title: A Qualitative Exploration of Low-Income Women's Experiences Accessing Abortion in Massachusetts.
abstract: BACKGROUND
  At a time when most states are working to restrict abortion, Massachusetts stands out as one of the few states with multiple state-level policies in place that support abortion access for low-income women. In 2006, Massachusetts passed health care reform, which resulted in almost all residents having insurance. Also, almost all state-level public and subsidized insurance programs cover abortion and there are fewer restrictions on abortion in Massachusetts compared with other states.
  
  
  METHODS
  We explored low-income women's experiences accessing abortion in Massachusetts through 27 in-depth telephone interviews with a racially diverse sample of low-income women who obtained abortions. Interviews were digitally recorded, transcribed, coded, and analyzed thematically.
  
  
  RESULTS
  Most women described having access to timely, conveniently located, affordable, and highly acceptable abortion care. However, a sizable minority of women had difficulty enrolling in or staying on insurance, making abortion expensive. A small minority of women said their abortion care could be improved by increasing emotional support and privacy, and decreasing appointment times. Some limited data also suggest that young women and immigrant women face specific barriers to care.
  
  
  CONCLUSIONS
  This study provides important, novel information about the need for state-level policies that support access to health insurance and comprehensive abortion coverage. Such policies, along with a well-functioning health care environment, help to ensure that low-income women have access to abortion. However, not all abortion access challenges have been resolved in Massachusetts. More work is needed to ensure that all women can access affordable, confidential care that is responsive to their specific needs and preferences.
authors.affiliation: Ibis Reproductive Health, Cambridge, Massachusetts. Electronic address: adennis@ibisreproductivehealth.org.
authors.forename: Amanda
authors.initials: A
authors.lastname: Dennis
authors.affiliation: Ibis Reproductive Health, Cambridge, Massachusetts.
authors.forename: Ruth
authors.initials: R
authors.lastname: Manski
authors.affiliation: Ibis Reproductive Health, Cambridge, Massachusetts.
authors.forename: Kelly
authors.initials: K
authors.lastname: Blanchard
mesh_terms: D000028:Abortion, Induced / Q000191:economics / Q000706:statistics & numerical data*; D000328:Adult; D005260:Female; D018166:Health Care Reform / Q000191:economics / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000458:organization & administration / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000191:economics*; D007407:Interviews as Topic; D008404:Massachusetts; D008484:Medicaid / Q000191:economics; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act; D011203:Poverty; D011247:Pregnancy; D036301:Qualitative Research; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult