Abortion Access in a Post-Dobbs Southeast United States: Changing Geospatial Patterns, Disparities, and the Experience of Traveling for Care [ID 1121]

INTRODUCTION: After the June 2022 Dobbs v Jackson Supreme Court decision, geographic restrictions to abortion increased. North Carolina was a unique state that provided second-trimester abortion care well into 2023 while bordering more restrictive states. With North Carolina’s newly restrictive laws, the Southeast now has become one large abortion desert. Without access to individual-level data, prior studies have had limited ability to evaluate Dobbs ’ effect on abortion access. METHODS: To evaluate changing abortion utilization patterns and disparities in the Southeast, we used regression, time series, and geospatial analyses of North Carolina Division of Public Health data on all abortions reported occurring in North Carolina between 2021 and 2023. RESULTS: We examined 114,709 abortions occurring in North Carolina from January 2021 to December 2023; 49,366 before Dobbs and 65,343 after. After Dobbs , people obtaining abortions in North Carolina were twice as likely to have traveled from out of state (38% versus 17% pre- Dobbs , P <.001) and more likely to be Black or Latinx ( P <.001). Compared to pre- Dobbs , abortions after Dobbs occurred on average 3 days later ( P <.001). The increase in gestational length was greater for patients traveling from out of state compared to in-state residents ( P <.001), and for Black and Latinx (both P <.01) compared to White individuals. CONCLUSIONS/IMPLICATIONS: Preliminary findings demonstrate a new pattern of abortion travel to North Carolina from other states in the Southeast, with significant racial and ethnic disparities. Analyses examining more granular time periods accounting for state-level policy changes and distances traveled for abortion over these time periods are currently in progress and will be presented.