Minnesota abortions grow as women from out of state continue seeking them

Abortions increased nearly 16% in Minnesota in 2023, driven by women traveling from states with more abortion restrictions as well as the state's easier access to medication options.

The 14,124 abortions in Minnesota in 2023 marked the second straight annual increase and reflected the impact of the U.S. Supreme Court decision in June 2022 to overturn Roe v. Wade, which had federally protected abortion access for decades.

More than 1 in 5 abortions in Minnesota in 2023 involved women from other states, the highest rate on record. The number of women coming from North Dakota, Iowa and Nebraska more than doubled after lawmakers in those states imposed restrictions on abortion access.

"Every single day, we have a couple people on the schedule who are flying in" for abortion appointments, said Amy Hagstrom Miller, chief executive of Whole Woman's Health, which operates a clinic in Bloomington and is Minnesota's second-largest abortion provider.

The trend of rising abortions among state residents and out-of-state visitors was reported this week by the Minnesota Department of Health, which met its new legislatively required deadline of producing 2023 abortion numbers by the end of last year.

In 2023, DFL lawmakers led changes to Minnesota's abortion reporting requirements, delaying the timing of the release and reducing the amount of information that women had to report. The document no longer contains aggregate information on why women sought abortions, such as whether economic concerns influenced their decisions.

Hagstrom Miller said the shifting trends in Minnesota have changed how her clinic receives patients, some of whom are driving from other states with their children. The waiting room now has toys for kids, and the clinic has quiet spaces where women can rest or nap before they return home.

"We never had to worry about people's flight schedules before," Hagstrom Miller said.

Abortions had been declining for years in Minnesota, which reported a record low 9,861 in 2015. Activists on both sides of the issue had celebrated declines in teenage pregnancies and abortions in Minnesota, which had invested in goal-setting classes in schools that taught teens to weigh the consequences of unprotected sex. Abortion numbers leveled off in the state over the past decade before increasing significantly in the past two years.

Minnesota saw a 9% increase from 2022 to 2023 in abortions among state residents. Abortions among Minnesotans age 19 or younger also increased slightly — from 942 in 2022 to 983 in 2023.

Abortion opponents faulted Minnesota for laws that maintained access at a time when border states have issued restrictions. South Dakota and Iowa have banned most abortions; Wisconsin requires patients to receive medication abortions in person from physicians and not online or from physician assistants or nurse practitioners. North Dakota's ban on most abortions after six weeks' gestation was ruled unconstitutional last fall.

Minnesota could see more abortions because it removed a requirement for providers to list alternatives, such as mentoring and support programs at pregnancy resource centers, said Cathy Blaeser, co-executive director for Minnesota Citizens Concerned for Life.

"Often women are making these decisions out of fear and pressure, because they are not given other options," she said.

Some of the increase is explained by the relocation of the Red River Women's Clinic, which moved from Fargo, N.D., to Moorhead in 2022 after the Supreme Court decision triggered legislation to restrict abortion access in North Dakota. Women from northwest Minnesota who traveled to the Red River clinic in prior years wouldn't have shown up on the annual state report. Now, Red River is Minnesota's fourth-largest abortion provider.

Access also has expanded in Minnesota beyond Planned Parenthood, which in 2020 performed 72% of abortions in the state at its locations in St. Paul and Rochester. Planned Parenthood remains Minnesota's largest provider, performing over half of the abortions in the state in 2023.

But telehealth providers of medication options have emerged. Just the Pill, Minnesota's third-largest provider, offers medication abortions through online consultations in four states.

The 2023 report is the first in which the state identified online providers such as Just the Pill by name. Carafem, Minnesota's fifth-largest provider overall, offers telehealth options beyond its clinics in Chicago, Atlanta and Washington, D.C.

The competition appears to have affected Robbinsdale Clinic, a longstanding Minnesota abortion provider that is reportedly closing this year.

Abortions numbers had declined by nearly one third at the clinic over the past decade. The Robbinsdale City Council voted in December to rezone the clinic building, which U.S. Internet is converting into a facility for fiberoptic internet infrastructure.

Abortions largely were provided through outpatient surgeries until 2020, the first year when the majority of the procedures in Minnesota involved medications. More than 9,000 of the abortions in the state in 2023 involved medications such as mifepristone, a trend likely to continue after a Supreme Court ruling last summer that preserved access to the drug.

Mifepristone is federally approved for abortions at or before the 10th week of pregnancy. More than 84% of abortions in Minnesota occur by this milestone within the first trimester, a slight increase over the past decade.

Minnesota's year-end report has become somewhat dated; it was previously released each year by July 1. Ruth Richardson, chief executive for Planned Parenthood North Central States, said the trends of 2023 continued into 2024 and are being influenced by shifts in state and federal policy.

November's election of Donald Trump as president caused an increase in women seeking long-acting birth control and even in men scheduling vasectomies because of concerns that his policies could restrict access, Richardson said. Patients coming to Minnesota from Iowa more than doubled after July, she added, when a court ruling allowed Iowa to impose a ban on many types of abortions.

"The numbers are staying pretty steady in terms of what we are seeing, and we're continuing to see people from all across the United States," she said. "It's a real reflection of the barriers that have been put into place" in other states.