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Experiences of women who travel for abortion: A mixed methods systematic review

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  • Jill Barr-Walker
  • Ruvani T Jayaweera
  • Ana Maria Ramirez
  • Caitlin Gerdts

Abstract

Objective: To systematically review the literature on women’s experiences traveling for abortion and assess how this concept has been explored and operationalized, with a focus on travel distance, cost, delays, and other barriers to receiving services. Background: Increasing limitations on abortion providers and access to care have increased the necessity of travel for abortion services around the world. No systematic examination of women’s experiences traveling for abortion has been conducted; this mixed-methods review provides a summary of the qualitative and quantitative literature on this topic. Methods: A systematic search was conducted using PubMed, Embase, Web of Science, Popline, and Google Scholar in July 2016 and updated in March 2017 (PROSPERO registration # CRD42016046007). We included original research studies that described women’s experiences traveling for abortion. Two reviewers independently performed article screening, data extraction and determination of final inclusion for analysis. Critical appraisal was conducted using CASP, STROBE, and MMAT checklists. Results: We included 59 publications: 46 quantitative studies, 12 qualitative studies, and 1 mixed-methods study. Most studies were published in the last five years, relied on data from the US, and discussed travel as a secondary outcome of interest. In quantitative studies, travel was primarily conceptualized and measured as road or straight-line distance to abortion provider, though some studies also incorporated measures of burdens related to travel, such as financial cost, childcare needs, and unwanted disclosure of their abortion status to others. Qualitative studies explored regional disparities in access to abortion care, with a focus on the burdens related to travel, the impact of travel on abortion method choice, and women’s reasons for travel. Studies generally were of high quality, though many studies lacked information on participant recruitment or consideration of potential biases. Conclusions: Standardized measurements of travel, including burdens associated with travel and more nuanced considerations of travel costs, should be implemented in order to facilitate comparison across studies. More research is needed to explore and accurately capture different dimensions of the burden of travel for abortion services on women’s lives.

Suggested Citation

  • Jill Barr-Walker & Ruvani T Jayaweera & Ana Maria Ramirez & Caitlin Gerdts, 2019. "Experiences of women who travel for abortion: A mixed methods systematic review," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-26, April.
    • Handle: RePEc:plo:pone00:0209991
    DOI: 10.1371/journal.pone.0209991
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    References listed on IDEAS

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    1. Robert W. Brown & R. Todd Jewell & Jeffrey J. Rous, 2001. "Provider Availability, Race, and Abortion Demand," Southern Economic Journal, John Wiley & Sons, vol. 67(3), pages 656-671, January.
    2. Grossman, D.A. & Grindlay, K. & Buchacker, T. & Potter, J.E. & Schmertmann, C.P., 2013. "Changes in service delivery patterns after introduction of telemedicine provision of medical abortion in Iowa," American Journal of Public Health, American Public Health Association, vol. 103(1), pages 73-78.
    3. Gerdts, C. & Fuentes, L. & Grossman, D. & White, K. & Keefe-Oates, B. & Baum, S.E. & Hopkins, K. & Stolp, C.W. & Potter, J.E., 2016. "Impact of clinic closures on women obtaining abortion services after implementation of a restrictive law in Texas," American Journal of Public Health, American Public Health Association, vol. 106(5), pages 857-864.
    4. Upadhyay, U.D. & Weitz, T.A. & Jones, R.K. & Barar, R.E. & Foster, D.G., 2014. "Denial of abortion because of provider gestational age limits in the United States," American Journal of Public Health, American Public Health Association, vol. 104(9), pages 1687-1694.
    5. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    6. Levels, Mark & Sluiter, Roderick & Need, Ariana, 2014. "A review of abortion laws in Western-European countries. A cross-national comparison of legal developments between 1960 and 2010," Health Policy, Elsevier, vol. 118(1), pages 95-104.
    7. Ellertson, C., 1997. "Mandatory parental involvement in minor's abortions: Effects of the laws in Minnesota, Missouri, and Indiana," American Journal of Public Health, American Public Health Association, vol. 87(8), pages 1367-1374.
    8. Joyce, Ted & Tan, Ruoding & Zhang, Yuxiu, 2013. "Abortion before & after Roe," Journal of Health Economics, Elsevier, vol. 32(5), pages 804-815.
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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. Kimport, Katrina, 2022. "Reducing the burdens of forced abortion travel: Referrals, financial and emotional support, and opportunities for positive experiences in traveling for third-trimester abortion care," Social Science & Medicine, Elsevier, vol. 293(C).

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