Kari White1, Janet M Turan2, Daniel Grossman3. 1. Department of Health Care Organization & Policy, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address: kariwhite@uab.edu. 2. Department of Health Care Organization & Policy, University of Alabama at Birmingham, Birmingham, Alabama. 3. Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California.
Abstract
BACKGROUND: In 2013, Alabama required women seeking abortion to have a consultation visit followed by a 24-hour waiting period. These requirements may adversely affect return for timely care among those traveling long distances for services. METHODS: Using de-identified billing data from two Alabama clinics for all abortion encounters in 2013, we calculated the distance traveled from women's residential zip code and the number of days between their in-person consultation and procedure visits. To assess the associations between distance traveled and return for an abortion visit and length of interval between visits, we used logistic and ordinal logistic regression, respectively. RESULTS: Of the 2,730 women attending a consultation visit, 58% traveled less than 25 miles one way to the clinic, 13% traveled 25 to 49 miles, 21% traveled 50 to 100 miles, and 8% traveled more than 100 miles. Overall, 19% of women did not return to either clinic for an abortion procedure after their consultation. Distance traveled was not associated with return for an abortion visit (odds ratio, 1.04; 95% confidence interval, 0.76-1.42). Among women who returned, 59% had less than 7 days, 29% had 7 to 13 days, and 12% had 14 or more days between their consultation and procedure visits. Compared with women traveling less than 25 miles, those traveling 50 to 100 miles had significantly longer intervals between visits (odds ratio, 1.25; 95% confidence interval, 1.01-1.56). CONCLUSIONS: Although most women returned for their abortion procedure, many traveling long distances had a week or more between visits. Because delays may limit women's options for affordable abortion care, evidence-based policies should be adopted to facilitate women's timely receipt of services.
BACKGROUND: In 2013, Alabama required women seeking abortion to have a consultation visit followed by a 24-hour waiting period. These requirements may adversely affect return for timely care among those traveling long distances for services. METHODS: Using de-identified billing data from two Alabama clinics for all abortion encounters in 2013, we calculated the distance traveled from women's residential zip code and the number of days between their in-person consultation and procedure visits. To assess the associations between distance traveled and return for an abortion visit and length of interval between visits, we used logistic and ordinal logistic regression, respectively. RESULTS: Of the 2,730 women attending a consultation visit, 58% traveled less than 25 miles one way to the clinic, 13% traveled 25 to 49 miles, 21% traveled 50 to 100 miles, and 8% traveled more than 100 miles. Overall, 19% of women did not return to either clinic for an abortion procedure after their consultation. Distance traveled was not associated with return for an abortion visit (odds ratio, 1.04; 95% confidence interval, 0.76-1.42). Among women who returned, 59% had less than 7 days, 29% had 7 to 13 days, and 12% had 14 or more days between their consultation and procedure visits. Compared with women traveling less than 25 miles, those traveling 50 to 100 miles had significantly longer intervals between visits (odds ratio, 1.25; 95% confidence interval, 1.01-1.56). CONCLUSIONS: Although most women returned for their abortion procedure, many traveling long distances had a week or more between visits. Because delays may limit women's options for affordable abortion care, evidence-based policies should be adopted to facilitate women's timely receipt of services.
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