Advertisement

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

  • Liza Fuentes
    Correspondence
    Corresponding author. Tel.: +1-510-986-8926; fax: +1-510-986-8960.
    Affiliations
    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
    Search for articles by this author
  • Sharon Lebenkoff
    Affiliations
    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
    Search for articles by this author
  • Kari White
    Affiliations
    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
    Search for articles by this author
  • Caitlin Gerdts
    Affiliations
    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
    Search for articles by this author
  • Kristine Hopkins
    Affiliations
    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
    Search for articles by this author
  • Joseph E. Potter
    Affiliations
    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
    Search for articles by this author
  • Daniel Grossman
    Affiliations
    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
    Search for articles by this author

      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

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Contraception
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Grossman D.
        • Baum S.
        • Fuentes L.
        • White K.
        • Hopkins K.
        • Stevenson A.
        • et al.
        Change in abortion services after implementation of a restrictive law in Texas.
        Contraception. 2014; 90: 496-501
      1. Texas Policy Evaluation Project. Impact of Abortion Restrictions in Texas. Available at http://www.utexas.edu/cola/txpep/_files/pdf/TxPEP-ResearchBrief-ImpactofAbortionRestrictions.pdf [Accessed December 20, 2015].

        • Penchansky T.
        • Thomas W.
        The concept of access: definition and relationship to consumer satisfaction.
        Med Care. 1981; 19: 127-140
        • Fereday J.
        • Muir-Cochrane E.
        Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development.
        Int J Qual Methods. 2006; 5: 80-92
        • Kimport K.
        • Preskill F.
        • Cockrill K.
        • Weitz T.A.
        Women's perspectives on ultrasound viewing in the abortion care context.
        Womens Health Issues. 2012; 22: e513-e517
        • Kavanagh E.K.
        • Hasselbacher L.A.
        • Betham B.
        • Tristan S.
        • Gilliam M.L.
        Abortion-seeking minors' views on the Illinois parental notification law: a qualitative study.
        Perspect Sex Reprod Health. 2012; 44: 159-166
        • Gerdts C.
        • Dobkin L.
        • Foster D.G.
        • Schwarz E.B.
        Side effects, physical health consequences, and mortality associated with abortion and birth after an unwanted pregnancy.
        Womens Health Issues. 2015; 26: 55-59
        • Upadhyay U.D.
        • Biggs M.A.
        • Foster D.G.
        The effect of abortion on having and achieving aspirational one-year plans.
        BMC Womens Health. 2015; 15: 102
        • Roberts S.C.
        • Biggs M.A.
        • Chibber K.S.
        • Gould H.
        • Rocca C.H.
        • Foster D.G.
        Risk of violence from the man involved in the pregnancy after receiving or being denied an abortion.
        BMC Med. 2014; 12: 144
        • Zane S.
        • Creanga A.A.
        • Berg C.J.
        • Pazol K.
        • Suchdev D.B.
        • Jamieson D.J.
        • et al.
        Abortion-related mortality in the United States: 1998–2010.
        Obstet Gynecol. 2015; 126: 258-265
        • Jerman J.
        • Jones R.K.
        Secondary measures of access to abortion services in the United States, 2011 and 2012: gestational age limits, cost, and harassment.
        Womens Health Issues. 2014; 24: e419-e424
        • Grossman D.
        • Holt K.
        • Peña M.
        • Lara D.
        • Veatch M.
        • Córdova D.
        • et al.
        Self-induction of abortion among women in the United States.
        Reprod Health Matters. 2010; 18: 136-146
      2. Texas Policy Evaluation Project. Texas women's experiences attempting self-induced abortion in the face of dwindling options. Available at http://www.utexas.edu/cola/txpep/_files/pdf/TxPEP-Research-Brief-WomensExperiences.pdf. [Accessed January 21, 2016].

      3. Texas Policy Evaluation Project. Abortion Wait Times in Texas: The Shrinking Capacity of Facilities and the Potential Impact of Closing Non-ASC Clinics. Available at http://sites.utexas.edu/txpep/files/2016/01/Abortion_Wait_Time_Brief.pdf. [Accessed January 21, 2016].

        • Colman S.
        • Joyce T.
        Regulating abortion: impact on patients and providers in Texas.
        J Policy Anal Manage. 2011; 4: 775-797
        • Dennis A.
        • Henshaw S.K.
        • Joyce T.J.
        • Finer L.B.
        • Blanchard K.
        The impact of laws requiring parental involvement for abortion: a literature review.
        Guttmacher, New York2009
        • Joyce T.J.
        • Henshaw S.K.
        • Dennis A.
        • Finer L.B.
        • Blanchard K.
        The impact of state mandatory counseling and waiting period laws on abortion: a literature review.
        Guttmacher Institute, New York2009