necessarily any less concerned than we were before about the possibility of these kind of data mandates going into effect and/or using the data in appropriate ways to either make providers ask patients questions they wouldn't have otherwise asked, that are very stigmatizing, or potentially put providers at risk'.