Advertisement

Barriers to medication abortion among Massachusetts public university students

      Abstract

      Objective

      Proposed legislation in Massachusetts would require public university health centers to provide medication abortion services on campus. This study assesses need for these services by investigating current travel time, costs, wait times and insurance acceptance at off-campus, abortion-providing facilities nearest to public universities in Massachusetts.

      Study Design

      This investigation projected the total number of students obtaining medication abortions each year at the 13 Massachusetts public universities based on campus enrollment figures and age- and state-adjusted medication abortion rates. Using a cross-sectional study design, the research calculated the distance and public transit time from campuses to the nearest abortion-providing facilities. Researchers contacted facilities to determine costs, wait times and insurance acceptance.

      Results

      We estimate 50 to 115 of Massachusetts public university students obtain medication abortion services each month, or 600 to 1,380 each year. Students have to travel between 2 and 42 miles to reach the nearest abortion-providing facility, with a population-weighted average distance of 19 miles each way. Travel time on public transportation to reach the nearest abortion-providing facility takes between 18 and 400 hundred minutes, with a population-weighted average of 103 minutes each way. Average cost of medication abortion was $680, and average wait time to the first available appointment was 8 days. Eight of 13 abortion-providing facilities did not have weekend appointments. All of the nearest abortion-providing facilities in Massachusetts accepted Mass Health, but one nearest facility was out of state and did not. All accepted multiple private insurance plans.

      Conclusions

      College students face cost, scheduling, and travel barriers to abortion care. Offering medication abortion on campus would reduce these barriers.

      Implications

      The barriers to medication abortion experienced by students attending public universities in Massachusetts fall particularly hard on female and low-income students, who are disproportionately students of color. Offering medication abortion on campus would reduce these barriers and enhance gender and racial equity on campus.

      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

        • Jones RK
        • Jerman J.
        Population group abortion rates and lifetime incidence of abortion: United States, 2008-2014.
        Am. J. Public Health. 2017; 107: 1904-1909https://doi.org/10.1363/46e0414
        • Prentice M
        • Storin C
        • Robinson G.
        Make it personal: how pregnancy planning and prevention help students complete college.
        American Association of Community Colleges, Washington, D.C.2012 (Available at: https://powertodecide.org/sites/default/files/resources/primary-download/make-it-personal.pdf [Accessed 12 January 2022])
        • National Center for Education Statistics
        Short-term enrollment in postsecondary education: student background and educational differences in reasons for early departure, 1996-1998.
        Department of Education, Washington, D.CU.S.2002 (Available at: https://files.eric.ed.gov/fulltext/ED470227.pdf [Accessed 12 January 2022])
        • Biggs MA
        • Gould H
        • Foster DG.
        Understanding why women seek abortions in the US.
        BMC Womens Health. 2013; 13: 29https://doi.org/10.1186/1472-6874-13-29
      1. Cantor D, Fisher B, Chibnall S, Townsend R, et. al. Association of American Universities (AAU) report on the AAU campus climate survey on sexual assault and sexual misconduct. 2020. Available at: https://www.aau.edu/sites/default/files/AAU-Files/Key-Issues/Campus-Safety/Revised%20Aggregate%20report%20%20and%20appendices%201-7_(01-16-2020_FINAL).pdf [Accessed 12 January 2022].

        • Upadhyay UD
        • Cartwright AF
        • Johns NE.
        Access to medication abortion among California’s public university students.
        J Adoles Health. 2018; 63: 249-252https://doi.org/10.1016/j.jadohealth.2018.04.009
      2. California Legislature. S.B. 24. Public health: public university student health centers: abortion by medication techniques. 2019. Available at: http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200SB24 [Accessed 12 January 2022].

      3. Massachusetts Legislature, H. 2399 An act to require public universities to provide medication abortion. 2021. Available at: https://malegislature.gov/Bills/192/H2399 [Accessed 12 January 2022].

      4. U.S. News & World Report. College rankings, fall 2019. Available at: https://www.usnews.com/best-colleges [Accessed 15 July 2021].

      5. Advancing New Standards in Reproductive Health. Issue brief: safety and effectiveness of first-trimester medication abortion in the United States. 2021. Available at: https://www.ansirh.org/sites/default/files/2021-05/medication-abortion-safety_2021.pdf [Accessed 12 January 2022].

        • Jones RK
        • Witwer E
        • Jerman J.
        Abortion incidence and service availability in the United States, 2017.
        Guttmacher Institute, New York2019 (Available at: https://www.guttmacher.org/report/abortion-incidence-service-availability-us-2017 [Accessed 12 January 2022])
        • GenBioPro,Inc
        Mifepristone tablets, 200mg for oral use.
        Highlights of prescribing information. GenBioPro, Inc., Las Vegas, NV2019 (Available at: https://genbiopro.com/wp-content/uploads/2019/05/genbiopro-prescribing-information.pdf [Accessed 12 January 2022])
      6. NARAL Massachusetts (now Reproductive Equity Now). Hospital and clinic providers, Available at: https://www.abortioncaremass.org/providers [Accessed 12 January 2022].

      7. Abortion Finder. Find a verified abortion provider. Available at: https://www.abortionfinder.org/ [Accessed 15 July 2021].

        • Thompson KMJ
        • Sturrock HJW
        • Foster DG
        • Upadhyay UD.
        Association of travel distance to nearest abortion facility with rates of abortion.
        JAMA Netw Open. 2021; 4e2115530https://doi.org/10.1001/jamanetworkopen.2021.15530
        • Bryant AG
        • Narasimhan S
        • Bryant-Comstock K
        • Levi EE.
        Crisis pregnancy center websites: information, misinformation and disinformation.
        Contraception. 2014; 90: 601-605https://doi.org/10.1016/j.contraception.2014.07.003
        • Swartzendruber A
        • English A
        • Greenberg KB
        • Murray PJ
        • Freeman M
        • Upadhya K
        • et al.
        Crisis pregnancy centers in the United States: lack of adherence to medical and ethical practice standards; a joint position statement of the Society for Adolescent Health and Medicine and the North American Society for Pediatric and Adolescent Gynecology.
        J Pediatr Adolesc Gynecol. 2019; 32: 563-566https://doi.org/10.1016/j.jpag.2019.10.008
        • National Abortion Rights Action League
        Just because you’re pregnant: lies, half-truths, and manipulation at crisis pregnancy centers in Massachusetts.
        NARAL, 2011
        • Pascoe M
        • Hetrick SE
        • Parker AG.
        The impact of stress on students in secondary school and higher education.
        International Journal of Adolescence and Youth. 2020; 25: 104-112https://doi.org/10.1080/02673843.2019.1596823
      8. Massachusetts Legislature, H. 5179 An Act Providing Access to Reproductive Health Services. 2020. Available at: https://malegislature.gov/Bills/191/H5179 [Accessed 12 January 2022].

      9. U.S. Food and Drug Administration. Questions and answers on Mifeprex; 2021. [Accessed 12 January 2022].

      10. Planned Parenthood League of Massachusetts. Telemedicine abortion care. Available at: https://www.plannedparenthood.org/planned-parenthood-massachusetts/campaigns/telemedicine-abortion [Accessed 12 January 2022].

      11. Taylor M, Turk J. Race and ethnicity in higher education: a status report. Washintgon DC: American Council on Education and the Andrew Mellon Foundation; 2019. Available at: https://1xfsu31b52d33idlp13twtos-wpengine.netdna-ssl.com/wp-content/uploads/2019/11/Low-Income-Students-Brief-final.pdf [Accessed 12 January 2022].

      12. Available at: https://nces.ed.gov/pubs2019/2019038.pdf [Accessed 12 January 2022].