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Abortions for out-of-state women are climbing in Illinois - and that's sure to grow

As abortion access elsewhere has become more restrictive, Illinois providers have seen a dramatic rise in residents from neighboring states seeking the procedure here.

In 2020 alone, nearly 21% of all abortions performed in Illinois were for residents of other states, according to Illinois Department of Public Health records. Six years earlier, out-of-state residents made up 8.1% of all abortions in Illinois.

Illinois abortion-rights advocates believe that figure will continue to grow after the leak of a draft opinion from a majority of the U.S. Supreme Court that would strike down the landmark Roe v. Wade case, which legalized abortion nationwide almost 50 years ago. A formal decision from the court is expected next month.

"It can be a challenge to keep up with the demand for care," said Jennifer Welch, president and CEO of Planned Parenthood of Illinois. "We offer many different health care services, but we are seeing an increase in patients seeking abortions who live outside the state."

From 2015 to 2020, the number of those who received abortions in Illinois but live elsewhere increased by more than 200%. Out-of-state residents accounted for 9,686 of the 46,243 abortions performed in Illinois in 2020, IDPH figures show. In 2015, just 3,210 abortions performed in Illinois were for residents of other states.

"A> neighboring states take draconian steps to eliminate reproductive freedoms, we have taken action to fight abortion access restrictions and are proud that Illinois will remain a reproductive health care 'oasis,'" said Illinois Attorney General Kwame Raoul, in the wake of the Supreme Court leak. "Laws that severely restrict abortion access in one state drive women to utilize health care resources in neighboring states. This is something we are continuing to see in Illinois."

The vast majority of those out-of-state patients who come to Illinois for abortion services are residents of Missouri - 6,578 of them just in 2020. Abortion services in Missouri became so restrictive that Planned Parenthood of Missouri opened a clinic on the Illinois side of the St. Louis metropolitan area, in Fairview Heights.

Missouri currently requires a 72-hour wait and parental consent; Illinois does not. If Roe is overturned, Missouri has another law that could go into effect that would essentially ban all abortions unless the health of the pregnant person is in jeopardy.

"People are coming (from) as close as St. Louis, who may not have all their money. And as far as Louisiana," said Kawanna Shannon, director of patient access at Planned Parenthood of the St. Louis Region and Southwest Missouri. "It is requiring us to work longer hours, but we understand the goal, right? And we're all 100% into the goal."

Indiana residents made up the second-highest population of those receiving abortions in Illinois. In 2020, 1,878 Indiana residents received an abortion in Illinois, up 47.5% from 2015.

In 2015, 55 Kentucky residents got an abortion in Illinois. By 2020, 142 Kentucky residents received an abortion here.

IDPH reported fewer than 50 Tennessee residents received abortions in Illinois in 2015, but by 2020 that number had climbed to 108.

The number of Wisconsin residents getting an abortion in Illinois has generally held steady from 2015 to 2020, records show, averaging about 530 a year.

Some abortion opponents in Illinois said overturning Roe doesn't go far enough.

"By and large, the overturning of Roe v. Wade is a victory because the high court is realizing that from a legal standpoint it was poor decision," said Amy Gehrke, executive director of Illinois Right to Life. "But Illinois remains a haven of abortion extremism, and it's only going to get worse."

Gehrke believes restrictive laws in many states are driving a nationwide decrease in abortions in recent years, but abortion-rights advocates argue it is more likely due to easier access to medical inhibitors, such as birth control and the "morning after pill."

The pill is available over-the-counter, and its use is not considered an abortion, IDPH officials said.

A 2019 study by the Guttmacher Institute, a sexual and reproductive health and rights research and policy organization, stated "the decline in abortions appears to be part of a broader decline in pregnancies, as evidenced by fewer births over the same period."

A shift has also occurred in the age range of those receiving abortions in Illinois, IDPH records show. Before 2018, women from ages 20 to 24 were most likely to receive abortions in Illinois. Since then, women 25 to 29 are the largest segment of the population receiving abortion services.

Meanwhile, abortions among teenagers have also dropped significantly over the past decade. IDPH records show there were 34% fewer abortions for those under the age of 20 in 2020 than in 2011.

Welch said "medical advancements" have made abortions more accessible, largely through the use of antiprogestins. Antiprogestins are pills that induce an abortion in the early stages of a pregnancy. It is now the most common abortion method in the state, IDPH records show.

The use of antiprogestins has increased 150% from 2015 to 2020.

"The biggest difference is the medication can be taken at home, so the patient doesn't have to be in a health center for a procedure," Welch said. "It can be done on the patient's timeline."

The overwhelming majority of abortions are also performed less than eight weeks into a pregnancy, the state health agency reports.

In 2020, 57.8% of all abortions occurred before two months. In 2015, less than half of all Illinois abortions occurred before eight weeks gestation.

Welch said whatever the outcome of the Supreme Court's decision on Roe, her organization will continue to advocate for abortion access statewide to whoever needs care.

"I don't think there is a change in the message," she said, "because abortion is still safe and legal here in Illinois."

• The Associated Press contributed to this report.

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