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Mexico-Based Accompaniment Collectives for Abortion in the US After Dobbs
Alexandra Wollum1, Sofia Braunstein1, Sandra H Cardona Alanís2
1Ibis Reproductive Health, Oakland, California.
JAMA Network Open
|June 17, 2026
Summary
Requests for medication abortion support surged in US states with bans, particularly from communities facing poverty and language barriers. Accompaniment collectives are vital for those with limited access to facility-based care.
Area of Science:
- Reproductive Health
- Public Health Policy
- Sociomedical Sciences
Background:
- Increasing abortion restrictions necessitate understanding self-managed medication abortion trends.
- Limited data exists on the geographic and demographic profiles of individuals self-managing abortions post-Dobbs decision.
- Mexico-based accompaniment collectives provide crucial support for self-managed abortions in the US.
Purpose of the Study:
- To characterize requests for self-managed medication abortion support received by Mexico-based accompaniment collectives.
- To analyze the sociodemographic and geographic factors associated with these requests.
Main Methods:
- Cross-sectional study analyzing 2850 records from two Mexico-based accompaniment collectives in 2023.
- Examined state abortion policy context, sociodemographic characteristics (poverty, insurance, language), and travel distance.
- Assessed request rates per 100,000 female individuals (aged 15-49) by zip code tabulation area (ZCTA) characteristics.
Main Results:
- 82.9% of requests originated from states with complete abortion bans.
- Request rates increased with ZCTA-level poverty and Spanish-speaking population share.
- ZCTAs over 8 hours from facilities in ban states showed the highest request rates (7.85 per 100,000).
Conclusions:
- Requests for accompaniment support are concentrated in states with abortion bans.
- Accompaniment collectives disproportionately serve communities facing significant structural barriers.
- These collectives play a critical role in ensuring access to abortion care for marginalized populations.
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