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The authors analyzed data from the Guttmacher Institute's 2008 nationally representative survey of 8,338 abortion patients and found that women living in states with a mandatory counseling and waiting period requirement, those in rural areas and women seeking second-trimester abortion services were more likely to travel greater distances than their counterparts.
"Many women travel substantial distances to access abortion services. This can present a barrier, particularly for poor and low-income women, who make up the majority of women seeking abortions, and for women in rural areas" says lead author Rachel Jones. "For women in states with mandatory counseling and waiting periods, the barrier is even greater, and one some women may not be able to overcome."
In 2008, 25 states required mandatory counseling followed by a waiting period, typically 24 hours. In seven of those states, in-person counseling was required, necessitating two visits. This study found that women who lived in a state with a 24-hour waiting period were more than twice as likely to travel greater distances as women in states with no waiting period requirement regardless of whether there was a two-visit requirement.
Although two-thirds of U.S. abortion providers offer second-trimester abortion services, that percentage drops with each additional week's gestation. Therefore, women seeking later procedures are more likely to have to travel greater distances. The authors found that women obtaining abortions at 16 weeks or later were twice as likely to have traveled 25, 50 or 100 miles or more compared with women seeking first-trimester procedures.
Women who live in rural areas have to travel greater distances for many services, including primary care and even groceries. It is therefore not surprising that 31% of women who lived in rural areas traveled more than 100 miles to access abortion services, and an additional 43% traveled between 50-100 miles. Rural women are underrepresented among abortion patients.
Previous studies of the distances women travel to access abortion services have relied on estimates from providers. This study, which estimated distance based on women's zip codes, is more precise. However, it is important to note that this study does not address women who were unable to access abortion services because they could not overcome barriers posed by geographic distance, which for some is exacerbated by laws mandating counseling and waiting periods before an abortion procedure.
This study serves as a baseline, as a number of states have introduced restrictive abortion legislation since 2008 that may make it necessary for women to travel even further and may prevent some women from accessing abortion services at all.
"Between 2010 and 2013, we have seen an unprecedented number of abortion restrictions introduced and enacted at the state level," says Guttmacher state policy expert Elizabeth Nash. "This study will serve as a useful benchmark to analyze the impact of those restrictions on women's ability to access abortion services."
"How Far Did U.S. Women Travel for Abortion Services in 2008?" is currently available online and will appear in a forthcoming issue of the Journal of Women's Health.
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