Patient experiences with pre-abortion healthcare interactions in Ohio, West Virginia, and Kentucky after Dobbs

Since the Dobbs decision, abortion seekers have experienced frustration and distress in navigating care within dynamic legal contexts. Pre-abortion interactions with healthcare professionals, such as clinicians and administrative staff working in healthcare settings other than abortion clinics, may play an important role in one's abortion-seeking journey. In this study, we examined how patients perceived the impact of their pre-abortion healthcare interactions when seeking abortion in three states that restricted abortion after Dobbs and how these interactions facilitated or impeded abortion access. Nearly half of interviewees (n = 32/74) interacted with clinicians and/or healthcare administrative staff between pregnancy confirmation and abortion. Of the 52 interactions that participants described, half involved interactions that impeded participants' abortion access, including judgment, dismissal, paternalism, and insufficient or inaccurate information. Participants described feeling distressed by these interactions, occasionally stating that these interactions reduced their trust in their clinician or the medical system. However, just over a third of participants reported abortion-facilitative experiences, receiving encouragement, support, and helpful information about abortion and state laws. Our study adds to the gatekeeping literature and qualitative research on abortion seeker perspectives since Dobbs through analysis of first-hand accounts illuminating the patient experience of navigating care under restrictive and rapidly changing laws and institutional policies. These findings affirm the significance of gatekeepers and facilitators in patient receipt of logistical, informational, and emotional support - be it through healthcare professionals or other sources - in abortion accessibility, particularly for abortion seekers living in abortion restrictive states.