Access to abortion services is affected by a variety of factors, including the cost of the procedure, the gestational age limits at which providers offer services and antiabortion harassment. According to "Secondary Measures of Access to Abortion Services in the U.S., 2011-2012: Gestational Age Limits, Cost and Harassment," by Jenna Jerman and Rachel Jones of the Guttmacher Institute, there was relatively little change in any of these measures between 2008 and 2011–2012. The new analysis relies on data from the Institute’s 16th census of all known abortion providers in the United States.
In 2011–2012, the median cost of a surgical abortion at 10 weeks’ gestation was $495, and an early medication abortion cost $500. By comparison, the inflation-adjusted charge in 2009 for the same procedures was $503 and $524, respectively. The cost varied by facility size: facilities with the largest caseloads charged the least ($450), while those that performed fewer than 30 procedures per year charged the most ($650). Because women were more likely to obtain abortions at facilities that charged less, on average, women paid $480 for a surgical procedure at 10 weeks in 2011–2012, compared with $483 in 2009 (adjusted for inflation).
"Although the cost of abortion has remained stable, we know that cost still poses a huge barrier for many women seeking abortion services," says study author Rachel Jones. "Women often pay out of pocket, borrow from friends and family or forgo rent or groceries in order to come up with the money to pay for the procedure. It is critical to ensure that women are able to access abortion, including medication abortion, early, when the procedure is safer and more affordable."
As in 2008, almost all abortion facilities (95%) offered abortions at eight weeks’ gestation in 2012. Seventy-two percent did so at 12 weeks, 34% at 20 weeks and 16% at 24 weeks in 2012. However, there were important variations in service provision by provider type. Very few nonspecialized clinics and physicians’ offices performed abortions after nine weeks’ gestation, likely because these types of facilities were more likely to offer only medication abortion.
The study also assessed the distribution of abortion facilities by region. While hospitals and physicians’ offices make up more than half of abortion-providing facilities in the Northeast and the West, the majority of providers in the Midwest and the South were clinics—which account for the overwhelming majority of abortions in all regions. Moreover, while 84% of clinics experienced at least one form of harassment, clinics in the Midwest (95%) and the South (89%) reported harassment more frequently than those in the Northeast (78%) and the West (79%).
The authors note that since this study period, a number of factors affecting access to services have changed, including a large number of enacted abortion restrictions, mostly in the South and Midwest. As services become more restricted in these regions, barriers to access increase. They suggest that policymakers use this information to remove obstacles to abortion care and protect women’s access to services.
"Secondary Measures of Access to Abortion Services in the U.S., 2011-2012: Gestational Age Limits, Cost and Harassment," by Jenna Jerman and Rachel Jones of the Guttmacher Institute is available online and will appear in a forthcoming issue of Women’s Health Issues.