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Real-Time Effects of Payer Restrictions on Reproductive Healthcare: A Qualitative Analysis of Cost-Related Barriers and Their Consequences among U.S. Abortion Seekers on Reddit

Author

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  • Jenny A. Higgins

    (Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI 53715, USA
    Collaborative for Reproductive Equity (CORE), University of Wisconsin-Madison, Medical Sciences Center 4245, Madison, WI 53706, USA)

  • Madison Lands

    (Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI 53715, USA
    Collaborative for Reproductive Equity (CORE), University of Wisconsin-Madison, Medical Sciences Center 4245, Madison, WI 53706, USA)

  • Taryn M. Valley

    (Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI 53715, USA
    Collaborative for Reproductive Equity (CORE), University of Wisconsin-Madison, Medical Sciences Center 4245, Madison, WI 53706, USA
    Department of Anthropology, University of Wisconsin-Madison, Madison, WI 53706, USA)

  • Emma Carpenter

    (Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI 53715, USA
    Presidential Management Fellows Program, U.S. Office of Personnel Management, Washington, DC 20415, USA)

  • Laura Jacques

    (Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, WI 53715, USA
    Collaborative for Reproductive Equity (CORE), University of Wisconsin-Madison, Medical Sciences Center 4245, Madison, WI 53706, USA)

Abstract

Objective: The Hyde Amendment and related policies limit or prohibit Medicaid coverage of abortion services in the United States. Most research on cost-related abortion barriers relies on clinic-based samples, but people who desire abortions may never make it to a healthcare center. To examine a novel, pre-abortion population, we analyzed a unique qualitative dataset of posts from Reddit, a widely used social media platform increasingly leveraged by researchers, to assess financial obstacles among anonymous posters considering abortion. Methods: In February 2020, we used Python to web-scrape the 250 most recent posts that mentioned abortion, removing all identifying information and usernames. After transferring all posts into NVivo, a qualitative software package, the team identified all datapoints related to cost. Three qualitatively trained evaluators established and applied codes, reaching saturation after 194 posts. The research team used a descriptive qualitative approach, using both inductive and deductive elements, to identify and analyze themes related to financial barriers. Results: We documented multiple cost-related deterrents, including lack of funds for both the procedure and attendant travel costs, inability to afford desired abortion modality (i.e., medication or surgical), and for some, consideration of self-managed abortion options due to cost barriers. Conclusions: Findings from this study underscore the centrality of cost barriers and third-party payer restrictions to stymying reproductive health access in the United States. Results may contribute to the growing evidence base and building political momentum focused on repealing the Hyde Amendment.

Suggested Citation

  • Jenny A. Higgins & Madison Lands & Taryn M. Valley & Emma Carpenter & Laura Jacques, 2021. "Real-Time Effects of Payer Restrictions on Reproductive Healthcare: A Qualitative Analysis of Cost-Related Barriers and Their Consequences among U.S. Abortion Seekers on Reddit," IJERPH, MDPI, vol. 18(17), pages 1-11, August.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:17:p:9013-:d:622738
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    References listed on IDEAS

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    1. Joanna Venator & Jason Fletcher, 2021. "Undue Burden Beyond Texas: An Analysis of Abortion Clinic Closures, Births, and Abortions in Wisconsin," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(3), pages 774-813, June.
    2. Rachel K Jones & Jenna Jerman, 2017. "Characteristics and Circumstances of U.S. Women Who Obtain Very Early and Second-Trimester Abortions," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-15, January.
    3. Sarah C M Roberts & Nancy F Berglas & Katrina Kimport, 2020. "Complex situations: Economic insecurity, mental health, and substance use among pregnant women who consider – but do not have – abortions," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-16, January.
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    Cited by:

    1. Pleasants, Elizabeth & Parham, Lindsay & Weidert, Karen & Anderson, Emma & Dolgins, Eliza & Prata, Ndola & Upadhyay, Ushma D. & Marshall, Cassondra, 2024. "Waiting to start abortion: A qualitative exploration of narratives of waiting shared in a Reddit community for abortion post-Dobbs leak in 2022," Social Science & Medicine, Elsevier, vol. 349(C).
    2. Doris W. Chiu & Ava Braccia & Rachel K. Jones, 2024. "Characteristics and Circumstances of Adolescents Obtaining Abortions in the United States," IJERPH, MDPI, vol. 21(4), pages 1-16, April.

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