ABORTION PATIENTS’ AWARENESS AND UNDERSTANDING OF AN EARLY PREGNANCY ABORTION BAN AND ACCESS TO IN-STATE CARE

Abstract

Objectives

Explore We aimed to explore pregnant Texans’ awareness and understanding of a 2021 state law prohibiting abortion after detectable embryonic cardiac activity when navigating to abortion care.

Methods

We recruited Texans who obtained out-of-state abortion care after implementation of Senate Bill 8 (SB8) by providing flyers to abortion facilities in seven states and using online ads. Between October 2021 and February 2022, we conducted in-depth telephone interviews with English-speaking participants ≥15 years of age to explore their experiences seeking care. We used inductive and deductive codes in our thematic analysis describing participants’ understanding of how the law limited abortions.

Results

Most of the 65 participants discovered their pregnancy soon after a missed period, and less than half had heard of SB8 prior to pregnancy. Those who identified their pregnancy early and heard SB8 changed when an abortion could be obtained described the stress of scheduling appointments to confirm whether they could secure in-state care; a few felt rushed to make a decision. Having heard SB8 described as a six-week ban, participants were upset and frustrated to learn they were ineligible for in-state care because clinicians dated their pregnancy from weeks since last menstrual period (vs conception), there was evidence of cardiac activity before six weeks gestation, or cardiac activity appeared between ultrasound visits.

Conclusions

Pregnant Texans’ limited awareness of SB8 and the disjuncture between their understanding of the law and how it applied in early pregnancy increased time pressures and logistical burdens during their process seeking abortion care.