As abortion clinics have closed and state legislators have erected obstacles to the procedure, thousands of Hoosier women are traveling out of state to seek abortions, according to state and federal data analyzed by IndyStar.

Overall, the number of abortions performed on women from Indiana has declined by about 14% between 2009 and 2017, the year for which the latest data was available. Nationwide, abortions have dropped by about a fifth since 2009.

But during that period, the proportion of out-of-state abortions has doubled, and in all more than 18,000 women left Indiana to get abortions largely in neighboring states. In all, about a quarter of the abortions performed on Hoosier women took place outside the state.

The largest area of growth was in Illinois, where almost four times as many Hoosier women underwent an abortion in 2017 than did in 2009. By contrast, the number of Indiana women getting abortions in Ohio, Kentucky and Michigan remained relatively steady.

Why travel is necessary

A variety of factors can cause a woman to cross state lines to get an abortion, said Elizabeth Nash, state policy analyst for the Guttmacher Institute, a research and policy organization that collects and analyzes data on reproductive issues in the United States.

The closest clinic may be in a bordering state, or a woman may have trouble scheduling the procedure at an increasingly limited number of abortion clinics. Stigma may also be a factor, Nash said.

"Because abortion is so stigmatized in this country, some people might want to travel a little bit outside their community, because they don’t want people they know to know that they’re going into an abortion clinic," Nash said.

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Restrictions on abortion access may also be a factor.

"The idea that women have to travel to access legal (abortion) is not new," said Tracey Wilkinson, a pediatrician, researcher and member of Physicians for Reproductive Health, referring to the days before abortion was legal in the U.S., when some woman would travel to other countries to receive abortions.

Indiana has passed several abortion restrictions in the past decade, most recently banning a procedure that is commonly used during the second trimester. (The law was signed by Gov. Eric Holcomb but is currently tied up in the courts.)

Illinois sees more out-of-state women

The share of abortions performed on out-of-state women in Illinois more than doubled between 2012 and 2017, according to data compiled by the Associated Press.

Illinois lacks several of the abortion restrictions passed by bordering states, including Indiana. For example, in Illinois Medicaid covers the cost of abortions, and the state does not ban abortions after 20 weeks. And, whereas an abortion provider in Indiana is required to provide a variety of information and counseling at least 18 hours before the procedure, Illinois has no such waiting period.

Illinois also has more abortion providers. According to data from Guttmacher Institute, Illinois had 40 abortion providers in 2017. Indiana had nine.

That sits well with Ryan McCann, executive director of the Indiana Family Institute, which advocates for tougher regulations on abortions in Indiana.

"We want to protect the lives of the unborn, but we also want to protect the lives of Hoosier women across the state," McCann told IndyStar.

McCann said he believes women seeking abortions are better off in a state like Indiana, which heavily regulates the procedure, clinics and providers, compared to Illinois. McCann also said that while women can access fewer abortion clinics for other health care needs, the state has several other options available.

But advocates for a woman's right to have an abortion believe that such laws, rather than helping women, deny or delay care to them.

"These restrictions on abortion providers are working, in their cumulative effect, as they were intended," said Jane Henegar, executive director of the American Civil Liberties Union of Indiana. Her organization has successfully challenged the state’s attempts to place restrictions on access to abortions, and is currently fighting several laws passed by the Indiana legislature.

"This is not an accident, that woman are confused about what their rights are or where they can access their rights," she said.

Emily Hopkins is a data reporter for IndyStar's investigative team. Reach them at 317-444-6409 or emily.hopkins@indystar.com.