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Research study

Distance traveled for abortion and source of care after abortion

Many factors affect abortion access in the United States, including the availability of abortion providers and how far women have to travel to reach them. As with any medical procedure, some women want subsequent care after abortion – either routine follow-up to confirm the abortion is complete or because they are concerned about symptoms. When women do seek follow-up care after their abortion, they may return to the original abortion provider or they may go to an emergency department (ED). To evaluate the how far women travel to seek abortion care, factors associated with traveling greater distance, and how distance affects where women seek care after abortion, we conducted a retrospective analysis of 39,747 abortions and all health care for up to six weeks after the abortion at any clinical site, using Medi-Cal billing data from 2011-2012. 

Key findings

  • Overall, 12% of California women traveled 50 miles or more and 4% traveled 100 miles or more for Medi-Cal covered abortion.
  • Some groups of women were more likely to travel long distances: 51% of rural woman, 20% of women obtaining abortions at hospitals, and 22% of women obtaining second trimester or later abortions traveled 50 miles or more.
  • Women travelling longer distances for an abortion were more likely to seek abortion-related follow-up care at an ED and were less likely to return to their abortion provider.
  • Follow-up rates and location differed by abortion type
    • 77% of medication abortion patients (largely for routine follow-up), 4% of 1st trimester patients, and 3% of 2nd trimester or later patients returned to their abortion provider. 4% of medication abortion patients, 3% of 1st trimester patients, and 2% of 2nd trimester or later patients sought abortion-related care at EDs after an abortion.
  • The cost of follow-up care at EDs (median $961) was significantly higher than follow-up care at the abortion provider (median $536).

For more information about distance and post-abortion care seeking, see our issue brief titled, "Distance traveled for abortion and source of care after abortion in California’s Medicaid Program" and related infographic.

This study has two publications. The first, “Distance traveled for Medicaid-covered abortion care in California,” can be found at the journal BMC Health Services Research.  The second, “Distance Traveled for an Abortion and Source of Care After Abortion,” can be found at the journal Obstetrics & Gynecology.

  1. California Department of Health Care Services. Medi-Cal Funded Induced Abortions, 2010. Sacramento, CA: California Department of Health Care Services; 2011.
  2. Jones RK, Jerman J. Abortion Incidence and Service Availability In the United States, 2011. Perspect Sex Reprod Health 2014;46:3-14.
  3. Jones BS, Weitz TA. Legal barriers to second-trimester abortion provision and public health consequences. Am. J. Public Health. 2009;99(4):623-630.

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ANSIRH is a program within the UCSF Bixby Center for Global Reproductive Health and is a part of UCSF's Department of Obstetrics, Gynecology & Reproductive Sciences.

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