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Colorado provided more abortions last year than any year in almost four decades, nearing the peak set in the mid-1980s before more effective forms of birth control became widely available. 

The 22% increase in the number of abortions that occurred in Colorado from 2021 to 2022 was due to the surge in patients from other states where terminating a pregnancy was severely restricted. Colorado saw a 500% increase in patients from Texas, which in 2021 banned abortions after about six weeks of pregnancy. Abortions sought by people from Colorado increased slightly less than 2%.

There were 14,154 abortions in Colorado last year, including surgical abortions and those induced by medication. The last time the number of abortions was above 14,000 in the state was 1986, according to data from the state health department. 

Abortion clinics told The Colorado Sun they are seeing unprecedented demand for abortions later in pregnancy, into the second trimester. That’s because the procedure at that stage is banned in many states. 

Patients are getting abortions later in their pregnancies in part because they must plan to drive several hours or buy plane tickets. On top of that, wait times for appointments grew since the Texas law took effect and the U.S. Supreme Court struck down the constitutional right to an abortion, opening the door for states to ban or restrict access to the procedure.

“When people don’t want to be pregnant, they will seek abortion care all over the country,” said Adrienne Mansanares, president and CEO of Planned Parenthood of the Rocky Mountains. “It doesn’t subside because of these terrible laws.” 

Patients are arriving more stressed than ever, with some fearing they are being followed or that authorities in their home states will take their children away. Planned Parenthood has booked hotel rooms for patients who fear authorities are following their paper trail, Mansanares said. 

“Those traveling patients come with such a deep amount of shame, fear,” she said. “There is no way we could have predicted the deep feelings of stress and strain not only from people traveling from out of state but also people in state still dealing with the effects of the pandemic.” 

Most out-of-state patients are coming to Planned Parenthood’s clinic off Interstate 70 in Denver’s Park Hill neighborhood, a quick drive from Denver International Airport. But clinics in Colorado Springs and Fort Collins are seeing an influx of patients driving into the state for the first available appointment, she said. 

Planned Parenthood’s clinics in the region, which includes New Mexico, southern Nevada and Wyoming, have seen almost a 40% increase in patients from Texas since the heartbeat law took effect almost two years ago.

Some patients are driving to Fort Collins from Texas because they can get an earlier appointment there than they could in New Mexico, Colorado Springs or Denver. “The miles just slide off of them because they are there, finally,” Mansanares said. 

70% of Planned Parenthood patients received abortion pill

To try to adapt to the surge in out-of-state patients, Planned Parenthood has hired more staff, improved training and added emotional debriefing sessions for physicians and nurses, she said. Clinics also have expanded waiting areas and added snacks and juice, and some are handing out gift cards for gasoline. 

After the fall of Roe v. Wade last year, the average wait time for an appointment at Planned Parenthood of the Rocky Mountains was 27 days. It’s now down to nine days, though the goal is three. 

About 70% of Planned Parenthood abortion patients are getting the “abortion pill,” the common term for a nonsurgical abortion induced by medication. Patients first take a pill called mifepristone, which blocks the body’s progesterone, a hormone needed for pregnancy. Within the next 48 hours, patients take a second medication, called misoprostol. The process is highly effective and is only recommended in the first 11 weeks of pregnancy. 

Patients can get a prescription after a telehealth appointment, but they must be in Colorado and must take the first dose of medication in Colorado. 

Several states have banned or restricted the abortion pill. In Texas, the pill cannot be prescribed via telehealth and cannot be mailed. Prescriptions are not allowed at all after seven weeks of pregnancy.

Once people cross into Colorado, they can attend a telehealth appointment with Planned Parenthood or another Colorado abortion care provider. They can pick up the medication at a local pharmacy, or have it mailed to a Colorado address, including a post office. An organization called Just the Pill also has mobile clinics and dispenses the abortion pill in Colorado towns near the state border.

Comprehensive Women’s Health Center, which provides abortion care in the Denver area, is seeing a huge increase in out-of-state patients seeking abortions and, in particular, later in pregnancy, into the second trimester. 

Before the Texas law passed, about 5% of the health center’s patients were from outside of Colorado. Now it’s about 33%. 

And the percentage of patients seeking abortions into the second trimester has climbed to 30% from 10%.

The wait for later abortions is two or three weeks, said Dr. Rebecca Cohen, an obstetrician-gynecologist at the center. While nurse practitioners aren’t prohibited from performing abortions past the first trimester in Colorado, not many are trained to do so. Many doctors are not either, Cohen said. The Comprehensive Women’s Health Center has some of the few specialists in Colorado trained in abortions into the second trimester, so an increasing number of patients in the state and out of state are seeking appointments. 

“For a lot of people, that wait is just mentally hard,” Cohen said, adding that as some women wait for their appointment, they are congratulated on their pregnancy despite being diagnosed with a fetal abnormality that will not result in a live birth. “We are making arrangements to see people as quickly as possibly.”

The longer wait times are not only emotionally harmful to patients, Cohen said, but the risk for complications during an abortion increases as the gestational age increases. And for women who have been diagnosed with pregnancy-related health conditions, the risk increases the longer they stay pregnant. 

“These laws do not benefit pregnant people,” she said.

The clinic also has seen an increase in telehealth appointments for the abortion pill, particularly among rural Coloradans. Wait times for those appointments are now about 10 days, down from three or four weeks when the patient surge began.

The clinic has heard stories, too, of women getting the abortion pill through means outside the legal or medical system, meaning they are ordering it online from other states or countries and taking it without medical care, Cohen said. 

Physician moved to Colorado when Tennessee banned abortion

Trying to get ahead of the patient surge, Comprehensive Women’s Health Center hired part-time physicians and nurses to provide abortions. But they were not trained in abortions past the first trimester, which is what the clinic needs most. 

But the health center recently hired Dr. Leilah Zahedi-Spung, who was the only abortion care provider in Chattanooga, Tennessee, when abortions became illegal in the state in 2022 after the U.S. Supreme Court ruling. Abortion is illegal in Tennessee from fertilization. The only exception is to prevent the death or the “irreversible impairment of a major bodily function” of the pregnant woman.

Zahedi-Spung moved in January to Colorado, where she would not have to fear going to jail, she said. 

“I mostly wanted to move to a place where abortion care was going to be protected so I didn’t have to think about moving again,” she said.

Many of Zahedi-Spung’s patients fly in and out of Denver on the same day, typically because they have jobs and families to get back to, she said. “A lot of people are very emotional. There is a lot that goes into them getting here,” she said. “They are stressed about that as well.” 

Pro-Life Colorado calls numbers disheartening, says won’t give up 

Anti-abortion groups, celebrating a year of wins across the country, called the Colorado numbers upsetting. 

“We are so disappointed about those numbers, about more women coming to Colorado as a travel destination for abortion,” said Nicole Hunt, life issues analyst for Focus on the Family, which is part of the Pro-Life Colorado coalition. “That is so disheartening.” 

But Hunt said she is encouraged by a Lozier Institute/Susan B. Anthony Pro-Life America analysis estimating that the fall of Roe v. Wade has prevented 60,000 abortions nationwide. “That’s 60,000 women who have had the opportunity to choose something other than death for their preborn babies,” she said. “We are encouraged by the fact that there is a net positive.”

The anti-abortion movement has its eyes now on Ohio, where residents will vote in the fall on whether to add the right to an abortion to their state constitution.

Coloradans should expect another anti-abortion ballot measure in 2024, Hunt said. 

“Here in Colorado, we haven’t given up hope,” she said.

The Cobalt Abortion Fund, which helps people pay for abortions and the travel to Colorado, spent three times more in 2022 than 2021. The organization spent $737,174 last year, including more than $220,000 on travel support. The fund helped 1,717 people pay for abortions and 640 people afford to get to the state. Of those 640, 49 were from Colorado and 435 were from Texas. 

The number of abortions in Colorado and nationally reached their height in the early 1980s, before the birth control patch, Depo-Provera shot or intrauterine devices, called IUDs, were easily obtained and affordable. 

John Ingold is a co-founder of The Colorado Sun and a reporter currently specializing in health care coverage. Born and raised in Colorado Springs, John spent 18 years working at The Denver Post. Prior to that, he held internships at...

Jennifer Brown writes about mental health, the child welfare system, the disability community and homelessness for The Colorado Sun. As a former Montana 4-H kid, she also loves writing about agriculture and ranching. Brown previously...