Differences in Financial and Social Burdens Experienced by Patients Traveling for Abortion Care

We compared perceived stress between women traveling 50 or fewer miles and more than 50 miles for abortion care. Secondary objectives were to compare individual-level stigma and hardship scores in patients by distance traveled to the clinic.

We performed a cross-sectional study of patients presenting for care at an independent abortion clinic in southern Illinois. Participants completed a self-administered, tablet computer-based survey asking about their experiences seeking abortion, including the Perceived Stress Scale (PSS) and Individual Level Abortion Stigma (ILAS) scale. We created a composite score to characterize patient hardship regarding abortion care (range, 0-4). We examined responses stratified by the patients' self-reported one-way distance traveled to the clinic (group 1, ≤50 miles; group 2, >50 miles).

A total of 308 women completed the survey. There was no significant difference in mean PSS scores (p = .71) or median ILAS scores (p = .40) between groups. A majority of the cohort reported moderate or high stress (68.2%). The median hardship score was significantly higher in the greater than 50 mile group (median, 1 [interquartile range, 0-2] vs. 2 [interquartile range 1-3]; p < .001). Patients who traveled more than 50 miles reported difficulties related to missing work (58.3%), delays in obtaining an abortion owing to financial costs (35.7%), lodging (13.9%), and transportation (11.3%).

There was no difference in PSS or ILAS scores by distance traveled among patients seeking an abortion; however, patients who traveled more than 50 miles had a higher hardship score, suggesting greater difficulty accessing abortion. The most common difficulties encountered included missing time from work and financial costs associated with the abortion.