Operationalizing the Hyde Amendment at Federally Funded Health Care Centers [A40

Abstract

INTRODUCTION: The Hyde Amendment restricts federal funding for abortion in the US. Currently, federal funding for abortion is only allowed in cases of rape, incest, or a threat to the woman’s life. METHODS: To understand how clinicians in federally funded settings care for patients who qualify for abortion permitted by the Hyde Amendment, we conducted semi-structured interviews with 17 clinicians [obstetrician-gynecologists (n=12), family physicians (n=2), and certified nurse midwives (n=3)] practicing in four states, including some that provide state funding for abortion (n=3). RESULTS: Most respondents stated there was no way they knew of to operationalize federally funded abortion care in their clinical setting in cases of rape, incest, or a threat to the woman’s life. Most clinicians described having referred patients to freestanding abortion clinics with the expectation that the patient would pay out of pocket or receive state-funded abortion care, despite the theoretical commitment to federal funding for such services; as one clinician stated, “…[we’re] kind of compounding trauma, you know, when you’re saying, ‘Okay, you have to go really far to receive the abortion…’.” Only one clinician described working at a federally funded health center that had a policy in place that allowed prompt delivery of permitted abortion care when needed. CONCLUSION: Even in cases of rape, incest, or a threat to the woman’s life, few patients are able to access federal funding for abortion services in settings without state funding for abortion. Efforts are needed to ensure equitable access to compassionate and timely care for these vulnerable patients.