New CORE study documents serious financial barriers to abortion care

CORE researchers published an innovative new paper that finds that cost is one of the largest obstacles to abortion care in the U.S. The new study was published in the International Journal of Environmental Research and Public Health.  The researchers studied the barriers to accessing abortion care for pregnant people through a novel method: by analyzing posts on the social media platform Reddit, which is used by over one-quarter of young adults in the U.S.

Findings from CORE’s new study underscore how overlapping barriers from funding to transportation and time off work create challenges for people who want or need abortion care. The obstacle of how to pay for an abortion and related costs is especially large in states such as Wisconsin—we are one of 33 states where Medicaid cannot be used to pay for abortion care, even though Medicaid does cover prenatal and birthing care costs.

The research team, which includes Jenny Higgins, MPH, PhD; Madison Lands, MSW, MPH; Taryn Valley, MS; Emma Carpenter, MSW, PhD; and Laura Jacques, MD, analyzed the 250 most recent Reddit posts that mentioned abortion. By studying what people posted to Reddit anonymously, instead of asking survey or interview questions, the researchers had a unique opportunity to learn about the questions and concerns that people face when considering an abortion before ever setting foot in a healthcare clinic.

CORE researchers identified four key themes of cost-related barriers to abortion:

  1. Inability to secure funds for abortion services and transportation
  2. Insufficient funds to select desired aspects of abortion services
  3. Insurance and administrative hurdles create unique barriers
  4. Relying on self-managed abortion options due to cost barriers

The following anonymous quote from the study illustrates Theme 4:

“I used Aid Access [an international mail-order service for medication abortion pills] to terminate my pregnancy because I couldn’t afford $500+ for the abortion counseling appointment and medical abortion. I didn’t qualify for aid because my finances look good on paper. But they don’t take into account your rent, health insurance, car payment, student loans, etc.”

Many other personal quotes in the study (see image below) illustrate the challenges that cost, long travel distances to clinics, abortion stigma, and other barriers create for people who need abortion services.

While some self-managed abortion methods, such as the medications mifepristone and misoprostol, are considered safe and effective, other methods may be harmful. The study’s results indicated that cost barriers lead some people to consider such illegal and potentially detrimental methods because they cannot afford medication or procedural abortion with a healthcare provider, due to lack of private or public insurance coverage for abortion services.

Results from this study contribute to growing evidence of the harmful effects of restrictions such as the Hyde Amendment, especially for people living on low incomes.

Read the full Cost-Related Barriers study here, and check out our research poster by CORE Research Manager Madison Lands below.