Background: In Texas, abortion is legal through 20 weeks; exceptions past this gestational age include “severe fetal abnormalities.” Abortion counseling in the setting of lethal or severely morbid fetal anomalies may be performed by Maternal-Fetal Medicine specialists (MFMs) in settings without Family Planning specialists (FPs), as is the case in many places in Texas. MFMs may counsel differently from FPs. While some information exists about patient experiences after diagnosis of fetal anomaly, we lack understanding about the experiences of women seeking abortion for this indication in a setting with significant abortion restrictions.

Objective: To describe counseling and access to care experiences of English- and Spanish-speaking women in Texas with lethal or severely morbid fetal anomalies who seek abortion by D&E.

Design & Methods: Women seeking D&E for lethal or severely morbid fetal anomalies at four Texas abortion clinics will be recruited for a qualitative study via an IRB-approved flyer. Sampling will include areas with FPs in hospitals and areas without. Participants will be interviewed via telephone to learn about their experience prior to clinic presentation. The interviews will be transcribed verbatim and the transcripts will be analyzed with an inductive and iterative process using grounded theory until thematic saturation is achieved.

Potential Impact: Findings will improve our understanding of abortion counseling and access to care experiences in the setting of lethal or severely morbid fetal anomalies in restricted abortion areas.