Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA.
Population Research Center, University of Texas at Austin, Austin, Texas, USA.
Health Serv Res. 2024 Feb;59(1):e14226. doi: 10.1111/1475-6773.14226. Epub 2023 Sep 12.
To assess 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 detectable embryonic cardiac activity.
In-depth telephone interviews with Texas residents ≥15 years of age who obtained out-of-state abortion care after SB8's implementation.
This qualitative study explored participants' experiences identifying and contacting abortion facilities and their concerns and considerations about traveling out of state. 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.
Texas residents self-referred to the study from flyers we provided to abortion facilities in Arkansas, Colorado, Kansas, Louisiana, Mississippi, New Mexico, and Oklahoma. We also enrolled participants from a concurrent online survey of Texans seeking abortion care.
Participants (n = 65) frequently obtained referral lists for out-of-state locations from health-care providers, and a few received referrals to specific facilities; however, referrals rarely included the information people needed to decide where to obtain care. More than half of the participants prioritized getting the soonest appointment and often contacted multiple locations and traveled further to do so; others who could not travel further typically waited longer for an appointment. Although the participants rarely cited state abortion restrictions or cost of care as their main reason for choosing a location, they often made sacrifices to lessen the logistical and economic hardships that state restrictions and out-of-state travel costs created. Informative abortion facility websites and compassionate scheduling staff solidified some participants' facility choice.
Pregnant Texans made difficult trade-offs and experienced travel-related burdens to obtain out-of-state abortion care. As abortion bans prohibit more people from obtaining in-state care, efforts to strengthen patient navigation are needed to reduce care-seeking burdens as this will support people's reproductive autonomy.
评估 2021 年 9 月参议院法案 8（SB8）实施后，得克萨斯州孕妇关于在州外获得堕胎护理的决定，该法案禁止在可检测到胚胎心脏活动后进行堕胎。
对得克萨斯州≥15 岁的居民进行深入的电话访谈，这些居民在 SB8 实施后在州外获得了堕胎护理。
这项定性研究探讨了参与者识别和联系堕胎设施的经验，以及他们对前往州外旅行的担忧和考虑。我们在主题分析中使用了归纳和演绎代码，描述了人们关于在哪里获得护理的决定以及他们如何评估可用的选择。
得克萨斯州居民从我们提供给阿肯色州、科罗拉多州、堪萨斯州、路易斯安那州、密西西比州、新墨西哥州和俄克拉荷马州堕胎设施的传单中自行向该研究报名。我们还从一项对寻求堕胎护理的得克萨斯州人的在线调查中招募了参与者。
参与者（n=65）经常从医疗保健提供者那里获得州外地点的转介名单，少数人收到了特定设施的转介；然而，转介很少包括人们决定在哪里获得护理所需的信息。超过一半的参与者优先考虑尽快预约，并且经常联系多个地点并为此走得更远；其他不能走得更远的人通常会等待更长时间才能预约。尽管参与者很少将州级堕胎限制或护理费用作为选择地点的主要原因，但他们经常做出牺牲，以减轻州级限制和州外旅行费用带来的后勤和经济困难。信息丰富的堕胎设施网站和富有同情心的预约工作人员巩固了一些参与者对设施的选择。
得克萨斯州孕妇做出了艰难的权衡，并经历了与旅行相关的负担，以获得州外堕胎护理。随着堕胎禁令禁止更多的人在州内获得护理，需要努力加强患者导航，以减轻寻求护理的负担，因为这将支持人们的生殖自主权。
