How distance traveled for abortion affects where women seek follow-up care

Many factors affect abortion access in the United States, including how far women have to travel to reach an abortion provider. As with any medical procedure, some women want follow-up care after abortion – either a routine visit to confirm the abortion is complete or because they are concerned about symptoms. When women do seek follow-up care, they may return to the original abortion provider or they may go to an emergency room. ANSIRH researchers analyzed data from 39,747 abortions in California to evaluate how far women travel to seek abortion care, factors associated with traveling a greater distance, and how distance affects where women seek care after an abortion.

Key findings:

• Overall, 12% of California women traveled 50 miles or more and 4% traveled 100 miles or more for Medicaid-covered abortion.
• Some groups of women were more likely to travel long distances: 51% of rural woman, 20% of women obtaining abortions at hospitals, and 22% of women obtaining second trimester or later abortions traveled 50 miles or more.
• Women travelling longer distances for an abortion were more likely to seek abortion-related follow-up care at an emergency room and were less likely to return to their abortion provider.
• The cost of follow-up care at emergency rooms was significantly higher than follow-up care at the abortion provider.

Increasing the number of rural Medicaid abortion providers and reimbursing providers for telemedicine and alternatives to routine follow-up would likely improve continuity of abortion care. It would also reduce state costs by shifting the location of follow-up from emergency rooms back to abortion providers.