Do women traveling greater distances to obtain abortion services experience undue burden?
Awarded 2016
Trainee Grants
Sarah Peterson, MD
University of Colorado

Objective: Legislative barriers to abortion access are evaluated by courts against ill-defined standards of imposition of “undue burden.” Recently, travel of >150 miles has been accepted legally as undue burden. We attempted to determine if women traveling 150 miles or more for abortions perceive greater burden than those traveling less. Method: We surveyed women in the waiting area of an outpatient abortion clinic in Denver, CO about their perceived burden in accessing that abortion. We created two groups: travel <150 or >=150 miles. We defined burden, then asked women to rate their overall level of burden associated with their abortion. We used a 5-point Likert scale to assess burden; ratings >=3 were considered high-burden. We used chi-squared tests to compare the two groups and multivariable logistic regression to identify independent predictors of high burden. Results: We enrolled 500 participants; 8.2% traveled >=150 miles. Women traveling farther were more likely to present in the second trimester, incur costs of >$500 and need someone else to drive them. Groups were equally likely to report high burden (39.6% vs. 48.7%; p=0.27). In logistic regression, being in the second trimester was the only independent predictor of perceived high-burden, not distance. Conclusions: Being in the second trimester lead to greater perception of burden by abortion patients. While this factor occurs more commonly in women who need to travel farther, distance alone does not increase perceived burden. Decision-makers should not over-emphasize distance traveled compared to other barriers, e.g., waiting periods, clinic closures and expensive TRAP regulations.