The true cost of traveling out of state for an abortion is more than financial

In June 2022, when the U.S. Supreme Court's Dobbs decision overturned Roe v. Wade, which provided Americans with a constitutional right to abortion, it changed what options Hanz Dismer had in the state of Missouri.

While abortion access was already severely limited in Missourit, minutes after the Supreme Court’s decision was released the state Attorney General Eric Schmitt issued an opinion to kick off the state’s trigger ban making it one of the first states to nearly outlaw abortion. At the same time, the state’s last remaining abortion clinic quickly halted its services. All of these events unfolded along the backdrop of Dismer’s unplanned pregnancy. 

“I took a pregnancy test after my shift in the clinic and realized that I'm pregnant, and I have more rights now than I will when I go home tonight,” Dismer told Salon. “That hit hard.”

The pregnancy wasn’t necessarily unwanted, Dismer told Salon. It just wasn’t “happening at the right time.” Ultimately, terminating the pregnancy was the best choice they could make for themself. But for Dismer, the rapidly changing legal landscape in their home state changed the calculus on how they could access abortion care. Not only in terms of where Dismer could access services, Dismer planned on getting an abortion at the clinic they worked at as a social worker in Illinois, but the support that accompanied Dismer. For example, Dismer didn't have anyone drive with them to the clinic.

“Because I didn't want anyone else to face the potential to be aiding and abetting an abortion, right?” Dismer said. “Not only was I faced with an unplanned pregnancy that I had to figure out if this was a good time in my life to become a parent, and what my partner's needs are, and all of that, but I also had to contend with the legal landscape, which made that decision making process unnecessarily traumatic.” 

Dismer isn’t alone in feeling the emotional toll of having to travel out of state for an abortion. A 2023 study published in the journal Contraception found that the emotional cost of having to travel out of state is a common experience.

“It's forcing shame and stigma on you during what is already the worst moment of your life,” one study participant testified. Another said, “It was very stressful having to plan that trip and get there and be away from everyone and everything I knew.”

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Following the Dobbs decision, states have been able to make their own laws severely restricting abortion access across the United States. According to the Guttmacher Institute, there has been a rise in interstate travel for abortion care since Dobbs overturned Roe v. Wade. The institute estimates one in five abortion patients traveled out of state for abortion care in 2023, compared to one in 10 who did so in 2020.

This week, Kari Lake brushed off criticism of abortion bans in her state of Arizona, saying "Even if we have a restrictive law here, you can go three hours that way, three hours that way, and you're going to be able to have an abortion."

But the reality is not so simple.

As Salon previously reported, shock waves and ripple effects are felt across the maternal health landscape when just one or two states implement near-total abortion bans. While many people think it’s easy to cross state lines to access care, it doesn’t come without both an emotional, and financial cost, to the patient.

Megan Jeyifo, executive director of Chicago Abortion Fund, knows firsthand the challenges people face when traveling state lines to access abortion care. Since Dobbs, Illinois has seen an influx in patients from the south. Data from the Society of Family Planning #WeCount found that after Dobbs, Illinois saw the biggest increase in out-of-state abortions. 

At the Chicago Abortion Fund, Jeyifo and her colleagues help provide medical referrals and financial support to people who are facing barriers to access abortion services. Jeyifo emphasized it is “traumatizing” to travel for this care. 

“People 100 percent internalize the difficulty that they face in accessing care, and can view it as a reflection of the morality of that care,” Jeyifo said. “I think part of our job as abortion funds is to say ‘It is not your fault this is hard. This is hard by design because politicians want us to not have control over our own bodies, and how we start or grow our families.’”

Then there’s the financial component. Jeyifo told Salon it’s almost unheard of that insurance will cover the procedure when traveling from a state where there’s limited access to abortion care. Medicaid will not cover a patient if they travel out of state for an abortion either. Jeyifo said the average support cost, like for lodging, CAF provides a patient is $380. The average voucher they provide for the procedure itself is $480. And that’s just an average.

Between the cost of flights and the cost of Chicago hotels, Jeyifo said it’s very easy to spend up to $1,500 or $2,000 on one person's travel expenses. Notably, it’s estimated that only one in three Americans can comfortably cover a $400 emergency expense. Frequently, CAF has to help arrange childcare for a patient, too. 

“We are literally supporting people that have to bring their children with them on an 11 hour or more one-way car trip,” Jeyifo said. “And that is a status quo, that is normalized at this moment. Childcare is a really huge barrier for our callers.”

Dr. Jennifer Kerns, a professor in the department of obstetrics gynecology and reproductive sciences at UCSF and staff physician at Trust Women, an abortion clinic in Kansas, said she sees firsthand the burden of people having to travel out of state for an abortion — sometimes to even have access to medication abortion.

“Some people are traveling by car, up to 12 hours just to drive to the clinic to access medications,” Kerns told Salon. “We routinely hear about how long it's taken patients to garner all of the resources needed to make arrangements, to make this trip, and we're only seeing the patients who actually ended up getting to us — we're not seeing the patients who made attempts or can't take that much time off of work or can't find anybody to watch their kids.”

In the lawsuit of women suing states, like Texas, for being unable to obtain proper healthcare while pregnant due to abortion restrictions, the stories reveal the massive burdens and barriers women face when having to travel out of state, too. At 15 weeks pregnant, one plaintiff suing Texas had to travel to a clinic in Colorado to undergo a selective reduction abortion procedure after learning one of her twins had the highly fatal genetic condition trisomy 18. The procedure and cost of travel totaled thousands of dollars, the lawsuit said. 

Kimberly Inez McGuire executive director of URGE (Unite for Reproductive and Gender Equity), told Salon this is especially for difficult for young people.

“Young people in this country are facing just extreme levels of economic precarity,” McGuire said. “They're struggling to find jobs that pay well, they're struggling to find jobs that have any paid sick time, and depending on the care that someone needs, it might be required that someone take one to three weeks to travel if they’re seeking abortion care.”

Traveling to access abortion care can turn someone’s life “upside down,” McGuire said. 

“People are having to decide if they're trying to pay rent, or buy this very expensive plane ticket,”McGuire said. “There are support networks out there, but there's never enough, right? It’s uprooting peoples’ lives, and it’s why we have got to end these abortion bans.”