North Carolina abortions sharply decline following state’s new restrictions, new data shows
In the month after North Carolina’s new abortion law took effect, the number of abortions performed in the state dropped by an estimated 30%, according to a new analysis from the Guttmacher Institute, a reproductive health research group.
The researchers said this drop likely represents hundreds of North Carolinians and out-of-state women who could not access abortion services due to restrictions outlined in the law, including a 12-week gestational ban and a mandatory in-person appointment 72 hours before the procedure.
About 2,900 abortions were performed in July, down from about 4,200 abortions performed in June, according to the group’s estimates, which are based on historical data and data sampled from select abortion clinics.
Dr. Jonas Swartz, an OBGYN who provides abortions at the Chapel Hill Planned Parenthood, said he found it notable that this drop was far greater than what you would expect if the laws only stopped abortions that occurred after 12 weeks — these abortions accounted for just 7% of cases in 2021, according to the most recent state data.
“It’s not like you only eliminated those cases that were beyond that first trimester,” he said. “They put barriers in place so that those under the legal limit were unable to access care.”
A mandatory, in-person appointment three days before the abortion was one of the largest new barriers that went into effect on July 1, he said.
Now that women have to show up for two appointments, Swartz’ patients have to organize several days of childcare, time off work and accommodations near the clinic, he said.
This is particularly onerous for women traveling hours from other states.
Until the NC’s new abortion restrictions took effect, North Carolina had been a hub for patients coming from Southern states where the procedure was more heavily restricted or banned. Shortly after the Supreme Court overturned Roe v. Wade, the number of abortions performed in the state increased by 37% — the largest increase in any state.
Now, some women cancel their appointments after hearing the new rules over the phone, he said.
“It’s just not feasible to come and spend three to five days in North Carolina to get the abortion,” he said.
Swartz also said the new law forced abortion clinics to pack their schedules with newly required appointments, which limited their capacity. The law also requires clinics to document their attempts to schedule patients for a third in-person appointment, further adding to the staffs’ workload.
“I think we’re still working to figure out how you provide twice as many visits with the same number of clinic slots,” he said.
Abortion rights advocates feared in the face of these new obstacles, patients would make longer trips to states with less restrictive rules. But Isaac Maddow-Zimet, the lead data scientist on the Guttmacher project, said their analysis did not find that abortion numbers in neighboring states rose a comparable amount.
“That’s one of the things that’s really a big question in our mind,” he said. “It might mean that people are obtaining care outside of the formal health care sector. It might be that some people are being forced to continue their pregnancy.”
For some anti-abortion groups, like the NC Values Coalition, this new data has been a welcome sign that the state’s new laws are working. Still, Tami Fitzgerald, executive director of the organization, said they could go further.
“The new law appears to be working to keep North Carolina from being a destination for abortion,” she said. “While 30% is an encouraging number, we still need to reduce abortions in North Carolina.”
Maddow-Zimet said there are a few caveats to this data.
There was a small decline in the number of abortions provided nationwide — by about 7% — likely due to seasonal changes in when people become pregnant.
He said that could have played a small role in the state’s decline but that the drop-off in North Carolina was too large to be seasonal variation alone.
“North Carolina’s drop was so much steeper than anywhere else,” he said. “It’s very clear that what we’re seeing — especially because it’s timed specifically with when the law came into effect — is largely the impact of that law.”
Teddy Rosenbluth covers science and health care for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. The N&O maintains full editorial control of the work.
This story was originally published October 11, 2023 at 4:00 AM.
