Access to abortion services across the US

Introduction: In the face of pending regulations and limits to insurance coverage for abortion services, little is known about access to abortion in the United States. Methods: Between 2008 and 2010 we interviewed 956 women seeking abortions at 30 U.S. sites. We examine travel and logistical barriers to receiving an abortion. Clinic staff recorded how many women were unable to have an abortion due to advanced gestation. Results: The most frequent barriers to receiving abortion care were cost of the procedure (47%), insurance coverage (29%), not knowing where to get an abortion (26%), difficulty figuring out how to get to the clinic (20%) and travel costs (19%). In seeking abortion services, 44% of women called more than one clinic and 42% visited at least one other abortion provider. Four percent of first trimester and 15% of second trimester patients traveled four or more hours to reach the clinic. On average, clinics are unable to provide an abortion to one woman every three weeks because they present beyond the gestational limit. Compared to first trimester patients in a multivariable model, being younger than 20 years old is the most important factor in predicting presenting at the clinic too late to have an abortion. Discussion: Clinics set gestational limits for the abortions they are able to perform. Data in this study suggest that women experience numerous financial and travel barriers in accessing care and that young women are more likely to be beyond the provider's gestational limits when they present for care.