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Report paints picture of a shifting abortion landscape in Upper Midwest

Amid wide national variability, abortion rates have remained relatively stable in Minnesota and North Dakota since 2017, while falling sharply in South Dakota. Abortion travel is likely behind the variations.

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ROCHESTER, Minn. — The release of new data charting a see-sawing of abortion services based on state residency suggests a growing economic divide for those seeking abortions.

The data, which emerge from a 2022 Abortion Provider Census released last week by the Guttmacher Institute, show abortion rates grew by 8% nationally since 2017, but exhibited significant variances from state to state over the past three years, including in the Upper Midwest.

The report found that abortion rates have remained largely stable in Minnesota and North Dakota between 2017 and 2020, but have fallen sharply during those three years in South Dakota.

According to separate abortion travel data, it's a pattern that likely suggests an increase in South Dakotans seeking out-of-state abortion care, indicating a growing divide between those who can afford to travel to get an abortion, and those who can't.

Minnesota providers performed 11,060 abortions in 2020

As of July 1, 2020, there were 10.2 abortions per 1,000 women between ages 15 and 44 performed in Minnesota, or 11,060 abortions for the year, according to the new data from Guttmacher, an abortion rights research organization.


In an ongoing pattern of stability, Minnesota saw just a 1% drop in 2020 from the 11,190 abortions performed in the state in 2019. Likewise, 2019 data reflected just a 4% increase from 10,740 abortions performed in the state in 2017.

North Dakota by contrast posted a lower abortion rate in 2020 than its neighbor to the east, at just 7.8 abortions per 1,000 women of child-bearing age, or 1,170 abortions for the year. That figure also largely moved little over the previous three years.

For Iowa and Wisconsin, the abortion rate has hovered between 5.8 and 6.5 abortions per 1,000 women between 2017 and 2020 respectively, a metric reflecting 3,510 abortions for 2020 in Iowa and 6,960 abortions for 2020 in Wisconsin.

Becca Clemens / Forum Design Center

Abortion rate in South Dakota plummets 74%

During this same time period, however, abortion plummeted in South Dakota.

South Dakota saw a 74% three-year abortion decrease in the latest Guttmacher report, with its incidence rate falling from 3.1 to .08 abortions per 1,000 women for the three years under study.

South Dakota providers performed 530 abortions in 2017, 420 in 2019, and just 130 abortions in 2020, according to Guttmacher.

That drop, however, is likely a reflection in part of increased interstate abortion travel over time, according to a separate study of abortion seeking published last March in the journal the Lancet.


The Lancet study, conducted by researchers from university positions in Wisconsin, Missouri and Ohio, found 740 South Dakota residents had obtained abortions in 2017, but that 324 of those were obtained beyond the state's borders.

This reflected a 43% out-of-state abortion rate for South Dakota residents during that year.

The Lancet study further noted a 2017 out-of-state abortion percentage of 18.2% in Wisconsin (or 1,375 out of 7,540 resident abortions ), and a 13.1% rate in North Dakota (or 127 out of 970 resident abortions).

The study reported a 10.7% travel rate for abortion care in Iowa (or 389 out of 3650 resident abortions), and just a 3.5% rate of out-of-state care among residents of Minnesota (for 354 out of 10,100 resident abortions).

The speculation began last month, after a leaked draft of a U.S. Supreme Court opinion suggested the court is poised to overturn Roe v. Wade, the 1973 decision that guaranteed the right to an abortion nationwide. Indigenous abortion rights advocates say the questions have mostly come from non-Native people: “All of a sudden, this issue that’s going to impact white women too — or impact white women more broadly — now we’re being seen as the potential savior."

Abortion travel

While the Guttmacher report asserted "there were no clear patterns to explain why some had increases or decreases," it also described some changes in its data as suggestive of abortion travel.

A 98% drop since 2017 in the abortion rate within Missouri, it found, was likely the partial cause of a coinciding 25% abortion increase in neighboring Illinois.

Today, Iowa, Wisconsin, North Dakota and South Dakota account for roughly 12,000 abortions annually, according to the Guttmacher report.


Nearly one in four women will have an abortion by age 45, according to Guttmacher, but 26 states are believed to be poised to restrict abortion if Roe v. Wade is reversed by the U.S. Supreme Court, suggesting a looming increase in abortion travel.

It's a development likely to place new pressure on providers within Minnesota. Regional Planned Parenthood spokespersons believe the state could see a 10-25% increase in abortion services within its borders.

Such an influx, according to Guttmacher figures, would create an additional 1,100-2,700 out of state patients seeking abortions annually.

Paul John Scott is the health reporter for NewsMD and the Rochester Post Bulletin. He is a novelist and was an award-winning magazine journalist for 15 years prior to joining the FNS in 2019.
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