Access to Choice: Differences Between Adolescent and Adult Abortion Funding Assistance Cases

Background and Purpose: Public funding bans, the scarcity of abortion providers, and parental consent laws all obstruct women’s reproductive rights and significantly increase their out-of-pocket costs (including travel expenses). These financial burdens are often addressed by abortion funds, organizations that provide financial assistance to patients seeking unaffordable abortions. The experiences of adolescents seeking financial assistance for abortion have not been previously explored. Results of a secondary data analysis of administrative cases from a national abortion fund, comparing cases of adolescent patients to cases of adult patients who received pledges for financial assistance to pay for an abortion from 2010 to 2014, offer vital insight into the lengths to which women, especially adolescents, must go to access abortion services.

Methods: A subset of 381 administrative cases representing adolescents ages 17 and younger from a national abortion fund’s call center was analyzed and compared to the 2,569 cases representing adults to examine differences in demographic characteristics and pregnancy stage, anticipated travel distance to the provider and whether or not distances were increasing over time. Additionally, the reported hardships and geographic origin of the adolescent cases were examined.

Results: Results suggest that the majority of adolescents (64%) and adults (50%) were African American and receiving a pledge in the second-trimester (adolescents, 72%; adults, 70%).  Adolescents reported experiencing unwanted pregnancy due to lack of contraception (61%), contraceptive failure (20%) and rape (17%). The majority of pledges were made to adolescents in the geographic South (47%) followed by the Midwest (24%). Results also suggest that adolescents anticipated traveling an average of 259 miles in 2014 to access the procedure, notably farther than the 172 miles adults planned to travel on average. Due to regulations restricting access to providers, average expected distances to obtain abortions were expected to increase over time. Oneway ANOVA was performed to test this hypothesis for adults and adolescents. The ANOVA results for adults were significant, F (4, 1975) = 4.27, p < .01. Bonferroni post-hoc tests found the difference between 2010 and 2014 to account for the significant F statistic, with average distance increasing from 2010 to 2014 by 103 miles. Results also suggest a change in miles adolescents traveled over time that was significant, F (4, 243) = 2.54, p < .05. Bonferroni post hoc tests found the difference between 2011 and 2014 to account for the significant F statistic, with average distance increasing from 2011 to 2014 by 154 miles.

Conclusions: Findings suggest that patients of all ages with pledges for abortion assistance face dire situations when trying to access abortion, and that adolescents and women of color are acutely affected. Young women must travel extensive distances and these have increased over time. Abortion access is particularly obstructed in the South and Midwest, paralleling abortion restrictions enacted by those states between 2010 and 2014. In order to ensure healthy development of all youth, repeal of policy prohibiting funding of abortion, and repeal of laws restricting abortion, especially those that deny adolescents’ reproductive rights, is recommended.