"I'm Barely Making Ends Meet the Way It Is": A Qualitative Analysis of Applications to Montana's Abortion Fund

Background and Purpose: Access to abortion care is an important reproductive justice issue that is under increased political attack. Although the legal right to abortion currently remains in federal law, the ability of individuals to actually access abortion care has long been a challenge, particularly for people of color and those unable to afford services. While there is increasing scholarship about the people who access abortion healthcare and the long-term benefits of receiving abortion care on demand, little is known about the specific needs and experiences of those who apply to abortion funds in the United States. Abortion funds assist people in removing financial barriers to abortion access by assisting with clinic, travel and lodging costs, in addition to providing informational resources. Abortion fund support may be especially relevant in rural settings like Montana, where much of the population lives in maternal healthcare deserts, and where weather and long distances act as barriers to accessing healthcare. Despite the importance of abortion funds in meeting unmet reproductive needs, little research explores the experiences of those using abortion fund resources.

Methods: To investigate the experiences of participants applying for abortion fund support in Montana, historic application data from Montana’s only statewide abortion fund was collected and assessed. We used the reproductive justice framework to frame our research questions and findings. Qualitative data from over 730 applications was coded in NVivo using descriptive qualitative research approaches, by a team of 6 researchers. All applicant stories were dual-coded and used to contextualize the lives and situations of people who applied to a Montana abortion fund between 2013 and 2021.

Results: Key themes identified in our analysis entailed obstacles to accessing abortion care, including: applicant age, cost of procedure, distance to clinic, transportation barriers, not qualifying for Medicaid, fear and stigma, difficulties locating providers, pregnancy stage, political climate, lack of family or partner support, and personal safety. Applicants also described their reasons for needing the financial support of the abortion fund, their thoughts and feelings about having an abortion, and their reasons for wanting an abortion.

Conclusions and Implications: Our findings indicate that people seeking abortions in and around Montana have unique life circumstances and barriers related to economic disparity, political climate, community support, and the rurality of the state. The current study is unique in the scope of its qualitative data and offers a powerful glimpse into the challenges and concerns that people requesting abortion assistance face and how abortion funds work with clients to diminish some of these barriers to healthcare access. Recommendations and implications for other abortion funds, abortion care providers, and reproductive justice advocates and scholars are discussed, in addition to study limitations and areas of future research. Attention to the needs of abortion fund clients, and the radical forms of care offered by abortion funds, remains pertinent as reproductive rights continue to be threatened across the United States.