Michigan was to be a 'haven state' for abortion. It didn’t happen

Michigan, where abortion remained legal in 2022, was predicted to be a ‘haven state’ for patients seeking abortions.
For a while, clinics saw a surge in out-of-state patients
Now, business has slowed — so much so that brick-and-mortar clinics may struggle to stay open

At Michigan’s abortion clinics, phones were ringing, appointment books were full and patients were waiting — sometimes for weeks — to see a doctor.

It was 2022. The US Supreme Court had just sent a seismic jolt through the national abortion landscape, leaving patients with unplanned pregnancies scrambling to states like Michigan where abortion remained legal.

These days, though, some abortion providers may be falling victim to their own success.

They’ve won their battle for greater access, having fought to keep abortion legal and available — via telehealth and mailed abortion pills — in rural stretches of Michigan without providers.

But in doing so, providers have undercut their own budgets. Patients that once walked through their doors for a surgical abortion or to meet with a doctor before taking pills for a medical abortion are going online instead to out-of-state and even international abortion pill providers.

Related:

Telehealth was designed to expand access in places without providers, but “some of our (telehealth) patients are a mile from our building,” said Shelly Miller, executive director of Scotsdale Women’s Center clinic in Detroit.

Moreover, Michigan’s expected role as a “haven state” in 2022 never materialized.

More than 140,000 people traveled across state lines to obtain abortion care in 2025, according to new data this month by the New York-based Guttmacher Institute, a non-profit research and advocacy organization focused on sexual and reproductive health and policy.

But fewer than 2,000 of them arrived in Michigan, including 890 from Ohio and 730 from Indiana. That’s down from about 2,700 in both 2023 and 2024. (Data for 2022 aren’t available.)

Just three patients appeared for appointments for surgical abortions Tuesday at Scotsdale — a change from the times when there were 10 patients a day — enough to cover salaries, equipment expenses and other costs, said Shelly Miller, executive director of the clinic, she said.

“Ten sustains you,” Miller said of the patient volume, “three scares you.”

A surge, then a shift

It’s a surprising turn after a more than decade of upheaval in abortion access across the US, including switches in federal policy, court challenges and statewide votes.

Just more than four years ago, the US Supreme Court struck down the landmark Roe v. Wade case, upending nearly a half-century-old law that kept abortion legal across the US.

In Michigan, where the procedure remained legal, clinics along its borders faced a surge in appointments, especially from Ohio and Indiana residents — so much so that waiting lists stretched into weeks.

Gov. Gretchen Whitmer sits at a table holding up signed legislation, while surrounded by others also holding up papers. The desk has two signs reading "Bans Off Our Bodies" — Michigan Gov. Gretchen Whitmer holds up signed legislation repealing a 1931 abortion ban statute, which criminalized abortion in nearly all cases, during a bill signing ceremony, Wednesday, April 5, 2023, in Birmingham. The abortion ban, which fueled one of the largest ballot drives in state history, had been unenforceable after voters enshrined abortion rights in the state constitution last November. (AP Photo/Carlos Osorio)

Months later, Michigan voters doubled down on access, enshrining the right to abortion in the state constitution later the same year. The Legislature debated, then passed several bills, further expanding access, and Michigan ended its decades-long requirement to report abortions to the state.

Michigan was primed, it seemed, to welcome out-of-state travelers with unwanted pregnancies for years to come.

But the landscape was shifting elsewhere, too.

Clinics like Northland Family Planning Centers, which operates clinics in Southfield, Sterling Heights and Westland, had for a time been considered “shield providers” for patients from Ohio and elsewhere.

But Ohio residents voted in 2023 to toss out its ban on abortions, making the procedure legal to nearly 22 weeks of pregnancy with few exceptions. Like Michigan, it enshrined the right to the procedure in the state constitution.

“Now we were no longer needed,” Renee Chelian, Northland’s founder, said.

A Planned Parenthood clinic in Lansing on July 31, 2026, displays a sign indicating that the facility is closed permanently — As more people seek abortion care online, some independent clinics tell Bridge they’ll struggle to keep brick-and-mortar facilities open. At the same time, Planned Parenthood of Michigan continues to close clinics because of federal funding cuts, its leaders say. (Kelly House/Bridge Michigan)

To the west, Indiana continued its abortion ban.

But Illinois bolstered its support for out-of-state travelers seeking abortions, becoming a “hub” for patients, Isaac Maddow-Zimet, Guttmacher data scientist and study lead, told Bridge.

A largely Democratic-led Illinois Legislature has funded easier access, establishing a hotline to coordinate care and support between the Chicago Abortion Fund and hospitals. It allocated $4 million to Planned Parenthood to counter federal cuts.

And in January, Gov. JB Pritzker was on hand as several groups launched the Prairie State Access Fund to support out-of-state patients seeking reproductive and gender-affirming services.

The result?

Nearly 1 in 4 people leaving their home state to seek abortion head to Illinois, according to Guttmacher. That included 190 travelers last year from Michigan.

All this access elsewhere, however, hobbles the ability of providers in Michigan to maintain budgets for brick-and-mortar care.

In-person patients bring in more dollars to pay for surgical abortions, since medication abortion is generally less costly than surgical procedures.

Prices vary, but out-of-pocket costs for abortion pills through the website Hey Jane start at $299, according to its website, compared to $400 at Scotsdale or $600 at a Michigan Planned Parenthood clinic. (Options can be more affordable for those who qualify for financial assistance.)

“You’re taking out the first blocks and something will tumble. Who is going to take care of patients who don’t qualify for a pill, who are too far along for a pill?” Miller, at Scotsdale, said.

Planned Parenthood’s budget woes

Michigan’s largest provider, Planned Parenthood of Michigan, this week announced the permanent closure of three more clinics — Lansing, Livonia and Warren. From a high of 14 clinics just a few years ago, it now operates just seven and a virtual clinic.

Paula Thornton Greear, President and CEO of Planned Parenthood of Michigan, framed the closures as the result of cuts in federal Title X and Medicaid dollars.

The funding infrastructure fundamentally changed, Greear said, telling Bridge the decision was “incredibly difficult.”

The announcement may have been a shock to patients — the clinics’ doors were closed the same day as the announcement. Still, leaders had warned of possible closures in May when Planned Parenthood asked Gov. Gretchen Whitmer for $5 million in emergency aid.

That request was unsuccessful, but Washtenaw County commissioners this month allocated $500,000. And last week, the Oakland County Board of Commissioners will consider a $1.5 million plan to support the provider — a plan Right to Life of Michigan criticized, given the national agency’s ties to a reported $47 million being spent in elections.

Right to Life of Michigan’s legislative director and policy advisor, Genevieve Marnon, questions the travel data, as well any of the data associated with abortion.

In 2023, Michigan ended a decades-long requirement to report abortion data — the type of abortion, the demographics of the patient, and even their marital status. It is now one of only six states that collect no data, according to Guttmacher, which bases its data on surveys.

Safety concerns

But some worry that the shift away from Michigan’s brick-and-mortar buildings and toward online abortion services threatens patient safety.

It can be difficult to discern reputable online providers from those peddling bogus pills, several clinic operators and doctors told Bridge. Even those virtual providers with legitimate abortion pills may not thoroughly ask patients questions to detect a dangerous ectopic pregnancy.

In-person care often includes an ultrasound to confirm gestational age and that the fetus is properly situated in the uterus.

Michigan also still requires parental consent for abortions, unless a judge decides otherwise. It’s easy to lie on an online questionnaire, Chelian said.

Greater access to the abortion pill — something she has fought for, now threatens brick-and-mortar care, said Renee Chelian, founder of Northland Family Planning Centers, which provide abortion in Southfield, Sterling Heights and Westland clinics. (Courtesy of Renee Chelian)

There’s also a worry that online sites may share personal information with analytics tools and, ultimately, to Google, according to an investigation by the news site Propublica.

Most worrisome, is that online providers may not offer emergency follow-up care, Chelian said.

She recalls one patient of Northland Family Planning Centers who returned to her Texas home after receiving a medication abortion at the clinic. The patient called Northland in a panic after she continued to pass blood clots.

“She was scared to see her own doctors” in Texas, which restricts abortion, Chelian said.

Chelian tried to call a national help line to find the patient help in her home state, but with no luck.

Ultimately, the woman flew back to Michigan, where a Northland provider prescribed four extra misoprostol, the second drug in a two-drug regimen to trigger an abortion. The woman safely passed the clots, Chelian said.

And in-person clinics may actually reduce abortions, said Dr. Audrey Stryker, a long-time Michigan provider.

People with an unwanted pregnancy often panic, she said.

Talking with a provider — rather than simply filling out a form — can help clarify their decision. Sometimes, that means deciding against an abortion, Stryker said.

“I don’t want to say women can’t make decisions online. I trust them to make the right decisions,” she said. “But online, you can take away that opportunity to just talk out what their concerns are, and to make a decision outside of panic.”

Thank you to our Michigan Health Watch Sponsors

Bridge Michigan Health Watch is made possible by generous financial support from our sponsors. Sponsorship supports our independent journalism mission but does not constitute sponsor endorsement of individual articles or editorial content. Bridge Michigan journalism remains fact- and data-driven and independent at all times.

Please visit the About page for more information and to subscribe to Health Watch. Interested in becoming a sponsor? Contact Emma Carr.