Abortion Access Varies Widely Across U.S.

Distances of 100 miles or more common for women in rural counties, study finds

By Mary Elizabeth Dallas

HealthDay Reporter

TUESDAY, Oct. 3, 2017 (HealthDay News) -- Women's access to an abortion clinic varies widely across the United States, with 1 in 5 traveling more than 43 miles to reach a clinic, a new study shows.

American women are, on average, 11 miles from an abortion clinic. But New Yorkers are within 3.2 miles of a clinic, while Wyoming residents must travel nearly 170 miles to access these services, according to researchers from the Guttmacher Institute in New York City.

"How far a woman has to travel for an abortion is a key measure of access, alongside stigma, restrictive laws and financial constraints," said study author Jonathan Bearak.

"Our findings illustrate the vast differences in access to abortion mapped across the U.S., with women in remote, rural areas facing the longest journeys for an abortion," Bearak added.

The study results were published Oct. 3 in The Lancet Public Health.

Laws in 14 states require that women have in-person counseling followed by an 18- to 72-hour waiting period before an abortion, the researchers noted. This can pose a substantial barrier "as women in these areas may also need to travel to and from the clinic twice," Bearak said in a journal news release.

For the study, researchers mapped the population of women of childbearing age and then looked at publicly accessible abortion clinics. They calculated how far the women would have to travel in each state and county.

The researchers found that on average in 2014:

  • Women in 23 states were within 15 miles of a clinic. In 16 states, the average distance was within 29 miles, while women in eight states averaged 30 to 89 miles away from an abortion clinic.
  • Some women in three states are more than 90 miles away from an abortion clinic. In remote areas of South Dakota, an abortion clinic could be more than 330 miles away.
  • Between 2011 and 2014, the average distance to an abortion clinic increased by at least 30 miles for women living in remote counties in Texas, Iowa, Montana and Missouri. All of these states, except for Iowa, tightened laws restricting access to abortion, according to the study.
  • On the flip side, the average distance to an abortion clinic for women in Kansas and Maine was significantly reduced.

Nearly half of pregnancies in the United States are unintended, and 42 percent of these end in an abortion, the authors noted.

"This study tells only part of the story. For women seeking specific types of providers, such as those who accept Medicaid, do abortions at later gestations, or are hospital-based, the distance might be even longer," said Ushma Upadhyay, an associate professor at the University of California, San Francisco, in a commentary linked to the study.

"Because provider availability decreases with each week of gestation, even a week's delay can reduce the number of providers substantially," Upadhyay wrote.