Emotional costs of forced travel for abortion care

Article

In a recent study, being forced to travel out of state for abortion care led to increased feelings of worry, stigma, and being cast out among patients.

Emotional costs of forced travel for abortion care | Image Credit: © fizkes - © fizkes - stock.adobe.com.

Emotional costs of forced travel for abortion care | Image Credit: © fizkes - © fizkes - stock.adobe.com.

This is part 2 of our 3 part series on abortion. Click here for part 1. Click here for part 3.

Alongside financial and logistical costs, people who must travel to receive abortion care also face emotional costs, according to a recent study published in Contraception.

Pregnant individuals often need to travel across state and national borders to receive abortion care, frequently because of service unavailability and legal restrictions. Financial and logistical costs associated with travelling for abortion care include gas or airline ticket, lodging, childcare, pet care, and lost wages.

After Dobbs v. Jackson Women's Health Organization overturned the constitutional right to abortion in June 2022, an increase occurred in the prevalence of women needing to travel for abortion care in the United States. To determine the emotional costs of abortion travel, investigators analyzed interviews with 30 US cisgender women who had to travel for abortion care.

From September 2016 to June 2018, participants were recruited if they had obtained an abortion after 24 weeks of pregnancy. Participants were aged 18 years and older and were comfortable with completing the interview in English.

A flyer was used to recruit participants who were turned away from 3 clinics in the Southeast because of gestational age, obtained an abortion at a clinic that provides abortion throughout pregnancy, or aborted a pregnancy after observing a severe fetal health issue.

Interviews were constructed in a semi-structured format using a modified version of the timeline interview methodology. Participants’ experiences of pregnancy, pregnancy decision making, abortion seeking, and abortion obtaining were discussed.

The interview was completed by 30 women, aged 18 to 43 years. Of the participants, 20 were White, 5 Hispanic, 3 Black, 1 Asian, and 1 biracial. At least some level of college education was observed in 21 participants, and most described themselves as being able to meet their financial needs. However, 9 were unemployed when receiving an abortion.

All participants spent at least 2 nights away from home when seeking abortion, with some spending up to 8 nights away. Nineteen flew to the facility where they received abortion care, with an average 3-hour drive to the airport and 2-to-6-hour flight to travel one way. The other 11 participants drove, with driving times of 9 hours to 2 days one way.

Emotional costs from difficulties in keeping pregnancy and abortion private were reported by many participants.Some participants had to disclose personal information to their workplace in order to travel, while others had to disclose information sooner than planned to their close families and friends since they were travelling out of state.

Many participants had to travel to unfamiliar locations to receive an abortion. This led to feeling overwhelmed and additional stress. Some participants had to leave behind family, friends, and support networks while traveling. Many were forced to rely on strangers to meet their basic needs, furthering their emotional stress.

Simply being denied abortion care in their local hospitals also caused emotional distress for many women. Some felt uncertainty about the morality of their abortion because of being denied care, while others felt it was inhumane to be forced to travel. This led to increased feelings of stigma.

Denial of abortion care also led some participants to fear about the safety of the procedure, wondering why doctors in their state would not provide care. The legal origins of many denials were a primary contributor to the emotional cost, causing some women to feel “cast out.”

These results expand upon prior research indicating the burdens of being forced to travel for abortion care. Investigators recommended providers understand the emotional costs of travel to better connect with their patients when they seek care.

Reference

Kimport K, PalupyRasidjan M. Exploring the emotional costs of abortion travel in the United States due to legal restriction. Contraception. 2023;120. doi:10.1016/j.contraception.2023.109956

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