Abortion patients' out-of-pocket expenditures for consultation visit: Financial burden of the two-visit requirement in Texas

As of September 2011, Texas law requires all women seeking abortion care to attend a consultation visit with an ultrasound at least 24 hours prior to their procedure. Little research has documented the impact of abortion restrictions on women. The aim of the study was to calculate the out-of-pocket expenditures, outside of clinic costs, for women attending their pre-abortion consultation visit and to examine the types of expenses that these women incur. We conducted a survey with 318 women seeking abortion services at clinics in 6 cities throughout Texas. Total out-of-pocket expenditures were calculated for individual participants by adding transportation and childcare costs, wages lost as a result of missing work, and cost of overnight stay between consultation and procedure visits. Twenty-five percent (25%) of women reported it was somewhat or very difficult to get to their consultation visit. Forty five percent (45%) of women reported some out-of-pocket expenditures and on average they spent $146 (median=$100). Lost wages accounted for the largest proportion of expenditures (mean=52%), followed by childcare and travel costs. Women who presented in their 1st trimester had lower mean expenses then women in the 2nd trimester ($53.92 vs $157.40, p<0.05). Almost half of abortion clients report a sizeable expenditure in order to attend the state-mandated consultation visit in Texas, without any proven health benefit. The two-visit requirement is a financial burden on clients—especially low-income women and those in the 2nd trimester.