When Courtney Buckman made the difficult decision to have an abortion, the obvious solution should have been to go to her nearest abortion clinic in Montana.



In fact the most practical option for Buckman was to have the procedure nearly 2,000 miles away from home – in New York.



Buckman is one of a growing number of women who are travelling to New York for abortions amid tightening restrictions and access to services across the country.



Under the Trump administration, 27 abortion bans have been signed so far this year across 12 US states – including in Georgia, Ohio, Kentucky, Alabama, Missouri and Mississippi, according to the Guttmacher Institute. As a result, Choices Women’s Medical Centre in Jamaica, Queens, has already seen a significant rise in women coming to the centre for abortions from the affected states.

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“It was actually just last week that I found out … it was six weeks along,” said Buckman, 24, at Choices, as her three-year-old daughter Belle watched a film on her phone nearby.



“And because I do have another child, there’s so much interplay with my personal situation because back in Montana where I live, it’s super expensive … Everything else that could possibly come with having another child at this specific moment just isn’t a situation that I could actually possibly handle. Right now I’m already leaning a lot on my family because I am a single parent.”



While she could have had a legal abortion in her home state, a shortage of clinics would have meant a six-hour round trip on a weekday, which could have potentially cost Buckman, who works in customer service, her job. Fortunately, she was able to get an appointment at a clinic during a trip she had already planned to New York.

Facebook Twitter Pinterest A protest against Alabama abortion law in Montgomery on 19 May 2019. Photograph: Michael Spooneybarger/Reuters

Roe v Wade was the landmark 1973 supreme court decision that guaranteed women in the US the right to an abortion. It remains intact for now, despite recent state efforts to restrict access, but obtaining and paying for an abortion has never been easy. Women face a shortage of clinics, tight restrictions on the way they are operated, high costs and fierce anti-abortion campaigns.



The Hyde amendment prevents Medicaid, primarily used by the poor, from using federal funding for abortions except for when a patient’s life is endangered or in rape or incest cases. As a state and federal scheme, some states cover the cost of abortions using their funds so that they are available on Medicaid, but the majority do not. Meanwhile, many private insurance plans don’t cover abortion care, offer limited assistance, or – in the case of some Republican-led states – insurers are banned from offering funds for abortion care.



An estimated 30% of US women will have an abortion by age 45, according to the Bixby Center for Global Reproductive health. A study conducted by the centre published in 2014 found that for half of the women surveyed, out-of-pocket costs for abortion care and travel amounted to more than one-third of their monthly income. For Buckman, the procedure cost, which she paid for out-of-pocket, came to $600, but she believes it would have been even more expensive in Montana.

New York city council recently announced a plan to pay $250,000 to New York Abortion Access Fund (NYAAF), making it the first city in the US to directly fund abortions. Last year a third of the patients it helped were from out-of-state, and NYAAF has said the funding will help to meet the increasing demand it expects to experience from these patients.

“Before Roe v Wade, New York City was a haven for women who wanted control over their own bodies and their health decisions,” said Councilwoman Carlina Rivera, co-chair of the Women’s Caucus at New York city council. “It’s time for our city to be that beacon for the country once again.”

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But the city’s clinics still face opposition. Choices, which sees up to 35,000 patients a year, 10,000 of whom have abortions, is targeted by protesters on Saturdays who surround the clinic holding placards and graphic images of foetuses and calling out to patients when they arrive.

Buckman, who knows women who have travelled to California and Washington for abortions, believes bans and restrictive laws will not stop women from terminating unwanted pregnancies. “If we really wanted to have an abortion, whether it’s legal or not, they [women] are going to have one – safely or not safely.”



She said the idea that male politicians – who lead the majority of the states which have enacted anti-abortion measures this year – should be allowed to determine the fate of women and their bodies is “ridiculous”.



“Unless they want to have a baby and be able to give birth to a child, then I don’t think they should really have a say in what I can and cannot be able to do. Personally, in my situation, it’s not me trying to be selfish, it’s me trying to be able to still provide for what I have right now,” she added.

Facebook Twitter Pinterest Merle Hoffman, the owner of Choices women’s medical center in Queens, New York, holds a giant coat hanger in her office that she took to a pro-choice protest at St Patrick’s Cathedral, Manhattan, in 1989. Photograph: Molly Redden/The Guardian

The Queens clinic has seen a significant rise in recent months of patients from other states, including Ohio, Texas, Pennsylvania, Alabama and Georgia. Recently they had two women from Bermuda.



Finance is the biggest issue for women seeking abortions, said Choices’ patient financial counsellor, Angelica Din. But the clinic goes to extraordinary lengths to ensure nobody is turned away – liaising with multiple organisations, including NYAAF, to find the funding for everything from accommodation to medical treatment and travel. Sometimes Merle Hoffman, president of Choices, will even fund them herself.



Din said: “[I try] really hard to get it for them because it’s a hard decision for them and it’s not easy.”



A recent patient cried when Din told her that she had found funding for the full $2,600 cost of her procedure.



“I make sure I find funding in whatever way … I haven’t had one patient yet not come in because they didn’t have the funds,” she said.



Hoffman, who founded the clinic in 1971, said the increase in women coming to New York for abortions reminds her of before Roe v Wade, when women arrived from around the country for abortions.



“[In] 1970 there were about five different states that decriminalised abortion, New York was one of them. So what happened between 70 and 73, thousands and thousands of women were coming into New York … it’s really a repeat of those days,” said Hoffman, who has a giant coat hanger in her office that she took to a pro-choice protest at St Patrick’s Cathedral, in Manhattan, in 1989.



“It’s as if to say, well you know you had almost half a century of the ability to decide your own autonomy and your own motherhood and its timing, but now you know we’re taking that power back. And believe me it’s a power struggle, that’s what it is.”



Before the recent wave of restrictions, which she said will affect the poor and women of colour the most, Choices would get four or five out-of-state patients coming for abortions per week. But now the figure is between seven and nine.



Hoffman said: “It will increase as the restrictions really start to hold. Now of course there’s appeals going on, so that can stop it for a while, but the general movement to restrict women’s freedom, autonomy, moral agency and access is really out there.”