Objectives: In late March 2020, Texas issued an executive order that was interpreted to prohibit most abortions. We compared Texas residents’ patterns of out-of-state travel before and during the order.
Methods: We obtained data on patients who obtained abortions between February and May 2020 at 23 facilities in Arkansas, Colorado, Kansas, Louisiana, Oklahoma and New Mexico. Using county of residence, we computed the number of out-of-state patients by region of Texas and the percentage who obtained care at the nearest out-of-state facility. We also compared distance traveled and gestational age for those who did and did not obtain care at the nearest location, using rank sum tests.
Results: In April 2020 (the month most affected by the order), 904 Texas residents obtained out-of-state abortions, compared with 154 in February 2020. Between February and April, the number of East Texas residents who obtained out-of-state abortions decreased by 19% (83 to 67), and the number of North Central Texans increased by 1492% (25 to 398). In April 2020, 87% of out-of-state patients did not obtain care at the nearest facility. Median one-way travel was 189 miles for residents who went to the nearest facility and 496 miles for those who did not (p<0.001). There were no significant differences in gestational age.
Conclusions: Most patients did not obtain care at the nearest out-of-state facility, which may reflect clinic congestion and variation in referral networks. Regional variation in out-of-state travel suggests that patients in some areas may not have been able to obtain an abortion during this period.
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