Trends in Abortion Utilization in West Virginia During a Period of Increased Abortion Restrictions, 2013–2020

ABSTRACT Objective To analyze changes in method, gestational duration, and out‐of‐state travel for abortion care in West Virginia and for West Virginians during a timeframe with increasingly restrictive abortion legislation and decreasing abortion availability. Methods We used publicly available data from the Centers for Disease Control and Prevention and data obtained from the Guttmacher Institute to calculate abortion rates by state of occurrence and state of residence and describe trends in abortion by gestational duration and method from 2013 to 2020. We constructed a timeline of abortion restrictions and clinic closures in West Virginia using news reports and legislation from Nexis Uni and the WV Legislature website. Results From 2013 to 2020, West Virginia enacted six abortion restrictions and one of two clinics in the state closed. During this time, the abortion rates both in West Virginia and for West Virginians experienced greater decreases compared to abortion rates in the South and United States (US). Patients in West Virginia had a lower percentage of abortions before 7 weeks (22%) compared to 41% in the region and 38% nationally. Patients in West Virginia had proportionally more aspiration abortions (79% compared to 70% in the South and US) until 2019, when state trends began to resemble regional and national trends. By 2020, a majority (52%) of all abortions for West Virginia residents occurred out of state, compared to 14% in the South and 9% in the US. Conclusion Abortion restrictions and a clinic closure coincided with decreased abortions at earlier gestational durations, increased use of medication abortion, and more out‐of‐state travel to a wider variety of states.