Maine has experienced an increase in abortions since the U.S. Supreme Court overturned Roe v. Wade in June, according to a new study.

Experts say the jump is being fueled by a number of factors, with only a small portion of the increase being attributed to women coming to Maine for abortion services because the procedure is now illegal in their home states.

The study, conducted by the Society of Family Planning Research Fund, a Denver-based nonprofit, shows that the national abortion rate decreased by 6% between April and August of this year. The decline coincides with the Supreme Court’s decision to strike down a 50-year-old constitutional right to abortion, a ruling that led to abortion becoming illegal in 12 states so far.

Using the same comparison months, the abortion rate in Maine increased by 18%. In states where abortion was banned, the abortion rate declined 95% from April to August, and in states where abortion remained legal, the abortion rate increased by an average of 11% during the same time period, according to the study, which was released Oct. 28. The study’s data comes from surveys of abortion providers.

Abortion was one of the major issues motivating voters in Tuesday’s elections, joining inflation among voters’ top concerns, according to numerous exit polls.

Residents in Michigan, California and Vermont enshrined abortion rights in their state constitutions on Tuesday. An Associated Press poll of about 90,000 voters nationally this year showed that about two-thirds of voters want abortion to be legal in most or all cases. Maine did not have an abortion measure on the ballot, but abortion rights advocates actively supported the successful effort to reelect Gov. Janet Mills, who campaigned on protecting access.

Nicole Clegg, vice president of public policy for Planned Parenthood of Northern New England, said it’s difficult to know why abortions are increasing in Maine, but it’s not being driven by residents of other states seeking services in Maine. That is happening, but those numbers remain small. Clegg said she suspects access to medication abortions, more telehealth appointments and expansion of Medicaid coverage are most likely why abortion rates are climbing in Maine.

GEOGRAPHICALLY REMOTE

“We’re too far away geographically to see much impact from people coming here from banned states for abortion services,” Clegg said. About 2,000 abortions are performed in Maine per year, with more than half done through Planned Parenthood, which has clinics in Portland, Biddeford, Sanford and Topsham.

West Virginia – about a 12-hour drive from Maine – is the closest state where abortion is now banned. To get to Maine, someone driving from West Virginia would pass through a number of states, including all of the Northeast, where abortion is legal.

Planned Parenthood clinics are providing some abortion services to people coming from banned states – about two dozen since June – but mostly it’s because those people have some connection to Maine, such as having a relative who lives here, Clegg said.

Clegg said that while the research by the Society of Family Planning is valuable, it’s most accurate to compare abortion rates by month to the same month of the previous year. Abortion rates tend to vary by season, with more abortions occurring in the summer and around the holidays.

From late June – shortly after the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade – to mid-October, Planned Parenthood in Maine provided abortion services to 36% more women than during the same period in 2021. Planned Parenthood performs roughly 75-125 abortions per month.

Clegg said one of the most significant factors leading to increased abortion rates in Maine may be the access to medication abortion for women in more rural areas. The Biden administration, in spring 2021, approved dispensing medication abortion pills through the mail, which Clegg said improved access for Maine people living farther from clinics. Previously, the pills could only be dispensed in-person.

Paired with more telehealth doctor’s appointments, Clegg said access has improved over the past year. The pandemic also could be a factor because of changes in family planning and dating trends over the past two years. A post-pandemic increase in pregnancies could mean there are more complication-related abortions.

Where abortions are declining – mostly in the South – women with the least means and ability to travel are more likely to lose access, according to a report by the Society of Family Planning.

“The declines in the numbers of abortions occurred in the same states with the greatest structural and social inequities in terms of maternal morbidity and mortality and poverty,” the report states. “Thus, the impact of the Dobbs decision is not equally distributed. People of color and people working to make ends meet have been impacted the most.”

MEDICAID EXPANSION IMPROVED ACCESS

In Maine, on the other hand, low-income populations have seen improved access to abortion in recent years.

Maine’s Medicaid expansion resulted in more women having health insurance and not needing to pay out-of-pocket for an abortion. Clegg said that while Medicaid expansion was approved in 2019, it took time for awareness to grow and the rollout to reach most people who are eligible. About 95,000 additional people in Maine have insurance through the Medicaid program, called MaineCare in the state.

“People can now access the care that they want in the way that they want it. That’s huge,” Clegg said.

At Maine Family Planning, which operates an abortion clinic in Augusta, they have seen a year-over-year abortion rate increase of 7.5%, comparing October through September of 2021-22 to the previous year.

Marisa Weil, vice president of development and community engagement for Maine Family Planning, said that while abortion access has improved in Maine, access is being shut down in many states. In addition to the 12 states where it’s currently banned, full abortion bans are likely in an additional 14 states, depending on a number of factors, including state court decisions, according to the Guttmacher Institute.

“People are suffering enormous harm from the action of the Supreme Court, reversing Roe and allowing this chaos to unfold across the country, pitting state governments against one another and limiting health care options for millions of people,” Weil said.