Abortion-Related Laws and Concurrent Patterns in Abortion Incidence in Indiana, 2010-2019

Abstract

Objectives. To analyze abortion incidence in Indiana concurrent with changes in abortion-related laws. Methods. Using publicly available data, we created a timeline of abortion-related laws in Indiana, calculated abortion rates by geography, and described changes in abortion occurrence coincident with changes in abortion-related laws between 2010 and 2019. Results. Between 2010 and 2019, Indiana's legislature passed 14 abortion-restricting laws, and 4 of 10 abortion-providing clinics closed. The Indiana abortion rate decreased from 7.8 abortions per 1000 women aged 15 to 44 years in 2010 to 5.9 in 2019. At all time points, the abortion rate was 58% to 71% of the Midwestern rate and 48% to 55% of the national rate. By 2019, nearly 1 in 3 (29%) Indiana residents who obtained abortion care did so outside the state. Conclusions. Access to abortion in Indiana over the past decade was low, required increases in interstate travel to obtain care, and co-occurred with the passage of numerous abortion restrictions. Public Health Implications. These findings preview unequal abortion access and increases in interstate travel as state-level restrictions and bans go into effect across the country. (Am J Public Health. 2023;113(4):429-437. https://doi.org/10.2105/AJPH.2022.307196).

FIGURE 1—

Abortion-Related Legislation and Facility Closures in Indiana: 2010–2019 Note. ACA = Affordable Care Act; HMO = health maintenance organization.

FIGURE 2—

Abortion Rate (Abortions per 1000 Women Aged 15–44 Years) in Indiana, the Midwest, and the United States by (a) State of Provision, and (b) State of Residence: 2010–2019 Note. Midwestern states include IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, and WI. We excluded the following states in national totals for the following years: CA, MD, NH, and NJ (2010–2019); DC and WY (2010–2018); ME (2012); and FL (2010–2016 for rates by residence).

FIGURE 3—

Abortion Rate by County of Residence (Abortions per 1000 Indiana Women Aged 15–44 Years) and Number of Abortion Clinics in the County in (a) 2010 and (b) 2019 *Ten counties (Crawford, Dearborn, Fountain, Harrison, Ohio, Perry, Pike, Switzerland, Union, and Washington) had between 1 and 5 patients who had abortions; rates included here are based on the median of 3 patients for these counties.

FIGURE 4—

Percentage of Patients Who Had Abortions Leaving Their State of Residence for the Abortion: Comparing Residents in Indiana, the Midwest, and the United States: 2010–2019