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171,000 Traveled for Abortions Last Year. See Where They Went.

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171,000 Traveled for Abortions Last Year. See Where They Went.

Source: The Guttmacher Institute

Orange states had a total or six-week ban in 2023.

More than 14,000 Texas patients crossed the border into New Mexico for an abortion last year. An additional 16,000 left Southern states bound for Illinois. And nearly 12,000 more traveled north from South Carolina and Georgia to North Carolina.

These were among the more than 171,000 patients who traveled for an abortion in 2023, new estimates show, demonstrating both the upheaval in access since the overturn of Roe v. Wade and the limits of state bans to stop the procedure. The data also highlights the unsettled nature of an issue that will test politicians up and down the ballot in November.

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Out-of-state travel for abortions — either to have a procedure or obtain abortion pills — more than doubled in 2023 compared with 2019, and made up nearly a fifth of recorded abortions.

Where patients traveled for abortions

Source: Guttmacher Institute

Note: Map reflects abortion laws as of Dec. 31, except in Wisconsin, where a ban was in place for a majority of the year. Routes with fewer than 100 patients are not shown.

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Most traveling patients went to the next closest state that allowed abortions. But those in the South, where 13 states banned or restricted the procedure, had to go farther.

One traveler was a 24-year-old woman from Columbus, Ga., who asked to be identified by only her first initial, A. She flew to New York City last summer after discovering she was past six weeks of pregnancy, when Georgia no longer allows abortion.

She decided to travel over a weekend instead of self-managing with pills at home. “I had to go back to work on Monday,” she said. “I just didn’t have that kind of time.”

Texas, the largest state to ban abortion, had the most residents travel across state lines for the procedure, the data shows.

Source: Guttmacher Institute

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Note: Routes with fewer than 100 patients are not shown.

On the receiving end, nowhere saw more out-of-state patients — and from more states — than Illinois.

An island of access in the Midwest

Source: Guttmacher Institute

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Note: Routes with fewer than 100 patients are not shown.

People in states where the procedure remained legal also traveled for abortions, sometimes because the closest clinic was across state lines or the influx of out-of-state patients made appointments scarce. The data shows that abortions rose in nearly every state where they remained legal.

Many traveling patients faced multiday trips, lost income and child care costs. Some patients were unable to travel. Earlier research found that in the first half of 2023, almost a quarter of women living in states with near-total bans — who may have otherwise sought an abortion — did not get one.

“Abortion is one of the most common procedures in medicine,” said Amy Hagstrom Miller, the founder of Whole Woman’s Health, which runs clinics in Maryland, Minnesota, New Mexico and Virginia.

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“We’re having people travel hundreds or thousands of miles for a procedure that typically takes less than 10 minutes and can be done in a doctor’s office setting,” she said. “Nobody does that for any other medical procedure.”

The new estimates of resident and out-of-state abortions come from the Guttmacher Institute, a research organization that supports abortion rights, and they offer the first detailed picture of the interstate travelers who helped push the number of abortions nationwide to a high in 2023. The researchers surveyed a sample of clinics in each state where abortion remained legal to estimate the number of abortions.

For some anti-abortion groups, the feeling of victory after the overturn of Roe has been dimmed by the number of people circumventing abortion bans — and the lack of political will to address the issue in an election year.

“We’re agitating some of the Republicans who would be very comfortable spiking the football, patting themselves on the back, running for re-election, and then focusing on other issues that they’re more interested in,” said John Seago, the president of Texas Right to Life.

“We’ve never had a sense of finality. We’ve only seen the other side escalate their efforts to promote abortion,” he added.

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Change in abortions by state

State

Abortions 2023

Change from 2019

Nonresident share

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Wyo. 420 385% 18%
N.M. 20,960 369% 71%
Kan. 20,640 206% 69%
Va. 34,610 110% 17%
Colo. 25,210 103% 28%
S.C. 9,040 81% 40%
Ill. 90,540 73% 41%
Del. 3,520 72% 8%
Nev. 15,980 61% 16%
N.C. 45,800 56% 35%
Mont. 2,220 38% 10%
Utah 4,110 35% 7%
Minn. 14,620 31% 21%
Ore. 11,930 31% 11%
Wash. 24,220 30% 8%
Mich. 37,510 29% 7%
Md. 38,600 29% 21%
Alaska 1,650 25% 3%
Vt. 1,490 25% 26%
Hawaii 3,910 24% 6%
Conn. 14,790 23% 6%
Pa. 37,850 21% 7%
N.J. 58,380 21% 7%
Iowa 4,150 20% 10%
Calif. 179,610 19% 4%
Fla. 85,220 18% 11%
Neb. 2,540 18% 15%
N.H. 2,450 17% 12%
Ohio 23,750 16% 13%
Maine 2,400 14% 6%
Mass. 21,570 13% 6%
N.Y. 130,800 12% 5%
R.I. 2,960 4% 10%
Ariz. 13,220 2% 3%
D.C. 9,100 -8% 53%
Ga. 33,500 -16% 24%
Ind. 4,530 -41% 21%
Wis. 870 -88% 1%

No results

Source: Guttmacher Institute

Note: No data was collected from 13 states that had near-total abortion bans for all of 2023. A ban was in place in Wisconsin for a majority of the year.

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The availability of abortion pills has significantly blunted the impact of many state bans. But some patients still must travel to see a provider because of a medical condition or how far along they are in pregnancy. Others simply prefer it.

“I didn’t want the pills to get delivered to my school,” said Mia, 20, a college student in Houston who asked to be identified by only her first name. Instead, last August, she drove 12 hours to an Albuquerque clinic. “In case anything went wrong, I didn’t know if I could go to a hospital,” she said. “I figured it would be best to go in person and that way I’d know that it was taken care of.”

The clinic covered the procedure’s cost, but Mia paid around $500 for gas, two nights at an Airbnb and Uber rides to get to and from her appointment.

The explosion of out-of-state travel has been met with support from abortion clinics and abortion funds, which expanded access to services and financial support for patients.

“Now we have places where people who’ve been driving all night can nap in our clinics,” said Ms. Hagstrom Miller. “We have couches. We have waiting rooms specifically for children, with toys. We bring in sandwiches and food.”

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States with liberal abortion laws have also played a significant role.

“It looks like the protective policies that the states are enacting do matter,” said Kelly Baden, the vice president for public policy at the Guttmacher Institute. “But we should not be normalizing the reliance on networks of volunteers and donations.”

Illinois has invested upwards of $23 million into expanding abortion access and reproductive health care since 2022. Providers in the state have extended clinic hours and increased staffing and the availability of hospital-based abortion care.

“Things are running along very smoothly,” said Dr. Allison Cowett, the medical director at Family Planning Associates, a Chicago clinic whose patient volume has doubled since 2018. “We’ve caught up to the speed of things. This is our new normal.”

The Chicago Abortion Fund provides, on average, about $880 to each patient seeking an abortion in Illinois, up from around $545 in 2022, thanks to donations and city and state grants.

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“It still feels precarious — you don’t know when the priority of a single institution or a single foundation will change,” said Megan Jeyifo, the fund’s executive director.

Despite restrictions, patients traveled across the Southeast

Source: Guttmacher Institute

Note: Routes shown are for patients traveling into and out of Florida, Georgia, North Carolina and South Carolina. Routes with fewer than 100 patients are not shown.

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In Florida, the fight over abortion restrictions is far from over, with consequences for women across the South. The state had an 18 percent rise in abortions last year, including nearly 10,000 out-of-state patients.

A six-week ban that took effect in May has already upended those patterns, and advocates are asking voters to preserve abortion rights in the state’s Constitution in November.

For now, the closest state offering abortions later than six weeks in pregnancy is North Carolina, which requires counseling and a 72-hour waiting period.

“It’s a logistical nightmare,” said Kelly Flynn, the chief executive of A Woman’s Choice, which has clinics in Florida, North Carolina and Virginia. To save patients two trips out of Florida, physicians at her Florida clinic are licensed in North Carolina so that they can perform the mandatory counseling before the patient travels north.

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Lawmakers split over Maduro’s seizure. And, CDC cuts childhood vaccine schedule

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Lawmakers split over Maduro’s seizure. And, CDC cuts childhood vaccine schedule

Good morning. You’re reading the Up First newsletter. Subscribe here to get it delivered to your inbox, and listen to the Up First podcast for all the news you need to start your day.

Today’s top stories

Ousted Venezuelan President Nicolás Maduro and his wife, Cilia Flores, pleaded not guilty yesterday to federal charges, which include narco-terrorism. U.S. military forces seized them both from their country over the weekend. Yesterday marked their first appearance in a federal court in New York.

Protesters express their anger toward ousted Venezuelan leader Nicolás Maduro and fly the Venezuelan flag outside the Daniel Patrick Moynihan United States Courthouse in New York City on Monday.

José A. Alvarado Jr. for NPR


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  • 🎧 Before sitting down in court, Maduro made eye contact with reporters and wished them a “Happy New Year,” NPR’s Jasmine Garsd, who was in the courtroom, tells Up First. Flores walked in behind him and appeared to have a swollen eye and a bandaged forehead, which her lawyers explained came from her getting hurt during her capture. Outside the courthouse were heated exchanges between two groups of protesters: those who were against America’s intervention in Venezuela and Venezuelans celebrating Maduro’s capture. A man named Izzy McCabe says the capture is a ploy to take oil and foreign resources from Venezuela. Another protester, Maria Seu, said many countries have been living off Venezuela’s resources for years.

President Trump is set to meet with House Republicans at the Kennedy Center today as lawmakers call for more information on the operation in Venezuela and the U.S. role there moving forward. The meeting comes a day after top administration officials briefed Capitol Hill leaders on Maduro’s capture, leaving a largely partisan divide on the operation. Lawmakers questioned Trump’s decision not to inform Congress before carrying out the weekend seizure. Democrats say the action, which the White House is calling a law enforcement operation, is an act of war. Meanwhile, Republicans have largely aligned with the president’s stance on the situation.

  • 🎧 Democrats say the operation is just the latest example of the White House circumventing Congress, NPR’s Barbara Sprunt says. House Speaker Mike Johnson said Trump has the authority to deploy military forces to address threats to the U.S. When the president has joined meetings like the one he is expected to attend today in the past, it has become almost like a rally. Sprunt says she expects the same again today. The party is gearing up for the midterm elections, which means Venezuela will likely not be the only topic discussed.

The Centers for Disease Control and Prevention is reducing its number of recommended childhood vaccines from 17 to 11. The agency’s new schedule, which includes vaccines that had previously been recommended for all children — such as those for rotavirus, hepatitis A and B, meningitis and seasonal flu — is now more restrictive. The agency made these changes in response to a memo Trump issued in December directing health officials to align the U.S. schedule with those in “peer, developed countries” such as Germany and Japan.

  • 🎧 The new restrictions will lead to fewer children getting vaccinated, with consequences that could be seen for years down the line, Dr. Sean O’Leary, with the American Academy of Pediatrics, tells NPR’s Pien Huang. The agency implemented these changes without any new scientific developments behind them, Huang notes. The agency sidestepped its own advisory committee and didn’t consult vaccine makers.

Today’s listen

seasonal depression WIDE.jpg

Does the lack of winter sunlight drain your energy, or do you struggle to keep up with life’s demands during this season? If so, you may be experiencing seasonal affective disorder, or SAD. In this episode of It’s Been A Minute, host Brittany Luse shares the morning routine she developed for herself to combat this type of depression. She is also joined by Dr. Norman E. Rosenthal, a psychiatrist and scientist who first described seasonal affective disorder in the 1980s, to receive feedback on her SAD routine and learn about how we can all think differently about the rough winter months.

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Special series

chapter-2.png

Trump has tried to bury the truth of what happened on Jan. 6, 2021. NPR built a visual archive of the attack on the Capitol, showing exactly what happened through the lenses of the people who were there. In “Chapter 2: Stop the Steal,” we look at how false claims of a stolen election mobilized Trump supporters.

On election night in 2020, Trump claimed victory and said the election was being stolen long before officials declared a winner. He and his allies launched the “Stop the Steal” movement almost immediately, even as U.S. courts rejected the widespread claims of election fraud. Trump campaign officials also admitted they found no evidence that could have changed the outcome of the election. Right-wing activists such as Infowars host Alex Jones and the white nationalist and Holocaust denier Nick Fuentes mobilized the movement. On the day that Congress was set to meet to certify the election, Trump pressured Vice President Mike Pence and Republicans in Congress to try to reject Biden’s victory. These videos highlight the movement that led to Jan. 6, 2021.

To learn more, explore NPR’s database of federal criminal cases from Jan. 6. You can also see more of NPR’s reporting on the topic, including an Instagram post debunking myths about looting.

3 things to know before you go

A pill form of Wegovy, the popular obesity drug previously available only by injection, is seen in a plastic tray.

A pill form of Wegovy, the popular obesity drug previously available only by injection, is now being stocked by pharmacies.

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  1. Pharmacies across the U.S. began stocking the pill version of the popular obesity drug Wegovy yesterday, offering patients an alternative to the injectable form.
  2. Minnesota Gov. Tim Walz ended his bid for a third term yesterday, saying that he wants to dedicate his final year in office to combating fraud in state programs rather than campaigning. (via MPR)
  3. Wegmans says it is using facial recognition technology in a handful of stores across multiple states to help identify people “previously flagged for misconduct.” (via WXXI)

This newsletter was edited by Suzanne Nuyen.

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US oil refiners gear up for comeback of Venezuelan crude

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US oil refiners gear up for comeback of Venezuelan crude

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US refiners are braced for a surge in Venezuelan crude that would make them early winners of President Donald Trump’s extraordinary plans for an energy-led regime change in Caracas.

Shares in America’s top refining groups jumped on Monday as traders bet their US Gulf Coast operations could snap up big volumes of Venezuelan heavy crude as Washington looks to ease sanctions and revive production.

Valero, the biggest US importer of Venezuelan crude, closed 9 per cent higher. Phillips 66 added 7 per cent and Marathon Petroleum 6 per cent. 

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“Our refineries in the Gulf Coast of the United States are the best in terms of refining the heavy crude,” said US secretary of state Marco Rubio on Sunday. “I think there will be tremendous demand and interest from private industry if given the space to do it.”

Trump this weekend touted the “tremendous amount of wealth” that could be generated by American oil companies returning to Venezuela’s oil sector after US forces captured President Nicolás Maduro and transported him to the US to face trial on drug-trafficking charges. 

That has sparked a burst of interest among energy investors keen to return to Venezuela — home to the biggest oil reserves in the world — decades after expropriations by Caracas led most to abandon the country. 

A flurry of executives was expected to arrive in Miami on Tuesday, where US energy secretary Chris Wright will pitch the benefits of channelling billions of dollars into reviving Venezuelan oil output, which has fallen from 3.7mn barrels a day in 1970 to less than 1mn b/d today as a result of chronic mismanagement, corruption and sanctions. 

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While any investment by US companies in rejuvenating Venezuelan oil production could take time, Gulf Coast refiners are well positioned to hoover up crude shipments as soon as sanctions are eased and more import permits are granted, something analysts say could happen quickly. 

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“Near-term, Gulf Coast refiners could be among the biggest winners of shifts that could occur here,” said Dylan White, principal analyst for North American crude markets at consultancy Wood Mackenzie. 

“The investment side of the coin in Venezuela is much more slow moving. It’s turning a very slow ship and it involves high-level decisions from a number of companies,” he said. “[But] sanctions policy changing in the US could change the economic benefits for US Gulf Coast refiners tomorrow.”

American refiners and traders import about 100,000-200,000 b/d of Venezuelan crude, down from 1.4mn b/d in 1997. Under current US sanctions, Chevron is the only American producer allowed to operate in the country and imports of Venezuelan crude are heavily restricted.

As much as 80 per cent of Venezuelan exports had been bound for China before the US imposed a naval embargo last month. Much of that could be quickly rerouted to the US if sanctions were lifted.

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“The natural proximal home for a lot of those Venezuelan heavy barrels would be the refining complex of the US Gulf Coast,” said Clayton Seigle, senior fellow at the Center for Strategic and International Studies, adding that the fact that the facilities were equipped to process Venezuelan heavy oil could explain “some of the short-term stock market reactions that we observed”.

Valero, Philips 66 and Marathon did not respond to requests for comment on their plans.

US refineries were largely set up before the shale revolution made America the world’s biggest oil producer. Almost 70 per cent of US refining capacity is designed primarily to handle the heavy grades common in Venezuela, Canada and Mexico rather than the light, sweet variety found in Texas oilfields, according to the American Fuel and Petrochemical Manufacturers.

Consultancy S&P Global Energy estimates that from 1990 to 2010, US refiners spent about $100bn on heavy crude processing capabilities, just before the fracking boom sent American production soaring.

“This finally gets some of the [return on investment] back,” said Debnil Chowdhury, Americas head of refining and marketing at S&P, of the potential for a return to significant imports of Venezuelan heavy oil.

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“We had a system that was kind of running de-optimised for the last 10-15 years. And this allows it to get a little bit closer to what it was designed for — which means slightly higher yields, higher margins.

“You get to basically use your asset more how it was designed because you’re getting the feedstock it was designed for.”

Data visualisation by Eva Xiao in New York

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Maduro seized, norms tested: Security Council divided as Venezuela crisis deepens

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Maduro seized, norms tested: Security Council divided as Venezuela crisis deepens

Why it matters: Council members are split over whether Washington’s move upholds accountability – or undermines a foundational principle of international order.  

Some delegations argue the action was exceptional and justified; others warn it risks normalising unilateral force and eroding state sovereignty.

Setting the tone, the UN Secretary-General cautioned that international peace and security rest on all Member States adhering to the UN Charter – language that framed a debate likely to expose deep and lasting divisions inside the chamber in New York – all as the Venezuelan leader appeared in a downtown federal courtroom just a few miles away.

US Ambassador Michael Waltz addresses the Security Council.

US: Law-enforcement operation, not war

The United States rejected characterisations of its actions as military aggression, describing the operation as a targeted law enforcement measure facilitated by the military to arrest an indicted fugitive.

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Ambassador Michael Waltz said:

  • Nicolás Maduro is not a legitimate head of State following disputed 2024 elections.
  • Saturday’s operation was necessary to combat narcotics trafficking and transnational organised crime threatening US and regional security.
  • Historical precedents exist, including the 1989 arrest of Panama’s former leader Manuel Noriega.

“There is no war against Venezuela or its people. We are not occupying a country,” he said. “This was a law-enforcement operation in furtherance of lawful indictments that have existed for decades.”

Venezuelan Ambassador Samuel Moncada addresses the Security Council meeting.

Venezuelan Ambassador Samuel Moncada addresses the Security Council.

Venezuela: Sovereignty violated; a dangerous precedent

Venezuelan Ambassador Samuel Moncada described his country as the target of an illegitimate armed attack lacking any legal justification, accusing the US of bombing Venezuelan territory, the loss of civilian and military lives, and the “kidnapping” of President Nicolás Maduro and First Lady Cilia Flores.

“We cannot ignore a central element of this US aggression,” he said. “Venezuela is the victim of these attacks because of its natural resources.”

Calling on the Council to act under its Charter mandate, he urged that:

  • The US be required to respect the immunities of the president and his wife and ensure their immediate release and safe return;
  • The use of force against Venezuela be clearly and unequivocally condemned;
  • The principle of non-acquisition of territory or resources by force be reaffirmed; and
  • Measures be adopted to de-escalate tensions, protect civilians and restore respect for international law.

Article 2 of the UN Charter in a nutshell

The ground rules for global cooperation 

Article 2 lays out the core principles that guide how countries work together under the United Nations. Here’s what it means:

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  • Equality for all nations: Every Member State, big or small, is treated as an equal.
  • Keep your promises: Countries must honour the commitments they made when joining the UN.
  • Peaceful problem-solving: Disputes should be settled without violence, to protect peace and justice.
  • No force or threats: Nations must not use force or threaten others’ independence or territory.
  • Support the UN’s actions: Members should help the UN when it acts to maintain peace—and never assist those opposing it.
  • Influence beyond membership: Even non-member States should follow these principles when peace and security are at stake.
  • Hands off domestic affairs: The UN cannot interfere in a country’s internal matters – except when enforcing peace under Chapter VII, which deals with actions to preserve international peace and security.

Read more about the UN Charter here.

Concern over use of force

Several Council members and others invited to take part expressed deep concern over the US military action, grounding their positions firmly in the UN Charter.

Colombia, Brazil, Mexico, Chile and Panama, underscored their region’s long-standing declaration as a zone of peace and warned that unilateral military action risked destabilising the Western hemisphere and aggravating displacement flows.

  • Colombia, in its first intervention as an elected Council member, rejected “any unilateral use of force” and cautioned that civilians invariably pay the highest price.
  • Brazil said the bombing and seizure of a head of State crossed an “unacceptable line,” warning of the erosion of multilateralism.
  • Mexico stressed that externally imposed regime change violates international law regardless of political disagreements.

Ambassadors also cited a worrying human rights situation inside Venezuela and the suffering of civilians, highlighting the need to ensure compliance with international law:

  • The United Kingdom highlighted years of suffering endured by Venezuelans – poverty, repression and mass displacement – while underscoring that respect for the UN Charter and the rule of law is essential for global peace and security.
  • Denmark and France acknowledged the imperative to combat organised crime and protect human rights – but warned that counter-narcotics efforts and accountability must be pursued through lawful, multilateral means.
A wide view of the United Nations Security Council meeting discussing threats to international peace and security, specifically regarding the situation in Venezuela.

A wide view of the Security Council meeting on the situation in Venezuela.

Regional voices backing US action

A smaller group of countries from the region took a different view.

  • Argentina praised the US operation as a decisive step against narcotics trafficking and terrorism, arguing that the operation and Mr. Maduro’s removal could open a path toward restoring democracy, the rule of law and human rights in Venezuela.
  • Paraguay also welcomed Mr. Maduro’s removal, calling for the immediate restoration of democratic institutions and the release of political prisoners, while urging that the transition proceed through democratic means.

Charter credibility at stake

Russia and China delivered some of the strongest criticism, characterising the US action as armed aggression and warning against the normalisation of unilateral force.

This position was echoed by countries beyond the Americas – including South Africa, Pakistan, Iran and Uganda – which warned the selective application of international law risks undermining the entire collective security system.

Representatives of Moscow and Beijing called for the immediate release of President Maduro and stressed the inviolability of head-of-State immunity under international law, framing the situation as a test of whether Charter principles apply equally to all States.

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Broadcast of the Security Council meeting regarding the situation in Venezuela.
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