Travel for abortion care: implications for clinical practice

Abstract

Purpose of review Traveling long distances to obtain abortion care due to restrictions and scarce availability is associated with significant obstacles. We review clinical strategies that can facilitate abortion access and outline considerations to ensure person-centered and equitable care. Recent findings Establishing a patient's gestational duration prior to travel may be beneficial to ensure they are eligible for their desired abortion method at the preferred facility or to determine if a multiday procedure is required. If a local ultrasound cannot be obtained prior to travel, evidence demonstrates people can generally estimate their gestational duration accurately. If unable to provide care, clinicians should make timely referrals for abortion. Integration of telemedicine into abortion care is safe and well regarded by patients and should be implemented into service delivery where possible to reduce obstacles to care. Routine in-person follow-up care is not necessary. However, for those who want reassurance, formalized pathways to care should be established to ensure people have access to care in their community. To further minimize travel-related burdens, facilities should routinely offer information about funding and practical support, emotional support, and legal resources. Summary There are many opportunities to optimize clinical practice to support those traveling for abortion care.

Implications of abortion legislation on birth defect surveillance

“…Currently, 21 states have banned or strictly limited abortion access before 18 weeks gestation, including 14 states that have passed complete bans regardless of gestational age (Guttmacher Institute, 2023). There has been a breadth of recent literature on the effect of Dobbs v Jackson on medical care for pregnant people who have received a prenatal diagnosis of a major birth defect or chromosomal anomaly (Grünebaum et al, 2023;Lerma et al, 2023;Raymond et al, 2023). However, it is unclear how abortion legislation will impact birth defect prevalence estimates reported by surveillance programs in the US.…”