002Abortion patients’ priorities and tradeoffs deciding where to obtain out-of-state care following texas 2021 abortion ban

Abstract

<h3>Objectives</h3> Explore pregnant Texans' decisions about where to obtain out-of-state abortion care following the September 2021 implementation of Senate Bill 8 (SB8), which prohibited abortions after embryonic cardiac activity. <h3>Methods</h3> To recruit Texans who obtained out-of-state abortion care after SB8, we provided flyers to abortion facilities in Arkansas, Colorado, Kansas, Louisiana, Mississippi, New Mexico, and Oklahoma. Between October 2021 and February 2022, we conducted in-depth telephone interviews with English-speaking participants ≥18 years of age who self-referred to the study to explore their experiences seeking care. We used inductive and deductive codes in our thematic analysis describing people's decisions about where to obtain care and how they evaluated available options. <h3>Results</h3> The 65 Texans who participated considered multiple factors when deciding where to obtain out-of-state care. Participants prioritized facility proximity and appointment availability. The majority called multiple facilities in surrounding states to find the earliest appointment, and were often told the next appointment was 2–4 weeks away. Some ultimately obtained care at a more distant location that had an earlier appointment, and others waited because they could not travel farther. Participants considered the economic hardships of caregiving responsibilities, lost wages, and travel expenses when weighing the tradeoffs between appointment availability and facility proximity, but few mentioned comparing abortion prices at different facilities. Informative facility websites and compassionate scheduling staff solidified participants' choice of care. <h3>Conclusions</h3> Pregnant Texans who could not get an in-state abortion after SB8 made difficult tradeoffs when deciding where to obtain out-of-state care that made seeking services burdensome.