title: Experiences Accessing Abortion Care in Alabama among Women Traveling for Services.
abstract: In Alabama, more than one-half of reproductive-aged women live in counties without an abortion provider. State regulations require in-person counseling (or confirmed receipt of materials sent by certified mail) followed by a 48-hour waiting period. We explored the impact of this service and policy environment on experiences accessing abortion care for women traveling long distances to clinics.
  
  
  
  We conducted in-depth interviews with 25 women who traveled more than 30 miles to an Alabama clinic providing abortion care between July and September 2014. Women were interviewed by telephone at least 1 day after their consultation, procedure, or follow-up visit. We used content analysis methods to code and analyze interview transcripts.
  
  
  
  Almost all women found a clinic by searching online or talking to others in their social networks who had abortions. These strategies did not always direct women to the closest clinic, and some described searches that yielded inaccurate information. The majority of women did not believe an in-person consultation visit was necessary and found it to be burdensome because of the extra travel required and long waits at the clinic. Two-thirds of the women were unable to schedule their abortion 48 hours later owing to work schedules or because appointments were offered only once a week, and four women were delayed until their second trimester even though they sought services earlier in pregnancy.
  
  
  
  It is often difficult for women in communities without an abortion provider to find and access timely abortion care. Efforts are needed to make abortion more accessible and prevent further restrictions on services.
authors.affiliation: Department of Health Care Organization & Policy, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address: kariwhite@uab.edu.
authors.forename: Kari
authors.initials: K
authors.lastname: White
authors.affiliation: Department of Environmental Health, Emory University, Atlanta, Georgia.
authors.forename: Victoria
authors.initials: V
authors.lastname: deMartelly
authors.affiliation: Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland, California.
authors.forename: Daniel
authors.initials: D
authors.lastname: Grossman
authors.affiliation: Department of Health Care Organization & Policy, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Turan
mesh_terms: D000023:Abortion Applicants / Q000523:psychology*; D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000328:Adult; D000554:Ambulatory Care Facilities; D005260:Female; D005865:Gestational Age; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D007878:Legislation as Topic; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D036301:Qualitative Research; D014195:Travel; D055815:Young Adult