The number of abortions in Minnesota declined last year to near-record lows, despite an increase in women coming from other states to terminate their pregnancies.

The 9,910 abortions performed in 2018 represented the third time the total has dropped below 10,000 since at least 1975, when a long, gradual decline began. It also represented a 2% drop from 2017, according to data released Monday in the state Health Department’s annual report on the procedure.

But the report also showed that the number of nonresident abortions increased in Minnesota, from 938 in 2017 to 1,014 last year. Nonresidents received more than 10% of the abortions in Minnesota last year, the first time that has occurred since 1992.

Officials with Planned Parenthood, which provides the majority of abortions in Minnesota, said women are traveling to Minnesota due to tightening restrictions in neighboring states.

“Minnesota is really a haven state, when you consider some of the states that are surrounding us that are pretty restrictive and hostile,” said Dr. Sarah Traxler, chief medical officer for the Planned Parenthood chapter for Minnesota, the Dakotas, Iowa and Nebraska.

Restrictions include South Dakota’s 72-hour waiting period, North Dakota’s ban on a specific late-term surgical procedure, and bans in Iowa and Wisconsin on abortions taking place after 20 weeks gestation. Iowa also had a waiting period and a ban on abortions once fetal heartbeats are detected, at roughly six weeks gestation, but its State Supreme Court ruled last year that both were unconstitutional.

Minnesota Citizens Concerned for Life, an organization that opposes abortion, disagreed that the rise in abortions involving nonresidents is a trend or a reflection of Minnesota becoming “a big referral state.” The organization is worried that progress against abortion could be undermined by a recent lawsuit filed in Ramsey County that challenges abortion restrictions, including parental notice for minors seeking to terminate pregnancies.

“This lawsuit would give the abortion industry free rein and wipe out even the most modest legal protections,” said Scott Fischbach, the organization’s executive director.

Planned Parenthood leaders have their own legal concerns — specifically the Trump administration’s attempt to block federal Title X family planning funds from going to any organization that provides abortions.

Apart from abortion, Planned Parenthood is the leading Minnesota provider of family planning services, including counseling and contraception, to more than 51,000 people at its Title X-funded health centers. Those service have reduced unwanted pregnancies and abortions, said Lauren Gilchrist, an executive vice president for the North Central States chapter that includes Minnesota.

“If that [funding restriction] moves forward, and excludes abortion providers from that program, we could see changes in that decreasing [abortion] trend,” she said.

More than 63% of induced abortions in Minnesota occurred at Planned Parenthood’s St. Paul and Rochester clinics. In 2010, it provided just 35% of abortions in the state. Its ascendance occurred amid the closing of two other clinics, the opening of its new St. Paul clinic in 2011, and the addition of medicinal abortion services in Rochester two years ago.

The state report shows a continued trend toward more abortions by medication, primarily mifepristone. The U.S. Food and Drug Administration approved the drug in 2000, but issued updated guidance in 2016 permitting its use up until 70 days gestation, compared to the original standard of 49 days.

The 3,594 medicinal abortions in Minnesota represented 37% of last year’s total, up from just 7% five years ago. Traxler said she expects that trend to increase, especially as obstetricians in smaller communities begin to offer it and give women an alternative to traveling to St. Paul for surgical abortions.

Abortions among women aged 19 and younger have dropped sharply in Minnesota, falling 17% in the last five years to reach 809 last year. In that same period, the number of abortions involving women 20 and older has dropped only 0.05%, and the number of abortions involving women in their thirties has increased.

Sex education programs that encourage good decision-making helped reduce unwanted pregnancies and abortions among teens, along with family planning programs for that demographic, Planned Parenthood leaders said.

Social media campaigns have influenced young adults as well, Gilchrist said. “That is increasingly where they get information overall, especially health information.”