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      Barriers to Abortion Care and Their Consequences For Patients Traveling for Services: Qualitative Findings from Two States : Barriers to Abortion Care and Their Consequences For Patients Traveling for Services: Qualitative Findings from Two States

      , , ,
      Perspectives on Sexual and Reproductive Health
      Guttmacher Institute

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          Abstract

          <div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d14089367e119">CONTEXT</h5> <p id="P1">Abortion availability and accessibility vary by state. Especially in areas where services are restricted or limited, some women travel to obtain abortion services in other states. Little is known about the experience of travel to obtain abortion. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d14089367e124">METHODS</h5> <p id="P2">In January and February 2015, in-depth interviews were conducted with 29 patients seeking abortion services at six facilities in Michigan and New Mexico. Eligible women were 18 or older, spoke English, and had traveled either across state lines or more than 100 miles within the state. Respondents were asked to describe their experience from pregnancy discovery to the day of the abortion procedure. Barriers to accessing abortion care and consequences of these barriers were identified through inductive and deductive analysis. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d14089367e129">RESULTS</h5> <p id="P3">Respondents described 15 barriers to abortion care while traveling to obtain services, and three major consequences of experiencing those barriers. Barriers were grouped into five categories: travel-related logistical issues, system navigation issues, limited clinic options, financial issues, and state or clinic restrictions. Consequences were delays in care, negative mental health impacts and considering self-induction. The experience of barriers complicated the process of obtaining an abortion, but the effect of any individual barrier was unclear. Instead, the experience of multiple barriers appeared to have a compounding effect, resulting in negative consequences for women traveling for abortion. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d14089367e134">CONCLUSION</h5> <p id="P4">The amalgamation of barriers to abortion care experienced simultaneously can have significant consequences for patients. </p> </div>

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          Most cited references24

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          Women's Mental Health and Well-being 5 Years After Receiving or Being Denied an Abortion: A Prospective, Longitudinal Cohort Study.

          The idea that abortion leads to adverse psychological outcomes has been the basis for legislation mandating counseling before obtaining an abortion and other policies to restrict access to abortion.
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            Denial of abortion because of provider gestational age limits in the United States.

            We examined the factors influencing delay in seeking abortion and the outcomes for women denied abortion care because of gestational age limits at abortion facilities.
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              Timing of steps and reasons for delays in obtaining abortions in the United States.

              We studied the steps in the process of obtaining abortions and women's reported delays in order to help understand difficulties in accessing abortion services. In 2004, a structured survey was completed by 1209 abortion patients at 11 large providers, and in-depth interviews were conducted with 38 women at four sites. The median time from the last menstrual period to suspecting pregnancy was 33 days; the median time from suspecting pregnancy to confirming the pregnancy was 4 days; the median time from confirming the pregnancy to deciding to have an abortion was 0 day; the median time from deciding to have an abortion to first attempting to obtain abortion services was 2 days; and the median time from first attempting to obtain abortion services to obtaining the abortion was 7 days. Minors took a week longer to suspect pregnancy than adults did. Fifty-eight percent of women reported that they would have liked to have had the abortion earlier. The most common reasons for delay were that it took a long time to make arrangements (59%), to decide (39%) and to find out about the pregnancy (36%). Poor women were about twice as likely to be delayed by difficulties in making arrangements. Financial limitations and lack of knowledge about pregnancy may make it more difficult for some women to obtain early abortion.
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                Author and article information

                Journal
                Perspectives on Sexual and Reproductive Health
                Perspect Sex Repro H
                Guttmacher Institute
                15386341
                June 2017
                June 2017
                : 49
                : 2
                : 95-102
                Article
                10.1363/psrh.12024
                5953191
                28394463
                70bb825c-8bfd-418b-bc2e-1ea3b8bb46f2
                © 2017

                http://doi.wiley.com/10.1002/tdm_license_1

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