As restrictions on reproductive health-care facilities have forced clinics around Ohio to close, people seeking abortion services have begun to head north to Michigan. The Cleveland Plain Dealer recently reported that after three of the state’s 14 clinics closed, some clinics in southern Michigan have reported an increase in the number of appointments by women from Ohio.

Rewire recently reported that in addition to the three clinics that have closed, two more are in danger of shuttering their doors due to the stringent regulations. That would leave just nine clinics left in a state with a population of more than 11 million. The America Civil Liberties Union has challenged the restrictions, which were put into the state’s budget without debate in June and soon after were signed by Gov. John Kasich.

Lara Chelian, appointment center manager with the Northland Family Planning Centers, told Rewire that while they have not compiled official numbers, they have seen the number of patients from Ohio increasing. “We estimate 30 to 40 patients a month are coming from Ohio, and that is a low estimate,” said Chelian. “It seems to increase every week because of the clinic closures and people making appointments for late-term abortions.”

The Center for Choice in Toledo was forced to close earlier this year because it could not obtain a transfer agreement with a local hospital. The clinic’s website and phone number now direct to Northland. “Sometimes they think they’re calling the Center for Choice clinic,” said Chelian.

Northland treats a variety of patients from all over Ohio and other states as well. “We get a lot of physician referrals from Ohio and Indiana,” said Chelian. “We are often times the closest clinic to treat patients with fetal indications—people who don’t find out until much later in their pregnancy that something is wrong.” Chelian said that Northland receives patients from all over the midwest and as far away as Kentucky.

The travel involved creates a significant barrier to access and can place quite a burden on patients. “For patients who need to terminate a pregnancy that are further along they have to have a two-day procedure,” said Chelian. “This creates a burden for them because they have to travel and then stay overnight.”

Chelian specifically cited the National Abortion Federation (NAF) for helping women who are financially unable to obtain abortion services through their Patient Assistance Fund. “We are very thankful and grateful for the NAF fund, which provides assistance for women that need to travel to access services,” she said.

Supporters of Ohio’s stringent abortion restrictions claim that women are not leaving the state to seek abortion services, and that the closure of clinics has led to fewer abortions being performed. Mike Gonidakis, president of Ohio Right to Life, told the Plain Dealer that he doesn’t think there is a “mad dash for the border” and that more people are choosing to continue their pregnancies or are preventing unwanted pregnancies in the first place.

“That’s maddening,” said Chelian, in response to Gonidakis’ comments. “It is completely inaccurate. We are seeing the direct result of clinic closures. There is still a huge burden for women to access services in this country, financially or otherwise. There are a lot of hurdles that women must navigate and they are choosing to do whatever they can to find abortion care.”