Reasons for Choosing Telehealth Abortion Based on Food Insecurity Status: United States, 2021-2022

Objectives. To determine differences in reasons for choosing telehealth abortion based on food insecurity status. Methods. We analyzed data from the California Home Abortion by Telehealth (CHAT) Study, which included survey responses from patients who received medication abortion care between 2021 and 2022 from 1 of 3 virtual US clinics. Based on responses from 1726 survey participants, we used multivariable logistic regression to analyze differences in reported reasons for choosing telehealth abortion among individuals who experienced food insecurity versus those who did not. Results. Compared with individuals in food-secure households, individuals who experienced food insecurity were more likely to choose telehealth abortion because of cost, challenges in finding transportation, challenges in finding child or dependent care, and concerns related to fear, judgment, and discrimination regarding care at an in-person clinic. Conclusions. When seeking an abortion, individuals in food-insecure households consider many factors relevant to their abortion care preferences and reproductive health. Telehealth abortion, with its lower cost, may be particularly appealing to individuals who experience economic constraints. (Am J Public Health. 2026;116(5):674-682. https://doi.org/10.2105/AJPH.2025.308372).