Objectives: Most research on cost-related abortion barriers relies on clinic-based samples, which likely misses people who never make it through the doors of a clinic. We set out to assess financial obstacles among anonymous posters to a social media site as they were considering abortion.
Methods: In early February 2020, we used Python to web-scrape and collate 250 Reddit posts that mentioned abortion, removing all identifying information and usernames. We established codes, then themes, with a combined deductive/inductive analytic approach, reaching saturation after analyzing 148 posts.
Results: Reddit users who mentioned cost most often described inability to secure funds for abortion procedures or transportation to the clinic. Second, some could collect partial funds but were unable to afford their desired abortion modality or attendant services such as sedation or follow-up appointments. Third, even those people with potential public or private insurance coverage reported challenges and delays due to often unclear administrative requirements. Finally, lack of funds led some to turn to self-management options, both well-established services such as Aid Access and non-evidence-based approaches such as veterinary or arthritis medications.
Conclusions: Reddit posters in this study described themes aligned with prior clinic-based research of abortion patients, while providing additional information on the real-time effects of cost-related barriers. Research with online populations holds promise for documenting pre-abortion barriers and experiences, including among those who never make it to a clinic. Study findings critically augment the evidence base for the harmful effects of, and need to overturn, the Hyde Amendment and other payor restrictions on abortion services.
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