Denial of abortion because of provider gestational age limits in the United States.
OBJECTIVE
We examined the factors influencing delay in seeking abortion and the outcomes for women denied abortion care because of gestational age limits at abortion facilities.


METHODS
We compared women who presented for abortion care who were under the facilities' gestational age limits and received an abortion (n = 452) with those who were just over the gestational age limits and were denied an abortion (n = 231) at 30 US facilities. We described reasons for delay in seeking services. We examined the determinants of obtaining an abortion elsewhere after being denied one because of facility gestational age limits. We then estimated the national incidence of being denied an abortion because of facility gestational age limits.


RESULTS
Adolescents and women who did not recognize their pregnancies early were most likely to delay seeking care. The most common reason for delay was having to raise money for travel and procedure costs. We estimated that each year more than 4000 US women are denied an abortion because of facility gestational limits and must carry unwanted pregnancies to term.


CONCLUSIONS
Many state laws restrict abortions based on gestational age, and new laws are lowering limits further. The incidence of being denied abortion will likely increase, disproportionately affecting young and poor women.
Ushma D. Upadhyay, Tracy A. Weitz, Rana E. Barar, and Diana Greene Foster are with Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, and the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco. Rachel K. Jones is with the Guttmacher Institute, New York, NY.
Ushma D
UD
Upadhyay
Tracy A
TA
Weitz
Rachel K
RK
Jones
Rana E
RE
Barar
Diana Greene
DG
Foster
D000023:Abortion Applicants / Q000523:psychology* / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D005865:Gestational Age; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008875:Middle Aged; D011247:Pregnancy; D011275:Pregnancy, Unwanted; D012959:Socioeconomic Factors; D013997:Time Factors; D014195:Travel; D014481:United States