Abstract
<h3>Objectives</h3> To assess access to abortion pills offered by clinics providing state-funded family planning services in California. <h3>Methods</h3> We identified a 20% random sample of clinics, stratified by county, participating in both California's Family Planning Access Care and Treatment (FPACT) and Medicaid (Medi-Cal) programs. We attempted to make two scripted calls as an uninsured "secret shopper" to 313 family planning clinics in California from October 2020 to September 2021. After asking about access to emergency contraception, clinic phone staff were asked, "If it turns out I'm pregnant, does your clinic offer the abortion pill?" and "Is it covered [by state funding?]." <h3>Results</h3> Clinic staff responded to 407 calls. Only 50 respondents (12%, 95% CI, 9%-–16%) reported their clinic offered abortion pills; 234 (57%, 95% CI, 53%-–62%) reported their clinic did not offer abortion pills, and 123 (30%, 95% CI, 26%-–35%) reported they were unsure whether the clinic offered abortion pills. Only 23 respondents (6%, 95% CI, 4%-–8%) accurately indicated to callers that abortion pills were available free to low-income individuals in California. Of the 149 clinics that we reached on two occasions, 52 (35%, 95% CI, 27%-–43%) consistently reported that the clinic did not provide abortion pills; however, only 9 (6%, 95% CI, 3%-–11%) consistently reported providing abortion pills. <h3>Conclusions</h3> As delays in accessing time-sensitive healthcare adversely affect health outcomes, efforts are needed to increase the number of family planning clinics providing medication abortion services and accurate information to clients seeking medication abortion.
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