People face multiple barriers to abortion care in the United States; barriers that are intensified for medication abortion due to a narrow gestational eligibility window, and burdensome federal distribution restrictions. Yet, due to limitations of common research recruitment strategies, existing research may systematically miss or underestimate the extent to which certain populations are underserved by medication abortion. Data collected from all people seeking abortion care, not just those who succeed in making it to an abortion clinic, are needed to identify barriers to medication abortion, and to inform effective interventions.
In Indiana, a state with the second most abortion restrictions enacted since 1973, surveillance data make evident that residents access abortion at low rates. However, no individual-level data on access to or experiences of medication abortion in Indiana exist. To measure the full scope of barriers to and experiences with medication abortion in Indiana, we propose a longitudinal, mixed-methods study of Indiana residents recruited through abortion funds in the region, and social media advertisements. At baseline, participants will be asked about knowledge of and preferences for medication abortion, and at follow-up, will be asked questions specific to whether or not they obtained medication abortion, barriers to care, and experiences versus expectations. Findings will inform interventions to target medication abortion barriers in Indiana for those that face the greatest barriers, to strengthen abortion fund support for medication abortion seekers, to invigorate and inform local advocacy, and will serve as a test case for replicating data collection across other restrictive states.