Prism | Massachusetts sees sharp rise in out-of-state abortion patients as state bolsters provider protections

New emergency amendments would strengthen protections for nurses who provide abortions

By Matt Olszewski | Originally published by Prism

The Massachusetts Department of Public Health’s Board of Registration in Nursing approved extensive emergency amendments on Jan. 8 to strengthen protections for nurses who provide abortions, as new data reveals a significant increase in patients seeking reproductive care in the state since the overturning of Roe v. Wade in 2022. Gov. Maura Healey also adopted these emergency regulations.

The emergency amendments, providing immediate protection for nurses from licensure disqualification and board discipline related to reproductive health care services, will remain active for three months after being filed with the Secretary of the Commonwealth’s Office. During this period, the regulatory process will continue with public comments and hearings before final approval is sought.

“We are committed to not only providing but actively promoting equal and appropriate access to health care for everybody. Reproductive care is health care. I think Massachusetts has a long tradition and history of protecting those rights of women and those rights of women and pregnant people,” said Katie Murphy, the president of the Massachusetts Nurses Association.

State data WBUR obtained from the Massachusetts Department of Public Health shows that Massachusetts health care providers performed 24,355 abortions in 2023, marking a 37% increase from 2022. This substantial surge was primarily because of a dramatic rise in out-of-state patients: 6,115 people traveled to Massachusetts for abortion care in 2023, compared to 920 in 2022, a nearly sevenfold increase.

The comprehensive data indicates that 65% of these procedures were medication-based abortions. Patients traveled from various regions, including areas classified by the state as mid-Atlantic, Plains, and Pacific, which encompasses Nevada, Arizona, Hawaii, and California, demonstrating the far-reaching impact of varying state regulations on reproductive health care access.

“When Roe was overturned, we worked with the Legislature to take immediate action to protect providers and patients from liability for providing or receiving an abortion,” Healey said in a press release announcing the emergency measures. “In Massachusetts, we’re always going to protect people’s rights and freedoms, and we’re going to make sure that everyone can access the high-quality health care they need.”

Taylor St. Germain, deputy director of Reproductive Equity Now, highlighted the state’s preparedness in an interview with Prism. “When the first Trump administration rolled around, we took proactive action to really make sure that we were codifying abortion in our state law to ensure that no matter what happens, with the fall of Roe, abortion remains legal here in our state,” St. Germain said. “So we passed the ROE Act in 2020, and this law codified the right to abortion care in Massachusetts.”

Challenges remain, said MaryRose Mazzola, the chief external affairs officer at Planned Parenthood League of Massachusetts. According to an analysis Mazzola said the organization conducted last year, “the one thing really holding us back” from becoming a high-access state was that young people still face barriers accessing abortion care. 

“We are advocating for repeal of parental consent requirements and the judicial bypass alternative requirement so that young people can fully access abortion care,” Mazzola said.

The nursing board enacted significant amendments to two critical regulations: one addressing investigations, complaints, and board actions, and the other covering licensure requirements. These changes expressly acknowledge and respond to the diverse legal landscape surrounding reproductive and gender-affirming health care across different states, advocates said.

“We really believe that it’s a political issue, it’s a wedge issue, rather than having to do with health care,” Murphy emphasized. “We will use every tool that we have to influence policymakers to make sure that women are as safe as possible.”

St. Germain noted the state’s financial commitment to increasing abortion access throughout the state. “We also made really bold investments in abortion care and access and funds in our state,” she said. “For the first time in Massachusetts history, we put money directly into abortion funds to ensure that patients here in Massachusetts are able to access care with that financial support as well.”

Public Health Commissioner Robbie Goldstein said in the press release that the new amendments send “a powerful and reassuring message to the dedicated Massachusetts nurses who provide compassionate, high-quality, reproductive and gender-affirming health care. They should be supported and celebrated in our Commonwealth.”

The timing of these regulatory changes carries particular significance as Donald Trump begins his presidency. Trump, who supported the Supreme Court’s 2022 decision to dismantle abortion rights, stated during his campaign that abortion regulation should remain under state control, pledging to veto any federal abortion ban.

“Massachusetts is having a really outsized impact on the national abortion access landscape because of that shield law that was passed [by the state] in 2022; it included telehealth protections for care,” St. Germain explained. The law safeguards those who engage in accessing or attempting to access reproductive or gender-affirming health care services while physically present in Massachusetts. It also protects those who assist others in accessing or attempting to access these services. The law further states that the provider is protected regardless of the patient’s location when the care was provided.

Murphy explained more about the interstate collaboration: “We have a relationship with states across the country—California, Minnesota, Michigan—because we realize we’re all working for exactly the same thing. We work closely with our legislators as well.”

Mazzola emphasized Planned Parenthood’s comprehensive approach, including community outreach. “It’s talking to folks all the time, and it’s not just folks who agree with us. So I think the No. 1 thing is really just showing all the services, all the work that Planned Parenthood does.”

Mazzola said the team can highlight, for example, that Planned Parenthood has a nationally recognized clinical research team and has worked on pain management and efficacy of different types of birth control and abortion care.

The Department of Public Health’s initiative extends beyond the immediate emergency measures, as the agency plans to implement similar protections for all licensed health care providers in Massachusetts who participate in reproductive care services. As the department’s data suggests, access to reproductive health care in Massachusetts could become increasingly significant for patients across the U.S., particularly as different states implement varying restrictions on reproductive health care services.