Distance Traveled to Obtain Clinical Abortion Care in the United States and Reasons for Clinic Choice

Abstract

Introduction: Greater distance to abortion facilities is associated with greater out-of-pocket costs, emergency room follow-up care, negative mental health, and delayed care among U.S. abortion patients. However, the distance U.S. abortion patients travel has not been reported since 2008, and no study has examined reasons abortion patients choose the particular facility where they obtain their abortion.Materials and Methods: We analyzed data from the 2014 Abortion Patient Survey and Abortion Provider Census to report abortion patients' one-way travel from their resident zip code to their abortion clinic, whether they went to the closest clinic, and reasons for facility choice. We report unadjusted and adjusted associations of patients' characteristics with travel distance and differences in average travel distance by abortion patients' reported reasons for choosing their facility.Results: In 2014, 65% of abortion patients traveled less than 25 miles one-way, 17% traveled 25–49 miles, and 18% traveled more than 50 miles. Abortion patients who were white, college-educated, U.S.-born, ≥12 weeks pregnant, and lived outside metropolitan areas were more likely to travel farther. Nearly half of abortion patients went to their nearest provider and 32% chose their facility because it was the closest.Conclusion: These results indicate that travel distance is an important determinant of abortion care access in the United States. Nearly, one-fifth of U.S. abortion patients traveled more than 50 miles one-way and the most common reason reported for clinic choice was that it was the closest.

Examining Public Opinion about Abortion: A Mixed‐Methods Systematic Review of Research over the Last 15 Years

“…And across the world's third largest nation, physical access to an abortion clinic varies tremendously. In 2019, six states had only one abortion clinic, Missouri appeared likely to become the first state without a clinic, and 20 percent of abortion patients had to drive 50 minutes or longer one way to obtain an abortion, often taking two trips because of mandatory waiting period laws (Fuentes and Jerman ; Guttmacher Institute ; Oliver and Smith ).…”

Distance to an Abortion Provider and Its Association with the Abortion Rate: A Multistate Longitudinal Analysis

“…[7][8][9] Further, they have shown that even in states with fewer restrictions, abortion access is often limited and requires traveling long distances. 2,[10][11][12][13][14] Cumulatively, past research indicates that distance is an integral component of access.…”

“…Studies have shown that these facility closures have reduced access to abortion services by significantly increasing the distance a patient must travel to reach a provider 7–9 . Further, they have shown that even in states with fewer restrictions, abortion access is often limited and requires traveling long distances 2,10–14 . Cumulatively, past research indicates that distance is an integral component of access.…”

Pregnancies, Births and Abortions in the United States, 1973–2017: National and State Trends by Age

“…At the state level, we do not calculate estimates by a cross of age with race and ethnicity because we believe that a key assumption-that patients in each age-group and race and ethnicity population group travel outside their home state for abortion services in roughly the same proportions-is violated for these data. Although no studies to our knowledge have examined the characteristics of patients travelling to other states (as compared with patients who have abortions in their state of residence), recent research has found strong differentials in distance travelled according to patient race, 35 likely reflecting structural differences in the substantial material, informational and social resources required to travel across state lines. 36…”