Kentuckians are still getting abortions. They’re just traveling out of state, new data shows

From January to July of this year, reported abortions in Kentucky dropped by almost 100% compared with 2021, according to state data.

Thirteen abortions were reported to the Cabinet for Health and Family Services between January and July of 2023, compared to 2,591 reported in 2021 during the same time frame — a reduction of 99.5%.

The marked cliff is a direct result of Kentucky’s trigger law and six-week ban, both of which took effect after federal abortion protections were overturned in June 2022. The trigger law bans all abortions except when a pregnant person’s life is immediately threatened, and the six-week ban, or fetal heartbeat law, outlaws abortions after fetal cardiac activity develops, which is usually around six weeks gestation.

The impact has been a near-total elimination of abortion, even in circumstances where the procedure is medically recommended, as the Herald-Leader has reported, including when a fetus is nonviable.

That trend is mirrored across the country in more than a dozen states that have enacted similar abortion bans, according to new estimates released this week from the Guttmacher Institute, a pro-abortion rights research policy center.

Despite roughly a dozen U.S. states outlawing it, the cumulative number of abortions provided so far this year actually increased nationwide compared to 2020. In states that have preserved access, like Illinois, demand for the medical procedure has ballooned.

Most states surrounding Kentucky, including Tennessee, West Virginia, Indiana, Ohio, Missouri and Arkansas, have passed laws restricting abortion. Illinois — a state without an abortion ban — is the outlier. There, abortion remains legal up to the point of viability. From January to June of this year, the number of abortions provided in Illinois grew by an estimated 69% (from 26,000 to roughly 45,000) compared with 2020, according to Guttmacher’s report.

Across the board, states without abortion bans saw similar increases: Abortions in Virginia increased by 60%, North Carolina by 57%, Michigan by 16%, and in Kansas, the number of abortions increased by 114%.

These estimates, which only count abortions by providers working in brick-and-mortar clinics and doctor’s offices, indicate that thousands of women who live in states that have restricted access traveled to states that haven’t. The true figures are likely even higher, since an estimated increase in abortion medication received by mail is not factored.

Kentucky’s 2023 data

Guttmacher’s report did not include numbers from Kentucky. The Herald-Leader obtained that data through an open records request. A more comprehensive 2022 annual abortion report is expected to be published this month by the Cabinet’s Office of Vital Statistics.

Historically, most abortions in Kentucky were provided at EMW Women’s Surgical Center and Planned Parenthood, both in Louisville. Both stopped providing terminations with the law change.

Pre-abortion ban, in a given month in Kentucky, between 300 and 400 abortions were provided, state data from recent years shows. So far this year, the most reported were in May: four. Most of the 13 were medication abortions, and most occurred in the second trimester, the latest being 21 weeks.

The Cabinet denied the Herald-Leader’s request to release the ages of individuals who’ve received abortions in Kentucky so far this year, even though that information has historically been public. The Louisville Courier Journal reported last September that, before Kentucky’s abortion bans took effect, the two youngest patients to need an abortion were under age 9. Under state law, sexual intercourse with a 9-year-old is first-degree rape. Kentucky’s current bans do not include exceptions for rape, incest or pregnant minors.

It’s unclear if any of the people who’ve needed an abortion so far this year in Kentucky were under the age of 18. In a response to the Herald-Leader’s request for ages, the Cabinet said it was withholding that information. Since there are so few reported abortions, “providing age along with the other data points provided may allow for a ready identification of the individuals,” a spokesperson said, and “may constitute a clearly unwarranted invasion of personal privacy.”

Piecemeal data provides some insight into how many Kentuckians are traveling out of state for this type of medical care. Before Indiana’s near-total abortion became law in August, state data showed 340 Kentuckians had traveled to the Hoosier state for abortions between January and March, representing roughly 90% of all abortions provided to non-residents. In 2022, a total of 950 Kentuckians got abortions in Indiana, WFPL reported in June. Other surrounding states have yet to publish their 2022 reports.

To Tamarra Wieder, Kentucky state director of Planned Parenthood Alliance Advocates, this enforces the reality that many people will continue to seek out this type of care despite local bans.

“Kentuckians didn’t stop needing abortions, they’ve just been forced to go elsewhere,” she said. “Those who had the means and the ability to leave the state are leaving the state for that type of care.”

Kentucky Republicans — who have doggedly sought to restrict abortion — so far have not formally tried to limit or scrutinize out-of-state travel to get abortions. But GOP Attorney General Daniel Cameron, who’s running for governor to unseat Democratic Gov. Andy Beshear, has signaled he wants to retain the right to access medical information of Kentuckians who do just that.

Cameron in June joined 18 Republican state attorneys general in co-signing a letter to the U.S. Department of Health and Human Services, arguing that its rule change proposal to shield patients’ reproductive health services information from officials in states that have criminalized abortion would “unlawfully interfere with states’ authority to enforce their laws.”

The rule change would make it harder for officials in states that have restricted access to reproductive health care, like abortion, to obtain patient medical information for care sought out of state if it’s for the purpose of investigating a civil or criminal law violation.

Out of state abortions

Though the full scope of Kentuckians traveling across state lines for reproductive health care isn’t known, organizations that help women to this end say demand is not letting up.

Kentucky Health Justice Network, which offers assistance to people who need help paying for their abortion, fielded more than 500 calls from January to July of this year (421 received donations from KHJN to pay for their abortions). That breaks down to 15-20 calls a week, said Savannah Trebuna, KHJN’s abortion support fund co-director.

KHJN not only helps foot the bill for the cost of the procedure, itself, but increasingly this year, they’ve helped cover the cost of gas for Kentuckians to travel to out-of-state clinics.

“Before the ban, a large barrier to people seeking care at clinics was just the cost of the appointment,” Trebuna said, which can range anywhere from $600 to $1,000.

In the more than year since the trigger law, donations spent on travel — what KHJN calls “direct assistance” — has increased 127%. Increasingly, “we’re seeing a large need for practical support, things like gas money or a flight, hotels and childcare expenses,” she said.

Where people go largely depends on geography and financial means, Trebuna said. Before August, 44% of people who called KHJN’s hotline traveled to Indiana (since Indiana’s ban, KHJN has sent close to 30 callers to Illinois for abortions). The closest access point in Eastern Kentucky is Bristol, Virginia, and in western Kentucky it’s southern Illinois, she said.

Kentucky’s abortion bans do not legally permit the standard of care treatment for when many abortions may become medically necessary, the Herald-Leader has reported. Unnecessarily prolonging a non-viable pregnancy, for example, can greatly increase the health risks for a pregnant person. But unless their life is immediately threatened, current law forbids doctors from terminating those pregnancies.

“There have been cases where we’ve had callers who would have died had they continued their pregnancy, but because they weren’t actively dying in front of a doctor, they were still referred out of state,” Trebune said.

The amount of money KHJN gives to each person varies. In the last two weeks, KHJN has averaged giving $450 to each caller to cover the cost of their abortion, and $80 for travel expenses. KHJN’s funds are largely possible because of private donations. That reality is problematic, she said.

“The way that abortion funds are operating right now is so unsustainable,” Trebuna said. “There will be a point where we can’t do as much as we’re doing now, because our resources are finite. These are not acceptable conditions for anybody, especially Kentuckians that have poor maternal health outcomes.”

Hospitals and health care clinics continue to refer patients out of state for abortions, but where depends, in many cases, on the individual and their doctor.

When asked about where patients needing abortions are pointed, a spokeswoman for Baptist Health Lexington said, “referrals for any procedure are a decision between the patient and the physician.”