LYNN — Massachusetts has become an increasingly prominent destination for abortion care, with new state data showing a dramatic rise in patients traveling from across the country, many navigating legal barriers, financial strain, and medical urgency to access services.
According to newly released figures from the state Department of Public Health, 49,450 abortions were performed in Massachusetts in 2024, more than doubling the total from the previous year. Of those, at least 27,863 involved patients from out of state, reflecting a major shift in where and how people are accessing reproductive health care.
The increase follows a series of policy changes in Massachusetts, including a 2023 shield law signed by Gov. Maura Healey that protects both patients and providers from out-of-state legal action. The law was built on earlier protections enacted after the U.S. Supreme Court overturned Roe v. Wade in 2022, eliminating federal abortion rights and allowing states to impose restrictions or bans.
Advocates say the data highlights Massachusetts’ growing role in the national landscape of abortion access, while critics argue it reflects a system lacking safeguards. On the ground, providers describe a more complicated reality, one shaped by travel, delays, and increasingly urgent care decisions.
Dr. Preetha Nandi, an OB-GYN and abortion provider at Tufts Medicine, agreed that the trend aligns with what she and colleagues have seen in recent years.
“Certainly,” she said. “We know that more patients are traveling to receive safe abortion care.”
Nandi pointed to national data showing a shift from about one in ten patients traveling out of state for care to closer to one in five. Much of that, she said, stems from restrictions that prevent patients from accessing services closer to home.
“There’s a lot more burden on patients when they have to travel away from home in order to access basic health care,” she said.
That burden can include taking time off work, securing child care, arranging transportation, and paying out-of-pocket for services that may no longer be covered by insurance once they cross state lines. For some, those logistical hurdles lead to delays in care.
“While abortion care is in general very safe… we know that delaying care, particularly later and later into the pregnancy, can incur increased risks,” Nandi stated.
In her practice, she has treated patients who traveled from states with strict bans, even in cases involving serious pregnancy complications.
“I’ve treated multiple patients… who have broken their water earlier in pregnancy than would be safe,” she shared. In some states, she explained, there are no exceptions for abortion care in such cases, forcing patients to travel long distances while facing risks like infection or bleeding.
For those patients, even the journey can be fraught with uncertainty.
“Can they take a flight? What if their flight needs to land in an emergency land… what states are on their route?” Nandi said. “This sheer fear and real risk… it really tears away at the dignity of receiving basic health care.”
Despite the growing number of out-of-state patients, Nandi said Massachusetts’ relatively robust provider network has so far prevented major disruptions for in-state residents.
“I don’t think that out-of-state patients… are really impeding on the access for in-state,” she stated, noting that the state benefits from a “very stable and growing workforce.”
Still, she emphasized that the broader national landscape is affecting the healthcare system in other ways. Providers are increasingly leaving states with restrictive laws, contributing to shortages not only in abortion care but in general reproductive health services.
“There’s deserts of care for general reproductive health care,” she noted, as clinicians relocate to places where they can practice without legal uncertainty.
A significant portion of abortion care is also shifting toward Telehealth. State data shows that roughly 31,000 procedures in Massachusetts were conducted via Telehealth, with providers prescribing medication abortion to patients in other states.
These typically involve two medications, mifepristone and misoprostol, and are most commonly used early in pregnancy.
While Telehealth has expanded access, it has not eliminated the need for travel. Some patients still cross state lines to obtain medication due to legal risks or lack of availability in their home states.
At the clinic level, providers say they are seeing the impact of these trends firsthand.
Dahneaqah, a Lynn-based nurse who works at an abortion clinic in Attleboro and previously worked in Florida, said she has noticed a “slightly” higher number of out-of-state patients in
Massachusetts, particularly from nearby states like Rhode Island and Connecticut.
“With there only being one Planned Parenthood in Rhode Island… the next best option would be to come to Mass,” she said.
Her experience in Florida during the early wave of post-2020 restrictions was even more pronounced.
“There was probably… I wouldn’t even be able to name how many that we saw increase,” she said, recalling an influx of patients from Texas and other states after new bans took effect.
That surge had immediate impacts on clinic operations.
“It definitely affected a lot of wait times,” she stated. “It was a lot of add-ons… a lot of people coming in at the last minute.”
In some cases, clinics extended hours late into the night to accommodate patients who had traveled long distances and faced tight timelines.
“If they had a flight the next day… it was just not okay to turn them away,” she said.
Staff also spent significant time counseling patients on post-procedure care, especially those traveling shortly after treatment.
“It was a lot of giving them precautions of what is normal, what isn’t normal,” she said.
Despite logistical challenges, both providers emphasized that patient care remains centered on individual circumstances and decision-making.
“These are extremely personal decisions for my patients and their families,” Nandi said. “Every patient situation is different and unique.”
She added that state and national policies often fail to account for that complexity.
“It’s such a shame when I have to have a conversation with a patient about why they can’t get care closer to home because of someone else… making these wide-sweeping changes,” she added.
Dahneaqah echoed that sentiment, noting that patients often arrive in vulnerable and emotional states, sometimes sharing deeply personal experiences.
“There’s so many different reasons that someone could want to make this choice,” she said. “The reasons that they have are valid.”
Both providers said the public conversation often focuses on numbers and politics, but they hope people understand the human realities behind the data.
“People deserve the right to safe care,” Nandi said. “These decisions… deserve to be at the hands of the patients and not anyone else.”
As more states continue to restrict abortion access, providers expect Massachusetts to remain a destination for care. While the system has so far absorbed the increased demand, it’s clear that the long-term implications on patients, providers, and the broader healthcare system are still unfolding.
