Abortions in Indiana spiked in the months after the Dobbs ruling, but the number of procedures across the state has since dropped nearly 50%, according to newly released state data.
The first three months after the U.S. Supreme Court overturned Roe v. Wade, Indiana clinics submitted an average of 1,048 terminated pregnancy reports each month, according to Indiana Department of Health data obtained by the Indiana Capital Chronicle.
But those abortion reports dropped sharply between October and January, averaging just 552 terminations per month. That is well below monthly averages for previous years.
State lawmakers passed a near-total abortion ban in August, but the procedure remains legal in Indiana while the law is being challenged in court. Under an injunction, the state’s previous abortion law stands – allowing abortions up to 20 weeks.
Still, providers say patients are confused about what’s allowed and what’s not, adding that such bans create a chilling effect and discourage people from seeking the procedure in Indiana.
Staff shortages are additionally limiting the ability of Hoosier clinics to provide abortions.
Planned Parenthood’s Indianapolis clinic – which provided the largest number of abortions in 2021 – hasn’t performed abortions since at least the end of February. The organization didn’t respond to requests about the matter but the website for the Georgetown Road location says it is providing only “abortion referrals.”
Dr. Katie McHugh, a licensed gynecologist in Indianapolis who provides abortion care, attributed much of the decline to uncertainty surrounding Indiana’s laws and whether the ban is still in effect.
“We still have patients coming in or calling into the clinic saying, ‘Where do I go? Can you refer me to a place out of state?’ And we’re like, ‘Sure. But we can also see you here,’ ” she said. “Even for the folks who are following this and are aware of the injunction, it’s still confusing.”
McHugh said she and other abortion care providers operate in a sort of legal limbo, where the anticipated decision from the Indiana Supreme Court could alter their practice indefinitely.
“It’s very complicated when you’re trying to schedule patients, when you’re trying to place supply orders (on medicine) … if you don’t know if you can literally provide care tomorrow,” McHugh said.
Katie Blair, advocacy and public policy director for the ACLU of Indiana – who has filed two lawsuits against the state ban – said “Although abortion remains legal, in the past decade, the Indiana General Assembly has enacted more than 50 abortion restrictive laws. These laws, combined with the looming ban that is now held up in the courts can make it more challenging for providers to offer reproductive care, and more difficult for women to access the care they need.”
By the numbers
In July, August and September, seven abortion care providers licensed in Indiana reported more than 1,000 pregnancy terminations each month, while abortions over the same time period in 2021 averaged just under 700 per month.
The state health department hasn’t yet released its full 2022 report, meaning the latest comparable numbers are from 2021.
The newest data provided by the Indiana Department of Health also only reflect when reports were submitted – not necessarily when the procedures were performed. But providers have 30 days to file the paperwork.
In the late summer months, part of the demand came from neighboring states with restrictive laws on abortion, McHugh said. As laws changed, so has the demand.
“Other states that were previously banned now have injunctions in place so that care is accessible,” McHugh said, highlighting Ohio.
Most abortions were illegal in Ohio as soon as the U.S. Supreme Court overturned Roe v. Wade in late June. Several Ohio clinics challenged the law, which started once embryonic cardiac activity could be detected around six weeks. A court issued an injunction on that ban in October.
Over the summer, Indiana made national news after a 10-year-old rape victim from Ohio sought abortion care in the Hoosier State. The child was one of potentially hundreds of Ohioans to seek abortion care providers.
As Indiana grappled with its own new restrictions, reported abortions fell to half the previous month’s reports, from 1,030 in September to 446 in October – even though abortion in Indiana was only illegal for about a week.
The 405 terminated pregnancy reports submitted in January 2023 is roughly half of the 793 terminations reported for January 2021.
The Indiana Department of Health doesn’t have February numbers yet, prolonging uncertainty about the impacts of the temporary closure of the Planned Parenthood location on the north side of Indiana in late February. That clinic alone performed more than one-quarter, or 29%, of all the state’s abortions in 2021.
Planned Parenthood, which operates four of the seven clinics providing abortion services, did not respond to multiple Capital Chronicle requests for comment.
Women’s Med Group Professional Corporation of Indianapolis, the clinic performing the second highest number of abortions in Indiana, performed 27% of the state’s procedures in 2021. The location similarly told the Capital Chronicle it needs to train more staff but declined to give an interview before publication.
Both clinics, along with Whole Women’s Health Alliance, were part of the lawsuit that paused the state’s near-total abortion ban.
Those bans, according to Whole Women’s founder and CEO Amy Hagstrom Miller, only kept people from accessing safe abortions in their communities.
“The same amount of people still need access to safe abortion; abortion bans don’t change the number of people that have unplanned pregnancies,” Hagstrom Miller said. “It’s not reducing the need, it’s just making people have to travel farther and oftentimes pushing them further into their pregnancy.”
Meanwhile, Indiana Right to Life CEO Mike Fichter said his group “suspect(s) Indiana briefly became an abortion destination in the months following Dobbs,” especially for women coming from Ohio and Kentucky.
“Both of these states had strong pro-life laws in effect almost immediately after Roe was overturned, yet Indiana’s new law did not go into effect until mid-September, and then just briefly, before it was blocked in court,” Fichter said in a written statement. “Had the legislature not tightened Indiana’s abortion law in last year’s special session, there is little doubt abortions would have continued to skyrocket in our state.”
‘Help Wanted’ at abortion clinics
As the availability of abortion wavered, doctors made other plans. Illinois became a hot spot, as the sanctuary state saw demand surge as all of its neighbors pursued bans. Pushed out of their home states, many physicians opted to license in Illinois and other states.
McHugh chose to license in Ohio and Maryland.
“We are all still in Indiana, though many of us have also become licensed in other states and are providing abortion care in other states,” McHugh said. “That is not necessarily the reason for decreased access, that is more a function of the … instability around whether abortion will remain legal in Indiana.”
As a licensed doctor, McHugh said she had flexibility that other staff didn’t – including positions at other clinics and health services beyond abortion.
“It is very difficult to keep staff at the front desk or people to help take vitals,” McHugh said. “(Those employees) need to make sure they have a steady and stable income to feed their families and pay their bills. It is very different for us to ask these low-paid but dedicated employees to continue to show up for a job that may not exist next week.”
Hagstrom Miller, with Women’s Health, reported the same staffing difficulty. One staffer relocated to Virginia while another took a different position within the company. Since the ban passed, the clinic hasn’t always been able to schedule appointments and closed intermittently.
“People want to be sure they have a stable income for their families,” Hagstrom Miller said. “I think all clinics are navigating this.”
The South Bend clinic, located at the Michigan border and roughly 90 minutes from Chicago, has the option to divert patients elsewhere if they can’t get scheduled in Indiana, including a virtual option in Illinois.
“Sometimes I call this the era of uncertainty. There’s a lot of uncertainty because we don’t know how long we can promise somebody work and we don’t know how long we’ll be able to be open,” Hagstrom Miller said. “We’re waiting for the final decision from the lawsuit.”
McHugh also doesn’t expect relief soon – so long as the abortion ban (or lack thereof) remains uncertain. But she said clinics have the responsibility to train their staff to ensure the safety of the procedure – which has a complication rate far below childbirth, especially in states like Indiana that have a high maternal mortality rate.
“We want to make sure that patients are safe; that the employees are supported with the education and the training they need,” McHugh said.
Hagstrom Miller wants Hoosier women to know that the clinic’s abortion care providers can still connect people to services, including funding and travel support.
“We are still answering our phones … we’re helping Hoosiers either get medication abortion by mail in Illinois, to travel to Indianapolis where clinics might be open or travel to Illinois or Michigan,” Hagstrom Miller said. “The one promise we know we can keep to our patients is that we’re going to answer those phones and we’re going to give you the most current information.”
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