Existing inequities in abortion care access have deepened following the overturning of Roe v. Wade, as safe, affordable, high-quality abortion care has been severely restricted across the nation. Southern and Midwestern states are subject to particularly restrictive policies that disproportionately affect vulnerable groups already enduring racial, socioeconomic, and geographic health inequities.

To circumvent restricted access, uptake of self-managed medication abortion is likely to increase among racially minoritized and low-resourced individuals. It is unclear, however, what criteria influence the decision to undertake self-managed medication abortion. Understanding what is most important, as well as differences by race, socioeconomic status, and geographic region, has critical implications for future interventions. To answer this question, we propose to conduct a discrete choice experiment with individuals of reproductive age (18-44 years) in Ohio, Kentucky, Tennessee, and West Virginia.

Objective 1: Use sequential mixed methods design to identify key attributes (e.g., legality, travel time, social support) that would influence obtaining a medication abortion outside of the formal health care sector.
Objective 2: Develop and pilot a preference assessment tool to elicit preferences for obtaining a medication abortion outside of the formal health care sector. The instrument will be preliminarily assessed using cognitive-based interviews.
Objective 3: Examine preferences, knowledge, attitudes, acceptability of obtaining a medication abortion outside of the formal health care sector using the discrete choice experiment piloted in Objective 2.

This project will lead to development of a novel abortion decision aid to help individuals navigate a complicated abortion care landscape and receive care they value.