Geographic Disparities in Access to Abortion Services in Western New York [14]

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Abstract

INTRODUCTION:

Many women must travel to access abortion services, representing a barrier to care. This study examines the distance traveled by patients receiving abortions for both maternal and fetal indications at a high-volume referral center.

METHODS:

Zip codes and procedure indication were obtained for patients receiving surgical abortions from 1/2011–2/2015 at the University of Rochester. Descriptive and bivariate analyses (cross tabs and logistic regression) were run to compare distance, time traveled, and county population density by procedure indication.

RESULTS:

Zip codes were obtained for 2971 patients, 9.2% of whom had procedures for fetal anomaly or demise. The majority of women (62%) traveled under 25 miles, with 6% traveling over 100 miles. Distance traveled and population density were significantly associated (P<.0001). Most women traveling under 25 miles (97%) lived in urban counties, while 92% of women traveling over 100 miles were from rural areas. There were significant differences in distance and time traveled by abortion indication. Women with fetal indications had 1.7 times the odds of traveling over 100 miles compared to women having maternally indicated abortions.

CONCLUSION/IMPLICATIONS:

Some patients in this study traveled substantial distances despite few legislative restrictions on abortion in NY. Rural women were disproportionately affected, and patients with fetal indications were also more likely to travel long distances. This may reflect a lack of abortion training among providers, particularly at advanced gestational ages when fetal anomalies or demise may be diagnosed. Additionally, these data may indicate an unmet need for elective terminations in rural areas.

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