Online asynchronous telemedicine is a remote service delivery structure through which clinicians use an online platform and mail delivery to provide medication abortion. To serve states with abortion bans and restrictions, US-licensed clinicians provide under shield laws that protect them from civil, professional, or criminal liability. Shield-law provision of medication abortion has had a profound impact on abortion access since the overturn of Roe v Wade, providing an alternative to out-of-state travel in states with abortion bans. Yet no prior research has examined people’s experiences accessing abortion through shield law provision in ban states or compared their experiences to those of people accessing care in protected states. In partnership with the two online asynchronous telemedicine services that serve people in all 50 states and DC, this project employs a mixed-methods approach to fulfill the following specific aims:

1) assess patient experiences seeking medication abortion, including the prevalence of and reasons for multiple ordering across providers;
2) examine how socioeconomic factors impact the experience of securing access to services, including which groups are most likely to need reduced or no-fee payment structures and how patients secure funds within their personal financial context; and
3) explore the experiences and unmet needs of patients managing their medication abortions, with particular attention to how state policy context influences willingness and ability to seek in-person care.

By investigating patient experiences at both the population and individual levels, this research will inform strategies for increasing equity in service access and addressing patients’ unmet needs.