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Despite restrictions, pregnant women still view abortion as obtainable

Advocates and policy-makers rightly point out how state-level abortion restrictions make it difficult to obtain an abortion, but little research has examined how people who consider abortion make sense of abortion obtainability and the extent of regulation of abortion care in their state. Now, new data illustrates how women—particularly those who live on low incomes—perceive abortion obtainability and adopt strategies to deal with these state-level restrictions.

Key Findings

Comparing participants in two states, most in the state with low regulation (Maryland) of abortion considered abortion easy to get, while many in the state with high regulation (Louisiana) considered it difficult to get.
Despite their measurable differences in access, participants in both states considered abortion generally obtainable.
Maryland respondents commonly perceived abortion as easy to get, likely because of the high service availability in the state and few policy restrictions on abortion.
Even with limited service availability and many barriers to abortion, participants in Louisiana believed that abortion was obtainable, even if not easy to get. They imagined they could overcome the barriers to abortion with the same strategies that they already employed for other challenges in their lives, such as by going into debt.

Study Design

Researchers conducted in-depth interviews with pregnant women who had considered but not obtained an abortion for their pregnancy. Thirty participants were in Maryland, a state with high abortion service availability and few policies restricting abortion, and 28 were in Louisiana, a state with low service availability and numerous restrictions. All participants reported financial insecurity, including food insecurity, housing insecurity, and/or the inability to regularly meet their basic needs, and almost all identified as Black, with four identifying as white, three as Hispanic, and one as biracial.


Several states are considered very hostile to abortion, with a record number of policies regulating abortion. Nonetheless, our research has found pregnant women who consider abortion and are subject to these state-level restrictions do not necessarily perceive them as barriers. In fact, participants commonly did not believe that these barriers were significant for their own and others’ abortion decision making. Past research has shown that women living on low incomes must regularly learn to manage their reproductive decisions in light of structural challenges and inequalities. The accounts from these participants show how people adapt to constraints on their reproductive autonomy, just as they manage many other challenges that restrict their freedom to live self-determined lives.

As the researchers write:

“Our findings suggest the need to consider people living on low incomes’ social context to understand how they perceive the abortion landscape in order to develop a systems-level response to their challenges. When abortion is understood as generally obtainable, then people’s responses to questions about how to improve care might not encompass their complex mix of needed resources. Instead, an exploration of how they adapt to constraints might provide useful guidance.”

The article, Abortion as Obtainable: Insights into how Pregnant People in the United States Who Considered Abortion Understand Abortion Availability, is available in Contraception.