Abstract
<h3>Objectives</h3> We aimed to measure barriers to accessing abortion care in Indiana, a state with hostile abortion policies that is anticipated to become even more restrictive. <h3>Methods</h3> Between June 2021 and April 2022, we recruited pregnant Indiana residents seeking abortion via Google advertisements and other online posts, as well as through abortion clinic waiting rooms and callers to local abortion funds. Participants completed a self-administered, online survey at baseline, and a follow-up survey approximately one month later to ascertain outcomes. We compared the proportion of people who reported an abortion at endline by recruitment method and social and economic barriers experienced, using chi-square tests of independence and multivariable logistic regression models. <h3>Results</h3> Overall, 351 participants completed the baseline survey and 205 (58%) participants completed endline. Among those recruited from Google ads, 46% had an abortion compared to 91% and 94% of participants recruited from an abortion fund or a clinic (p<0.01). Participants who reported experiencing abortion stigma — specifically, their family opposed abortion or they feared clinic protestors — (76% vs. 87%), who did not have paid jobs (76% vs. 88%), and were uninsured (65% vs. 86%) were less likely to have received an abortion than were those who did not report these experiences. <h3>Conclusions</h3> Anti-abortion sentiment and financial barriers prevented people from obtaining abortion care in Indiana, while abortion funds facilitated access. As abortion becomes increasingly restricted and likely clinically inaccessible in Indiana, facilitating connections to abortion funds and combating abortion stigma are critical strategies to ensure access to care.
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