At this point, the novel takes an odd turn as they take on a fairly leisurely road trip, visiting towns that are the namesakes of famous world cities (Rome, Lima, etc.). It's a little hard to understand why they drag out the trip this way and it slows down the pace of novel considerably, but Caletti has her reasons. Along the way, women come out and share with Ivy that they too have been in her position and that they also have had abortions. By the time Ivy gets to Oregon, she finds that she is far from alone.
Caletti's purpose is to demystify (and de-shame) abortions but pointing out that, as uncomfortable as the public discourse is, there's plenty of private conversation going on as a large number of women have gone through the experience. The book occasionally gets a bit preachy on the subject, but I thought it was a good talking point and allows the novel to make a constructive contribution to the issue.
Another theme in this book are frequent violations of the fourth wall as Caletti calls out the tendency to overdramatize abortions in novels on the subject. Ivy has some emotional turmoil, but she never wavers in her conviction that she's making the right decision. The procedure itself is dealt with matter-of-factly and concisely with no complicated preliminaries. There are not angry protestors, no last minute hysterics, and no drama at all. The only real tension is a bunch of petty harassment in her hometown (which seemed largely unnecessary and gratuitous). Her point is that abortion is only as dramatic as we care to make it.