Distance Traveled for Abortion at a North Carolina Tertiary Care Center Following Restrictive Legislation

Background North Carolina enacted 5 statutes restricting abortion between 2011 and 2016. Our objective was to compare the proportion of women who traveled more than 25 miles to a Southern tertiary care center during 2 distinct time periods (2011 and 2017). Methods We conducted a time-series retrospective cohort study of women who obtained an abortion at University of North Carolina hos­pitals in 2011 and 2017. We collected data regarding residence, demographics, gestational age, indication, parity, and referral source. Our primary outcome was distance traveled from a person’s residence to the study center. Results We enrolled 399 women, 139 in 2011 and 260 in 2017. In 2011, 72% (100 of 139) traveled more than 25 miles, compared with 75% (195 of 260) in 2017. Fewer women traveled greater than 100 miles from their residence to our clinic in 2011 (20%) compared to 2017 (26%). Fewer women from neighboring states were seen in 2011 than 2017 ( p = .04). Women seeking abortion in 2011 were 4 times less likely to have been referred from a freestanding abortion clinic compared with women in 2017 (9% [13 of 139] versus 37% [96 of 260]). Limitations The tertiary referral nature of our study limits generalizability. With 2 time-distinct cohorts, there may be factors that changed over the study period that remain unaccounted for. Conclusions A similar proportion of women traveled more than 25 miles for abortion before and after the legislative changes. Our finding that more women traveled greater than 100 miles to obtain an abortion in 2017 compared to 2011 highlights a key burden to abortion ac­cess in North Carolina. The increased number of women seen from freestanding abortion centers and from neighboring states following the legislative changes highlights an important geographical burden potentially associated with strict abortion restrictions.