Providers' perceptions of patient barriers when applying for public funding for abortions under the Hyde ammendment

Background:

In 1976, Congress passed the federal Hyde Amendment, prohibiting the use of federal Medicaid funding for abortions except in the cases of rape, incest, or life endangerment of the woman. Though anecdotal evidence suggests that seeking state funding for terminations under these circumstances is difficult for women, little is known about abortion providers' perceptions of their patients' circumstances.

Purpose:

The purpose of this study is to document the perceived impact of the Medicaid approval process on traditionally disenfranchised women.

Methods:

We conducted this qualitative and quantitative study and selected eight states based on the number of Medicaid-covered abortions and number of providers in the state. We approached all abortion providers in six of the states which had fewer providers, and a sample of providers in two states with large numbers of providers for telephone interviews. In the latter states we purposively selected providers in order to achieve maximum variation on geographical regions of the state and type of facility.

Results:

Twenty-four of the 35 planned 90-minute telephone interviews with providers have been conducted and interviews and analysis will be completed in February 2008.

Preliminary themes emerging include:

• language and cultural barriers for non-English speaking and immigrant women;

• disparate knowledge across women about support services for sexual assault;

• abortion as an often overlooked consequence of intimate partner violence.

Conclusion:

Many providers indicated that the current Medicaid system fails to meet the reproductive health needs of traditionally disenfranchised women and may further isolate them from support networks.