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The influx of abortion seekers to so-called clinic states — or states that have legal protections for abortion in place — is predicted to be large should Roe v. Wade be overturned. Projecting which states will see the largest increases has everything to do with geography.

A large influx of abortion-seekers is projected to look for services in North Carolina due to its proximity to many southeastern states where abortion is certain or likely to be banned if Roe is overturned. But unlike Illinois, the legal status of abortion in North Carolina is tenuous and highly dependent on whether anti-abortion candidates are successful in the state’s midterm elections over the coming months. The debate over abortion rights in North Carolina will likely be decided, at least for the time being, in 2023.

Clinics in North Carolina have already seen an increase over the past year of out-of-state abortion seekers, with some coming from as far as Texas in search of services, according to Amber Gavin, the vice president of Advocacy and Operations at A Woman’s Choice, a group of North Carolina and Florida-based abortion clinics. And if Roe is overturned, Gavin expects those numbers will keep climbing.

“I do think we’re going to see probably well over 50% to 80% [more] patients than what we’re currently seeing, ”she told Stacker in an interview.

Gavin also said A Woman’s Choice clinics are considering hiring more staff and physicians to accommodate the influx. “We’re working really hard with our staff, with abortion funds, with advocates on the ground to make sure that people who need and want that care are able to get it,” she said.

Illinois has long been a reproductive care hub for Midwesterners. Out-of-state patients seeking abortions rose from 2,970 in 2014 to 9,686 in 2020, according to Illinois Department of Public Health data. These numbers are projected to continue to rise as people come from Michigan, Indiana, Wisconsin, Ohio, Missouri, and even some Southern states. To increase access, two Planned Parenthood clinics have opened in recent years along the Illinois border. The state is one of the few in the Midwest where the right to abortion is certain to be protected long-term.

Many clinic states have made moves since 2019 to fund abortion services and codify abortion. Vermont, for instance, passed Act 47which preserves the right to reproductive choice, including abortion, in the year following the appointment of Justice Brett Kavanaugh to the Supreme Court. Several other states followed suit, including California, Connecticut, Oregon, Maine, and Illinois. The subsequent appointment of Amy Coney Barrett to the Supreme Court in 2020 cemented the court’s conservative supermajority and encouraged legal challenges to Roe v. Wade in 2021.

Some states have already taken steps to ensure access to safe abortions for people crossing state lines.

In 2019, New York funded the New York Abortion Access Fund, intended to help low-income abortion seekers from other states travel to New York for services. In March 2022, California passed SB 245, an act that eliminates out-of-pocket costs for abortions for those who have private insurance, as well as those on California’s Medicaid. In Oregon, legislators passed the Reproductive Health Equity Fund, which allocates $ 15 million to expand abortion services, including helping to cover expenses of those traveling to Oregon for abortions. And Connecticut Governor Ned Lamont is planning to sign a bill that would shield Connecticut abortion providers and out-of-state patients from being sued by states where abortion — even outside the state — is illegal.


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