As southern states ban abortion, thousands of patients head north—to Virginia

Virginia saw the largest abortion increase in the country last year.

When Florida’s six-week abortion ban went into effect last May, advocates warned it would ripple far beyond state lines. Nearly a year later, the numbers show where many of those patients went: Virginia.

While Arizona, California, Kansas, and Ohio had substantial increases in abortion patients, Virginia saw the largest increase in clinician-provided abortions of any state last year, according to new data from the Guttmacher Institute, a nonpartisan research and policy organization that focuses on sexual and reproductive health and rights.

READ MORE: People are leaving states with abortion bans, according to study

Out of 1,038,100 abortions provided nationwide, nearly 39,000 abortions were performed in the Commonwealth in 2024—5,500 more than in 2023. And almost one in four patients came from out of state—a steep rise from just 15% the year before.

The spike in abortions was impossible to miss for Dr. Danielle Johnson, a Virginia OB-GYN and abortion provider with Physicians for Reproductive Health, a national nonprofit that supports equitable health care. She said the data was fairly representative of what she expected.

“We hardly ever saw patients from Florida before, and now I see at least one patient from Florida every time that I’m in the clinic,” Johnson said.

The cost of access

For those arriving in Virginia, the procedure itself is only part of the challenge. Many need to find the funds for fare for travel, time to take unpaid time off work, arrange child care, and afford a hotel room. Johnson described her patients arriving at the clinic with a suitcase, hoping the procedure would be performed in time to catch their departing flight that evening.

That’s why the Blue Ridge Abortion Fund, a nonprofit which helps patients pay for abortions and transportation, was created. The fund reported a record year in fiscal year 2023–24, when it provided over $960,000 in assistance—including nearly $875,000 for clinic costs and $66,000 for practical support like rideshares, hotels, child care, and meals. Nearly 2,500 patients were supported, and 24% seeking care in Virginia came from out of state.

One of them was a patient named Olivia, who left her home state of Georgia and traveled to Virginia Beach at 16 weeks pregnant back in September 2024. 

According to BRAF’s impact report, she was afraid of legal consequences upon returning home. BRAF helped book her flight, hotel, and rideshares—and connected her with a legal helpline to ease her fears.

RELATED: Virginia repro clinics face uncertainty as Trump administration halts federal health funding

“She was just one of 42 callers we supported that week, and one of 181 we assisted throughout September,” the organization wrote in its report.

BRAF helped Olivia by connecting her with the Brigid Alliance, a nonprofit practical support organization. Unlike BRAF, which primarily covers the cost of abortion procedures, the Brigid Alliance funds the logistics—travel, housing, childcare, and more—for patients nationwide. According to its 2024 annual report, the organization served 1,390 clients last year, with over 75% traveling from a southern state, and 88% reporting that they lost wages as a result of pursuing out-of-state abortion care. 

Serra Sippel, executive director of the Brigid Alliance, said last year the organization helped 138 patients make the trip to Virginia, and four Virginians get to their appointments.

“It is [about] providing really critical care at a moment when folks can’t get care close to home,” she said. “So it’s really filling that gap, and it’s incredible the network of organizations that are supporting people who have to travel. We’re really working together to help people get to their care safely and making sure they have the funding for their procedures and getting that care.”

Sippel said that what’s happening in Virginia reflects a nationwide crisis in access.

“It’s important that Virginia is a state where people can access care,” she said. “It’s really critical. This is a failure of government that people have to travel so far, and regularly, for their health care.”

Even with help, some patients are still left behind—particularly minors.

Under the Code of Virginia § 16.1-241, anyone under 18 years old must either receive parental consent to have an abortion, or navigate a judicial bypass process in court. This type of law can pose significant challenges for minors who are unable to involve a parent due to circumstances such as family violence, sexual abuse, or complex guardianship or foster care situations. These factors may also make it more difficult to navigate the judicial bypass process.

The American Civil Liberties Union of Virginia, a nonprofit organization that protects and advances civil rights through advocacy, education, and litigation, is one organization that provides that direct representation through a network of attorneys to minors seeking a judicial bypass order.

“We represent minors who need abortion care, and generally they’re in the age range of 16-17, and they’re not confused,” said Geri Greenspan, senior staff attorney at ACLU VA. “They’re very clear about what they need, why, and have made a thoughtful decision. And the reason that they come to us is because the system that they have to navigate is complicated and burdensome, and so we help sort of shepherd them through that process.”

As an organization, she said they are “generally successful in helping its clients.” While they receive several referrals for clients, last year they helped five clients obtain court orders that authorized them for an abortion.

Greenspan said the Guttmacher Institute data reflects what her team has seen firsthand: patients are increasingly crossing state lines to seek care in the Commonwealth.

“That data underscores what everybody already knew, which is that Virginia is a critical access point for abortion access in the South and in this region,” she said. “And that not only do Virginians rely on the ability to access critical reproductive health care like abortion, but now, so do people from our neighboring states, and probably across the country.”

Virginia didn’t change—the South did

While abortion numbers stayed relatively flat nationwide—rising less than 1% in states without total bans—Virginia stood out. That’s because bans in neighboring states have reshaped where people can go.

RELATED: Amid growing threats to repro rights in Virginia, a local clinic is still trying to expand access

Florida and South Carolina now ban most abortions after six weeks from conception, regardless of whether women are aware of their pregnancies, North Carolina requires a 72-hour waiting period, and Texas and Alabama enforce near-total bans. With fewer local options, more patients are heading north to Virginia.

Virginia’s unique status as the only Southern state without a post-Roe abortion ban or waiting period has made it a haven. But it’s also left clinics and staff strained, Johnson said.

Her clinic recently raised the gestational limit from 16 to 18 weeks, with a goal of eventually offering care up to 22 weeks. The expansion has helped—but demand is rising faster than clinics can adapt.

“We’re definitely trying to hire more staff,” she said. “Generally, when we turn folks away, it’s just because of gestational age. Otherwise, we do everything we can to get people in.”

Access is legal—but not protected

But while abortion is legal in Virginia, it’s not protected in the state’s constitution. And Republican leaders have recently done more to limit reproductive rights. Earlier this month, Republican Gov. Glenn Youngkin vetoed the Virginia Right to Contraception Act, which included state House and Senate bills that would have protected the right to contraception. It is the second year in a row that Youngkin vetoed contraception protection in Virginia.

READ MORE: Gov. Youngkin vetoes contraception protections—again

“I have conversations with patients every day who are saying, ‘I’m worried about my ability to access contraception in the future,’” Johnson said. “They’re asking, ‘What can I do now?’”

Some are requesting sterilization—permanent procedures to prevent future pregnancies—not because they want them, but because they’re afraid their other options will disappear, she said.

What comes next

For Johnson, protecting abortion access in Virginia comes down to two actions: “Vote and donate.”

“Vote to maintain the Democratic majority in our state legislature to get the constitutional amendment across the finish line,” she said. “And donate—because abortion funds are how so many people are able to access care.”

Despite the uncertainty, Johnson said she remains grounded in gratitude and resolve.

“Abortion is health care,” she said. “My job as a physician is to help patients lead healthy lives—not decide for them what a healthy life is.”