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Awareness of abortion medications by mail options among patients traveling out-of-state for abortion: An exploratory
Alexandra L Woodcock1, Alexandra Gero1, Sarah Elliott1
1University of Utah Department of Obstetrics and Gynecology, Salt Lake City, UT, United States.
Objective:
To understand if patients who travel out-of-state for abortion care are aware of medications by mail options for medication abortion and explore predictors of awareness.
Study Design:
We recruited patients at family planning clinics in three western states (OR, UT, and WA) between September 2024 and February 2025. Individuals who traveled to a clinic outside of their home state, were 18 years of age or older, and spoke English or Spanish were eligible for participation in the cross-sectional survey. Participants self-reported data on socio-demographics, gestational age, reason for travel, and awareness of medication abortion pills-by-mail options. We assessed differences in, and predictors of awareness of pills-by-mail using chi squared test for categorical data and logistic regression.
Results:
The final analytic sample included 113 unique individuals. Most participants, 82 (73%), identified their gestational age to be < 11 weeks. Just over a third (n = 41, 37%) were aware of pills-by-mail. Among those who were aware, 21 (51%) learned about the pills-by-mail option online, 10 (24%) from social media, and 5 (12%) learned from a healthcare provider. Participants provided no dominant reason for traveling. Seven (17%) participants who were previously aware of pills-by-mail options indicated that they traveled because they desired a procedural abortion over a medication abortion. Individuals who completed the survey in Spanish (OR 3.66, 95% CI 1.03-13.10), and those with public health insurance (OR 3.85, 95% CI 1.25-11.86) were more likely to be aware of medications by mail options.
Conclusions:
Most participants traveling out of state for abortion were unaware of medications by mail options despite being < 11 weeks.
Implications:
These findings represent a lack of awareness of medications by mail options and warrant additional research. Increasing awareness of safe and legal abortion options, particularly medications by mail options, may increase access for individuals who may otherwise travel.
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