Midwest providers navigate interstate abortion access as laws evolve
Kentucky’s near-total abortion ban has now been in effect for two months, which has forced many patients to navigate to bordering states for care.
But that access could change quickly, with laws across the Midwest in flux — including in Indiana.
Erin Smith is the director at the Kentucky Health Justice Network, an organization that advocates for trans health, reproductive justice and abortion access.
They said demand for the group's services has grown since the United States Supreme Court ruled in June to overturn Roe v. Wade, setting off a cascade of restrictions across conservative states.
“We are losing our entire region,” Smith said. “And for Kentucky, that is terrifying.”
They said in the past few months, calls to the health justice network have doubled — up to 50 a week.
The organization has connected people with clinics in surrounding states. But near-total bans are currently being disputed in Indiana and Ohio courts.
If they hold up, Illinois will likely be the only state in the area with protections for abortion access.
Kentucky’s abortion access has shifted multiple times this year. In April, after the legislature passed a more than 70-page omnibus abortion bill, providers stopped services for a week. That bill was later partially blocked, but clinics stopped again in June after the Roe decision, setting in motion the state’s trigger ban.
Access was restored a week later following a ruling by Jefferson County Circuit Court Judge Mitch Perry, but the state court of appeals ruled in August the ban could be enforced, a decision later upheld by the state supreme court.
When the commonwealth had access, Smith says the group was getting a lot of calls from people trying to get to Louisville’s two clinics.
More recently, they’ve started getting more calls from people in other states including Texas and Oklahoma, trying to get to Chicago.
Smith said there’s more to the services than simply arranging travel.
“Each call is a new assessment,” they said. “Sometimes it’s like, ‘I need money for daycare or for child care services so I can go to my appointment in [whichever] state.’”
According to2020 data from the Illinois Department of Public Health, around 20% of the state’s more than 46,000 abortions were for people from out of state. Nearly 1,900 of those came from Indiana, the second highest of any state.
Dr. Amy Whitaker, chief medical officer at Planned Parenthood of Illinois, said prior to the Supreme Court decision in June, they saw patients from around 10 to 15 states. Since Roe fell, they’ve had patients from at least 28 states. The number of people coming from Indiana has doubled, and increased 18-fold from Kentucky.
“We expect to see thousands upon thousands more patients as more neighboring states, and states who relied on those neighboring states, go dark,” she said.
She says the need to travel has created an extra burden on patients, and more anxiety.
“They are having to travel tens of hours sometimes to have a procedure that often lasts about five minutes,” she said. “And it's especially upsetting of a burden when we know that in their very states just a few months ago, they were able to get it.
“Nothing has changed about the medical aspects of abortion. It's just about where you live.”
Whitaker said Planned Parenthood of Illinois has been expanding services to accommodate out-of-state patients, including adding staff and resources. Last month, the organization’s Champaign Health Center began offering procedural abortions.
They’re also doing telehealth to prescribe abortion medication. Patients must physically be in Illinois for the appointment and have the medication shipped to an Illinois address.
Smith, with the Kentucky Health Justice Network, said people have stepped up donations in the aftermath of Roe — cashing in parts of their 401Ks and donating stocks and bonds. Though they’re grateful for the support, Smith said they hope to see more funding to keep up with increased demand.
“We are playing a long game of having to transport people out of the Commonwealth of Kentucky to get access to safe and healthy abortions in other states and other parts of the country and other regions,” they said.
Indiana’s ban is currently blocked, but a court could reverse that decision soon. Kentucky’s ban was reinstated in August. Residents will decide on a constitutional amendment that would codify restrictions in the general election.