Understanding clinician perspectives on abortion care in rural communities: A quantitative and qualitative approach

Introduction: Abortion is one of the most common surgical procedures performed in the US, yet, women in rural communities face many obstacles when accessing needed care. In 2007 the Abortion Access Project launched the Rural Abortion Provider Initiative. This project leverages research on rural clinicians to advocate for improved reproductive health access.

Methods: Self-administered questionnaires were mailed to 1,359 clinicians in four rural states. Clinicians responded to questions about perception of need for reproductive health services, services they provide, how far women travel to obtain services, their interest in offering abortion care, and obstacles to providing abortion care in their practice. Qualitative detailing visits were used to augment information collected by survey effort.

Results: Respondents reported lower perceived need for abortion care than for other reproductive health services. Over half reported that women travel more than 100 miles to access abortion care, while only 9% reported that women traveled that great a distance for obstetric care, and none for contraceptive services. While few clinicians currently provide abortion care, 19% did express interest in offering medication abortion if training and support were made available.

Implications: Additional research, both quantitative and qualitative, is needed in order to understand and meet the unique public health challenge of ensuring abortion access for rural women. Individualized on-the-ground follow up, building on broader research efforts, can be used to engage clinicians embedded in rural communities to respond to women's reproductive health needs.