Access to abortion care in the deep south
Awarded 2013
Junior Investigator Grants
Kari White, PhD, MPH
University of Alabama, Birmingham

Objectives: We assessed how the restrictive policy and limited service environment in Alabama affects women’s access to abortion care. Methods: We analyzed anonymized billing data for all abortion encounters provided at two Alabama clinics in 2013 (n=2,216) to examine the distances women traveled to reach the clinic and the number of days between their consultation and procedure visits. We also conducted 25 in-depth interviews with women traveling >30 miles to a clinic to explore their experiences accessing services in this setting. Finally, we estimated changes in Alabama women’s geographic access to abortion after clinics suspended services following recent laws. Results: From the 2013 billing data, we found that 21% of women traveled 50-100 miles to a clinic and 9% traveled >100 miles; women of color were less likely and those in rural areas were more likely to travel longer distances than whites and urban women, respectively. In-depth interview participants located a clinic primarily by searching the Internet or asking trusted friends, although these strategies did not always direct them to the closest facility. Both billing data and in-depth interviews revealed that most women were unable to schedule their abortion immediately following the mandatory waiting period. Between 2013 and 2014, when two of the five clinics suspended services, the percentage of reproductive aged women living >100 miles from an Alabama clinic increased to 31%. Conclusions: Many women travel long distances for abortion services in Alabama and experience delays obtaining timely care. Steps can be taken to make abortion easier to access in the current environment.