ATLANTA — At a routine ultrasound when she was five months pregnant, Hevan Lunsford began to panic when the technician took longer than normal, then told her she would need to see a specialist.
Lunsford, a nurse in Alabama, knew it was serious and begged for an appointment the next day.
That’s when the doctor gave her and her husband the heart-wrenching news: The baby boy they decided to name Sebastian was severely underdeveloped and had only half a heart. If he survived, he would need care to ease his pain and several surgeries. He may not live long.
Lunsford, devastated, asked the doctor about ending the pregnancy.
“I felt the only way to guarantee that he would not have any suffering was to go through with the abortion,” she said of that painful decision nearly three years ago.
But the doctor said Alabama law prohibits abortions after five months. He handed Lunsford a piece of paper with information for a clinic in Atlanta, a roughly 180-mile (290-kilometer) drive east.
Lunsford is one of thousands of women in the U.S. who have crossed state lines for an abortion in recent years as states have passed ever stricter laws and as the number of clinics has declined.
Although abortion opponents say the laws are intended to reduce abortions and not send people to other states, at least 276,000 women terminated their pregnancies outside their home state between 2012 and 2017, according to an Associated Press analysis of data collected from state reports and the U.S. Centers for Disease Control and Prevention.
In New Mexico, the number of women from out of state who had abortions more than doubled in that period, while Missouri women represented nearly half the abortions performed in neighboring Kansas.
“The procedure itself was probably the least traumatic part of it,” Lunsford said. “If it would have been at my hospital, there would have been a feeling like what I was doing was OK and a reasonable choice.”
While abortions across the U.S. are down, the share of women who had abortions out of state rose slightly, by half a percentage point, and certain states had notable increases over the six-year period, according to AP’s analysis.
In pockets of the Midwest, South and Mountain West, the number of women terminating a pregnancy in another state rose considerably, particularly where a lack of clinics means the closest provider is in another state or where less restrictive policies in a neighboring state make it easier and quicker to terminate a pregnancy there.
“In many places, the right to abortion exists on paper, but the ability to access it is almost impossible,” said Amy Hagstrom Miller, CEO of Whole Women’s Health, which operates seven abortion clinics in Maryland, Indiana, Texas, Virginia and Minnesota. “We see people’s access to care depend on their ZIP code.”
Nationwide, women who traveled from another state received at least 44,860 abortions in 2017, the most recent year available, according to the AP analysis of data from 41 states.
That’s about 10% of all reported procedures that year, but counts from nine states, including highly populated California and Florida, and the District Columbia were not included either because they were not collected or reported across the full six years.
Thirteen states saw a rise in the number of out-of-state women having abortions between 2012 and 2017.
New Mexico’s share of abortions performed on women from out of state more than doubled from 11% to roughly 25%. One likely reason is that a clinic in Albuquerque is one of only a few independent facilities in the country that perform abortions close to the third trimester without conditions.
Georgia’s share of abortions involving out-of-state women rose from 11.5% to 15%, while North Carolina saw its share increase from 16.6% to 18.5%. North Carolina had one of the highest shares of out-of-state abortions in 2017. While both states have passed restrictive laws, experts and advocates say they are slightly more accessible than some of their surrounding states.
In Illinois, the percentage of abortions performed on non-residents more than doubled to 16.5% of all reported state abortions in 2017. That is being driven in large part by women from Missouri, one of six states with only a single abortion provider.
Even that provider, in St. Louis, has been under threat of closing after the state health department refused to renew its license.
Missouri lawmakers also passed a law this year that would ban almost all abortions past eight weeks of a pregnancy, but it faces a legal challenge.
About 10 miles from St. Louis, across the Mississippi River, is the Hope Clinic in Granite City, Illinois, which has seen a 30% increase in patients this year and has added two doctors, deputy director Alison Dreith said.
About 55 percent of its patients come from Missouri, and it also sees women from Indiana, Kentucky and Ohio. All those states have mandatory waiting periods to receive an abortion, a requirement Illinois does not have.
Dreith called it a scary time for women in states with highly restrictive laws and few clinics.
“The landscape that we’re seeing today did not happen overnight, and it was not by accident,” she said.
And Illinois isn’t the only place Missouri women are heading for abortions.
In 2017, Missouri women received 47% of all abortions performed in Kansas. That is in large part because the only access to the procedure throughout western Missouri, particularly the greater Kansas City area, is across the state line in Overland Park, Kansas.
Between 2011 and May 31 of this year, 33 states passed 480 laws restricting abortion, according to the Guttmacher Institute, a research organization that supports abortion rights.
In 2019 alone, lawmakers approved 58 restrictions primarily in the Midwest, Plains and South — almost half of which would ban all, most or some abortions, the group said.
The most high-profile laws, which face legal challenges that could eventually test the U.S. Supreme Court’s Roe v. Wade decision, would ban abortion after a fetal heartbeat can be detected — as early as six weeks.
Advocates say that if the Supreme Court upholds the latest restrictions, it will become more common for women to seek an abortion in another state.
“The intent of these lawmakers is to completely outlaw abortion and force people not to have abortions. But in reality, it pushes people farther and wider to access the care they want and need,” said Quita Tinsley, deputy director of Access Reproductive Care Southeast.
ARC Southeast is part of the National Network of Abortion Funds, a collective of 70 abortion support groups for women in six Southeast states. Some provide money to women to pay for abortions, while others also help with transportation, lodging and child care.
A third of women calling the group’s hotline for help end up traveling out of state for abortions, Tinsley said. Many choose Georgia because it’s convenient to get to and considered slightly less restrictive than some other states in the South.
In Georgia, which has a mandatory waiting period, a woman is not required to come to a clinic twice, like they are in Tennessee. But if Georgia’s new fetal heartbeat law survives a court challenge, it would have one of the earliest state-imposed abortion bans.
That would force many women to go even farther from where they live to terminate their pregnancies.
Of all states, New Mexico has seen the biggest increase in the number of women coming from elsewhere for an abortion — a 158% jump between 2012 and 2017, according to AP’s analysis.
The New Mexico Religious Coalition for Reproductive Choice helps an average of 100 women a year but is on track to assist 200 this year. Some of its 55 volunteers open their homes to women coming from out of state.
Executive director Joan Lamunyon Sanford said her group is doing what faith communities have always done: “Care for the stranger and welcome the traveler.”
Lamunyon Sanford said the need is growing as barriers increase and women are unable to access care where they live.
“They have to figure out so many details and figuring out how they are going to get the funding for everything,” she said. “Sometimes it’s just too much. And then they become parents.”
The coalition helped Beth Vial, who didn’t learn she was pregnant until she was six months along after chronic medical conditions masked her symptoms.
As a 22-year-old college student living in Portland, Oregon, Vial was beyond the point when nearly every abortion clinic in the country would perform the procedure.
Vial’s only option for an abortion was New Mexico, where a volunteer with the New Mexico Religious Coalition for Reproductive Choice drove her to and from the clinic in Albuquerque and brought her meals.
The support she received inspired her to join the board of Northwest Access Abortion Fund, which helps women in Oregon, Washington, Idaho and Alaska.
“To have people I didn’t even know support me in ways that I didn’t even really know I needed at the time was unlike anything I have ever experienced,” said Vial, now 24. “It has encouraged me to give back to my community so other people don’t have to experience that alone.”
Abortion opponents say the intent of laws limiting the procedure is not to push women to another state but to build more time for them to consider their options and reduce the overall number of abortions.
“I have been insistent in telling my pro-life colleagues that’s all well and good if the last abortion clinic shuts down, but it’s no victory if women end up driving 10 minutes across the river to Granite City, Illinois, or to Fairview Heights,” said Sam Lee, director of Campaign Life Missouri and a longtime anti-abortion lobbyist.
Anti-abortion activists also hope a broader cultural shift eventually makes these issues disappear.
“We are seeing this trend toward life and a realization of what science tells us about when life begins,” said Cole Muzio, executive director of the Family Policy Alliance of Georgia who advocated successfully for new abortion limits there. “Just because something is legal does not mean that it is good.”
Before the recent wave of legislation focused on limiting when an abortion can be performed, opponents largely worked to regulate clinics. Critics say those regulations contributed to more clinics closing in recent years, reducing access to abortion in parts of the country and pushing women farther for care.
Texas lost more than half its clinics after lawmakers in 2013 required them to have facilities equal to a surgical center and mandated doctors performing abortions have admitting privileges at a nearby hospital.
Even though the U.S. Supreme Court struck down key provisions of the law in 2016, most clinics have not reopened.
Candice Russell was among those who felt the impact. When she sought an abortion in Dallas in 2014, she was told she would have to wait more than two weeks because of an influx of patients from other parts of Texas where clinics had closed.
She feared she would not be able to miss work for back-to-back appointments, required under Texas’ mandatory waiting period, so she told the bar where she worked that a relative died and took out a payday loan to buy an airplane ticket to California. She had the procedure the next day.
“Even though I had to take on that horrendous loan and entered a debt spiral that lasted until about two years ago, I am really, really lucky,” said Russell, now 36 and working as deputy director of the Yellowhammer Fund, which helps women in Alabama seeking abortions. “There are a lot of people who just can’t do that. They can’t get on a plane and fly 1,500 miles for an abortion.”
Nationwide, 168 independent abortion clinics have closed since 2012, and just a handful opened over that time, according to the Abortion Care Network, a clinic advocacy group.
Some resulted from providers retiring and an overall decline in unplanned pregnancies, but advocates say many shut down because of restrictive laws.
“It’s not about safety of patients,” said Nikki Madsen, executive director of the Abortion Care Network. “It’s about closing clinics.”
For Lunsford, it took two years before she could begin managing the grief of losing her son, compounded by the hurdles she faced to carry out that painful decision — the drive to Atlanta, staying in a hotel and going to a clinic with doctors she didn’t know.
Lunsford, now 31, said she thinks about how she couldn’t hold her baby, an intimate goodbye that might have been possible if she had the abortion at a hospital. Before she left Atlanta, she asked the clinic’s staff to use the inkpad and paper she brought so she could keep her son’s footprints and handprints.
“Most of the laws I navigated, there was no reason for them,” she said. “None of them prevented my abortion. It just made it where I had to travel out of state.”
Contrary to the belief of some, the Buchanan County Sheriff’s Department doesn’t have a “no chase” rule.
According to Buchanan County Sheriff Bill Puett, deputies with his department make a decision on a case-by-case basis on whether or not to pursue a fleeing vehicle.
“Is it reasonable to pursue versus waiting to identify at a later time?” Puett said of what deputies must ask themselves when they begin a pursuit.
Puett said deputies involved in pursuits must radio the communications center with the factors of the chase. If a supervisor thinks the chase is too dangerous, they can instruct the deputy to back off.
“What’s the risk to the community? What’s the risk to citizens that might be walking in the area?” Puett said. “So chasing for a property crime, like a stolen car, is probably not going to last as long as if someone had tried to abduct a child.”
News-Press NOW reached out to to the St. Joseph Police Department to ask about its policy on pursuits, but the officials declined an interview. Puett did say the police department has access to a device called “StarChase,” which is a GPS tracking device that can be attached to fleeing vehicles.
According to the StarChase website, cars tagged with the device usually slow down to near the speed limit in under two minutes. In a statement, the American Civil Liberties Union said it wasn’t opposed to the device as long as it’s used in a situation where police already have probable cause.
Puett said the helicopter operations that the sheriff’s department and surrounding police agencies conduct also can be a way to follow suspects safely.
For the last year, the St. Kolbe-Puckett Center for Healing has helped individuals in St. Joseph overcome addiction and find a path to recovery.
The main focus of the center has been dealing with opioid addiction, however, the staff has began to deal with meth and heroin addicts as well.
Since the clinic opened, more than 150 patients have been treated. They’ve also had an 85 percent retention rate with the
use of suboxone.
Co-founder Mark Puckett helped start the clinic after his son overdosed on opioids.
“Suboxone gets them back on the level to be able to compete in what we call life,” Puckett said.
The clinic is free, which has made it difficult at times over the year to find funding.
Puckett said many individuals have stepped up to keep funding going with donations. Mosaic Life Care also has contributed to the clinic.
“People have been skeptical at first, but once they figure out we don’t just want their money, we want to save lives, it’s gone a long way,” Puckett said.
The clinic has multiple doctors who help out with the treatment process. Dr. Robert Corder has been with the clinic since December to help fight addiction issues.
“It made me mad that 50,000 people a year or more were dying of opioid overdoses, and I wanted to do something about it,” Corder said.
Puckett said the last year has had a lot of ups and downs, but they’ve started to see a downward trend in opioid overdoses in Buchanan County, with only two confirmed this year.
“It’s a plus, but it’s also a minus because I want that number to be zero,” Puckett said.
Corder believes the clinic has seen a lot of success partially due to the tight-knit group working there.
“I think we are a little more caring, and I think that really comes across to our patients that we really are concerned about them,” Corder said.
Corder was an obstetrician before he came to the clinic and has found the feeling of treating addicts to be heartwarming.
“I thought delivering babies was pretty rewarding, but seeing people get well from heroin use is pretty cool,” Corder said.
Since the clinic has opened, multiple agencies throughout Buchanan County have banded together to create an opioid task force to fight the crisis as a whole. A few of the agencies joining St. Kolbe-Puckett in the group are the City of St. Joseph Health Department, Northwest Health Services, the Family Guidance Center and the St. Joseph Police Department.
Puckett said the goals at St. Kolbe-Puckett moving into the next year are continuing to work to lower the number of overdoses to zero and possibly expanding services to rural areas.
“We might take our formula to those communities having problems and get them to buy in like we got in St. Joe,” Puckett said.
Puckett is happy that the community has bought in to what the staff is trying to do at St. Kolbe-Puckett and said now they can continue to move forward to save even more lives.
Cathedral of St. Joseph had their ground breaking for the new St. Gianna Early Childhood Development and Education Center during the week of the church’s 150th anniversary on Sunday afternoon.
The center will be open to the public by February and will hold around 120 children ages six weeks to six years. The pricing for the center is unknown at this time but will be available on the Cathedral’s website soon.
Father Hanson of the Cathedral of St. Joseph said the center was named after Saint Gianna because of her documented love of children as a pediatrician and mother.
The new center first came about a year ago when employees from Mosaic Life Care approached Father Hanson about the possibility of opening a new center in the abandoned building on 9th and Robidoux street.
“Thirty years ago, the hospital [Mosaic Life Care] actually ran a center out of one of our buildings, and they they gave us the chance to run this center instead,” Father Hanson said. “I don’t know the whole history of that, but the Catholic Church has always been involved in education. So it’s important for families to be supported, including when they have to both workers are single single family homes,” Father Hanson said.
Director of Cathedral Early Childhood Jocelyn Winter said the center will focus on play-based learning and conscious discipline.
“Children be able to express how they feel, and why they’re angry or wiser,” Winter said.
For more information about the St. Gianna Early Childhood Education and Development Center, go to Cathedral’s website at https://cathedralsj.org/blog/ground-breaking-st-gianna-early-childhood-education-and-development-center.