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Contraception. 2016 Apr;93(4):292-297. doi: 10.1016/j.contraception.2015.12.017. Epub 2016 Jan 6.

Women's experiences seeking abortion care shortly after the closure of clinics due to a restrictive law in Texas.

Author information

1
Texas Policy Evaluation Project, 305 E. 23rd Street, Stop G1800, Austin, TX, 78712, USA; Ibis Reproductive Health, 1330 Broadway Suite 1100, Oakland, CA, 94612, USA. Electronic address: lfuentes@ibisreproductivehealth.org.
2
Texas Policy Evaluation Project, 305 E. 23rd Street, Stop G1800, Austin, TX, 78712, USA; Ibis Reproductive Health, 1330 Broadway Suite 1100, Oakland, CA, 94612, USA.
3
Texas Policy Evaluation Project, 305 E. 23rd Street, Stop G1800, Austin, TX, 78712, USA; Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL, 35294, USA.
4
Texas Policy Evaluation Project, 305 E. 23rd Street, Stop G1800, Austin, TX, 78712, USA; Population Research Center and the Department of Sociology, University of Texas at Austin, 305 E. 23rd Street, Stop G1800, Austin, TX, 78712, USA.
5
Texas Policy Evaluation Project, 305 E. 23rd Street, Stop G1800, Austin, TX, 78712, USA; Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 1330 Broadway Suite 1100, Oakland, CA, 94612, USA.

Abstract

OBJECTIVE:

In 2013, Texas passed legislation restricting abortion services. Almost half of the state's clinics had closed by April 2014, and there was a 13% decline in abortions in the 6 months after the first portions of the law went into effect, compared to the same period 1 year prior. We aimed to describe women's experiences seeking abortion care shortly after clinics closed and document pregnancy outcomes of women affected by these closures.

STUDY DESIGN:

Between November 2013 and November 2014, we recruited women who sought abortion care at Texas clinics that were no longer providing services. Some participants had appointments scheduled at clinics that stopped offering care when the law went into effect; others called seeking care at clinics that had closed. Texas resident women seeking abortion in Albuquerque, New Mexico, were also recruited.

RESULTS:

We conducted 23 in-depth interviews and performed a thematic analysis. As a result of clinic closures, women experienced confusion about where to go for abortion services, and most reported increased cost and travel time to obtain care. Having to travel farther for care also compromised their privacy. Eight women were delayed more than 1 week, two did not receive care until they were more than 12 weeks pregnant and two did not obtain their desired abortion at all. Five women considered self-inducing the abortion, but none attempted this.

CONCLUSIONS:

The clinic closures resulted in multiple barriers to care, leading to delayed abortion care for some and preventing others from having the abortion they wanted.

IMPLICATIONS:

The restrictions on abortion facilities that resulted in the closure of clinics in Texas created significant burdens on women that prevented them from having desired abortions. These laws may also adversely affect public health by moving women who would have had abortions in the first trimester to having second-trimester procedures.

KEYWORDS:

Abortion; Abortion restrictions; Policy evaluation; Qualitative; Texas

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