Objectives
To examine trends and utilization patterns of NYC abortion services by non-residents since growing abortion restrictions across many states could drive women to seek care in less restrictive jurisdictions including NYC.
Study design
We used data from Induced Termination of Pregnancy certificates filed with the NYC Department of Health and Mental Hygiene in 2005–2015. An autoregressive integrated moving average (ARIMA) model was fit to the monthly non-resident abortion rate time-series. Pearson's chi-squared tests determined associations between women's residence and other variables.
Results
During 2005–2015, 885,816 abortions were reported in NYC with 76,990 (8.7%) among non-residents; 50,211 (65.2%) non-residents lived in other New York State counties. The NYC abortion rate declined from 49.4 per 1000 women 15–44 in 2005 to 32.7 in 2015 while the non-resident rate showed minimal change from 0.12 per 1000 US women 15–44 in 2005 to 0.10 in 2015. ARIMA(0,1,1)(0,0,1) [12] fit the time-series indicating minimal monthly changes in non-resident rates reflecting seasonal patterns and shorter-term dependencies between successive observations. Non-residents differed from residents in all investigated variables including terminating at 20+ weeks (9.0% vs 2.5%, p<.001) and having procedural methods (87.2% vs 82.2%, p<.001).
Conclusions
Non-residents constituted few abortion patients in NYC with minimal change in non-resident rates in 2005–2015. Non-residents more often sought later-term abortions and more complicated procedures posing greater associated costs/risks. Monitoring non-resident abortion trends and utilization patterns is valuable for planning local service delivery particularly in jurisdictions committed to providing comprehensive women's healthcare where non-residents may increasingly seek abortions.
Implications
While we found limited change in non-resident abortion rates in NYC in 2005–2015, other jurisdictions bordering more restrictive states could show different results and should consider conducting similar research. Such analyses are important in jurisdictions committed to providing comprehensive women's healthcare where non-residents may increasingly seek abortions in the future.