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Why Patients Travel the Nation for Abortions in Washington

Patients from abortion-banned states are traveling thousands of miles to receive the service in Washington state, where the procedure remains legal and where efforts are being made to protect abortion patients and providers.

(Frank Mina/The Seattle Times/TNS)
(Frank Mina/The Seattle Times/TNS)
(TNS) — The Texas woman's apartment has thin walls. Could neighbors hear her talking about her imminent flight to Washington for an abortion? Or could data from her phone be tracked, revealing she had searched for a way to end her pregnancy?

"And then, like, all of a sudden somebody shows up at my door."

"Maybe that's a little bit extreme," the woman, who agreed to be identified only by the initial A., said of her imagined scenario. "But also, maybe nooot?" She drew out the word as she considered the question aloud.

After the U.S. Supreme Court overturned Roe v. Wade last June, a raft of states banned abortion, prompting residents seeking to terminate pregnancies to travel elsewhere — sometimes far away. An increasing number of abortion patients from the South, particularly Texas, are now coming to Washington.

Secrecy, fear and confusion often accompany them at a time that the legal landscape is changing day by day, with hundreds of bills pending in state legislatures around the country. Most seek to restrict abortion but some, as in Washington, aim to strengthen access and protect providers and patients arriving from other states.

Dr. Erin Berry, Washington medical director for the Seattle-based Planned Parenthood affiliate, said out-of-state patients ask what they can say back home about their Washington abortions. "Can I tell my OB-GYN?"

Berry said she tells them what they are doing is legal. Washington's legally established right to an abortion applies because "you're located here and I'm located here." Texas laws, she adds for patients from there, "don't have control over us."

Her response corresponds to how Washington Attorney General Bob Ferguson and most legal experts interpret current law.

Justice Brett Kavanaugh wrote in a concurring opinion overturning Roe that he believes the constitutional right to interstate travel doesn't allow individual states to bar their residents from traveling elsewhere to get abortions. But that has yet to be tested in court.

Setting up legal battles that could wind up before Kavanaugh and his colleagues, some anti-abortion activists and lawmakers have proposed laws intending to block "abortion tourism" or "trafficking" — the latter what an Idaho bill calls helping a minor cross state lines for an abortion. Most bills around the country focus on providers or so-called aiders and abettors.

"It's hard for anyone to keep up," Berry said, and patients are unsure if they could be put in jeopardy. "The reality is, I think, all of us are unsure. ... You do feel there's a little bit of a target on your back."

Anticipating interstate strife, Ferguson recently announced several local law firms will participate in a free legal service for those facing prosecution or lawsuits related to abortion. And Democratic lawmakers have proposed a "shield law" that would ensure abortion-related warrants, subpoenas and other legal maneuvers from outside the state get no traction in Washington.

Those measures intend to help put at ease the growing number of people seeking abortions here, though the state's increase in out-of-state patients hasn't shot up as starkly as expected.

After Roe fell, the Guttmacher Institute, an abortion rights research organization, predicted Washington could see a 385 percent increase in out-of-state abortion patients. That has not yet materialized.

"I personally have always been saying it's not going to be a huge wave," said Mercedes Sanchez, a spokesperson for Cedar River Clinics, which has reproductive health facilities in the Seattle-Tacoma area and Yakima. "Instead, it's going to be like a slowly rising flood. And I think that's what we're seeing."

Predictably, patients from nearby Idaho, where abortion is banned, are coming to Washington. The Spokane-based Planned Parenthood affiliate, which operates clinics closest to the Idaho border, got 75 percent more Idaho patients this past January than it did in January 2022, according to spokesperson Paul Dillon.

More surprisingly, Cedar River and the Northwest Abortion Access Fund, a nonprofit covering travel and other expenses related to getting an abortion, are seeing a rise in patients from the South.

Sanchez said Cedar River is not publicly sharing numbers "out of an abundance of caution," given the shifting legal landscape. The abortion access fund compiled data showing it helped 49 such patients come to Washington and 22 to Oregon between Sept. 1 and Feb. 15 — five times more, in total, than during the same period a year before. Of the post-Roe patients in both states, 37 came from Texas.

'The Clock Is Ticking'

A. decided she couldn't go through with her pregnancy after the relationship with her partner deteriorated. He turned jealous and controlling, and they separated, she said.

She already had a child, and having another one alone "just feels wrong," she said one February night. She was still in Texas, taking things "moment by moment," a rush of feelings pouring out of her.

"Oh man, it's really, really hard," she said, alluding to Texas abortion laws. "It's almost as if other people have more rights to what you do with your own body."

A Texas law went into effect last August that makes providing an abortion a first-degree felony punishable by five years to life in prison, and a 2021 statute permits lawsuits against those who help someone obtain an abortion after a fetal heartbeat is detected.

Neither law calls for patients to be penalized. But South Texas law enforcement officials last year charged one woman with murder after she miscarried at a hospital and allegedly told staff there she tried to induce an abortion — charges later dropped for lacking a legal basis.

A. hadn't read the new abortion laws herself, but word of mouth led her to believe she was very much at risk for what she was about to do.

She first tried to go somewhere relatively nearby for her abortion. Texas is mostly surrounded by a block of states that ban the procedure. Kansas, two states north, does not.

But Kansas abortion clinics now face greater demand. A. said she couldn't reach any on the phone for two weeks, and when she finally got through, the only appointment available was another two weeks out.

"I'm freaking out ... because the clock is ticking," A. said. She was in her second trimester.

A sister in Washington suggested she come here.

A.'s experience mirrors what local abortion providers are finding with out-of-state patients, their abortions delayed by the search for providers and the need to arrange travel. "Patients are further along in their pregnancies when they come to see us," said Dr. Anuj Khattar, Cedar River's medical director.

Often, they're drawn to Washington because of a friend or family member here. "I have to go far, so let me pick the place where I have some support," patients reason, according to Berry.

A. also found support from the Northwest Abortion Access Fund, boosted by thousands of new donors and pledges from Seattle, King County and Oregon in the months following last May's leak of the Supreme Court's draft decision on Roe.

The fund booked her flight and hotel, paying for both, as well as the abortion. The nonprofit also arranged for rides during her stay, and picked up the tab for breakfast and sandwich fixings delivered to her room.

"They've kind of made it so the only thing I really have to do is get there and heal," A. said.

'A Different Country'

A few nights later, A. sat on a bed with her sister in a Renton hotel room, near the clinic where she had an appointment the next morning. Her arrival in a place where abortion is considered a right, rather than murder, seemed to awe her.

"I went to a different country today," she said.

She had only talked to clinic staff on the phone, but they had impressed her by taking time to thoroughly explain the surgical, two-day procedure that's standard for second-trimester abortions.

She kept listening for a judgmental tone. Instead, staff told her, "I'm so sorry you have to come this far."

Judgment greeted her the next morning, though, when her Lyft car pulled up to the Renton clinic. A handful of abortion protesters tried to get her to turn around.

"Don't kill your baby," A. heard as she walked inside. "There are other options."

A. continued on, more or less unfazed. She wasn't expecting to see protesters in Washington, but then again, she said, they had a small presence by Texas standards.

The procedure took about 15 minutes each day. In the recovery room, A. said, she met two other patients from out of state, including a woman from Arizona, where abortion is banned at 15 weeks or more of pregnancy. She and A. were staying at the same hotel, and a Northwest Abortion Access Fund volunteer drove them back together.

A. slept most of the day after the final procedure. When she woke up, she said she felt better now that it was over with. She felt good, too, she texted later, about donating fetal tissue to a university studying organ development.

She wouldn't mention that or anything else about her trip when she got back to Texas, and she worried about one person she had rashly told she was pregnant — bitterly regretting the disclosure and unsure what to say now.

Even family members didn't know about the pregnancy or abortion, the exception being her sister, who said: "I think this is something that we'll probably take to the grave."

(c)2023 The Seattle Times. Distributed by Tribune Content Agency, LLC.
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